'We're headed in the right direction'
CHARLESTON, W.Va. -- In Parkersburg, nurse practitioner Amy Edy volunteers countless hours to set up children's runs for the River City Runners and Walkers. "I'm so conscious, in my nursing job, of the obesity epidemic," she said. "This is one way I can help kids get hooked on health."
In Elkins, Forest Service employee Teri Evans does the same for Girls on the Run. Because of her, 200 grade-school girls in four counties run for fun after school. "If they learn to love running, it'll protect their health for the rest of their lives," she said.
In central West Virginia, West Virginia Mountain Bike Association volunteers helped cut trails through thick brush to connect hiking and biking trails in six counties.
In the Eastern Panhandle, Dr. Mark Cucuzzella spearheads a huge running race each year to pay for children's running clubs, walking trails and playgrounds.
They -- and people like them -- are reasons to hope that someday West Virginia will be off the top of every list of awful chronic diseases: diabetes, heart disease, obesity, etc.
All over the state, people are taking the lead. They're doing it, with or without state support, with or without pay, trying to make it easier to follow doctors' advice: Move more. Eat more fresh food, less fast food. Quit drinking soda pop.
Farmers markets have doubled in number since 2008, bringing fresh food to areas that had little or none. Rural parents are forming sport leagues to keep kids active. Churches sponsor exercise groups that bring lonely seniors together.
Maybe it's starting to work. Last year, the fifth-graders' blood pressure, cholesterol and obesity level all dropped, according to West Virginia University measurements.
The Children's Medicine Center at CAMC Women and Children's Hospital has had even better news. Five years ago, 44 percent of its patients ages 2 to 14 were obese or overweight. Today, that number has dropped to 36 percent.
"We've got a way to go, but we're headed in the right direction," said director Dr. Jamie Jeffrey. "We've got the attention of a lot of parents now. If we keep at it, we can turn this thing around."
Twenty years ago, obesity wasn't even on Kanawha County's list of biggest health problems. Now it tops the list. In 2012, 86 percent of local officials identified obesity as one of the top three problems in their counties, after lack of jobs and drugs, in a WVU study.
"Local officials are starting to realize community health is very much part of their job," said Patti Hamilton, director of the West Virginia Association of Counties. "Sidewalks, bike paths, farmers markets and hiking trails are part of economic development too."
Help from state government has been spotty. A new audit of the Department of Health and Human Services says state health programs are weak, fragmented and uncoordinated. Yet, at the same time, individual programs are rock stars:
- The Office of Child Nutrition got junk food and sodas out of the schools, improved the nutrition of school meals and increased the number of children eating, among other things.
- The Mid-Ohio Valley Health Department created an array of healthy projects for other communities to copy. The state's underfunded Community Transformation program is trying to spread them statewide.
- One in five West Virginians gets care through the state's community health centers, considered one of the strongest networks in the nation. The centers offer anti-diabetes programs and emphasize prevention.
- Public employees and their families have lost more than 16 tons of weight since 2004, through weight-loss programs of the Public Employees Insurance Agency, a prevention pioneer.
But nobody tracks local healthy lifestyle efforts statewide, so nobody really knows who is doing what. "People in one place don't always know what other communities are doing or what help is available from the state. So they can't inspire and help each other as much as they otherwise might," observed Kim Tieman, who represents the Claude Worthington Benedum Foundation in West Virginia.
One community might have 10 healthy lifestyle projects, while the next has none. "These towns could help each other," Tieman said.
In 2011, 33 state health leaders told a West Virginia Center on Budget and Policy interviewer that the state lacks strong leadership from the governor's office. "They all cited it as a major problem," said study author Renate Pore. "It's still true. And this is a time when we need a real leader."
In other states, mayors and governors are leading the charge.
- The Oklahoma City mayor challenged residents to lose a million pounds. He created a website called www.thiscityisgoingonadiet.com to track it. He lost 50 pounds. City residents lost the other 999,950.
- Iowa's governor launched the Healthiest State Initiative with a statewide walk. More than 291,000 people participated. The Initiative gives communities grants to carry out healthy lifestyle projects.
- Massachusetts' Mass in Motion program gives grants to communities, with the governor as head cheerleader. The schools measure the body mass index of all children and mail results and advice to parents. Obesity levels in Mass in Motion towns are dropping faster than those with no program.
In West Virginia, the governor's office has been oddly quiet. Gov. Earl Ray Tomblin's home county, Logan, has the state's highest diabetes rate and one of the nation's highest rates of early death. The Logan Diabetes Coalition struggles for funding. "So far, he just doesn't deal with health-care problems," Pore said.
- Before Tomblin took office, there was an active, state-supported Healthy Lifestyle Coalition. Now the members' terms have expired, but Tomblin did not renew their terms or appoint others. They meet anyhow.
- Facing a deadly epidemic, the state's Diabetes Prevention and Control program has a tiny budget and a staff of only two.
- The state GOHELP office, created in 2006, was supposed to coordinate local healthy lifestyle efforts and find ways to fund them. After the director and program staff quit, Tomblin did not replace them. Five of seven office spaces now sit empty.
"We created GOHELP partly to inventory our most successful programs so we could try them in other areas, but GOHELP didn't do that, for whatever reason," said Delegate Don Perdue, D-Wayne, chairman of the House Health and Human Resources Committee.
About $473,000 for GOHELP in this year's budget is unspent. Yet the Legislature put another $475,000 in the governor's account for GOHELP for next year, at Tomblin's request, bringing the amount available for GOHELP to nearly $1 million.
Why? "I'm not sure," Perdue said.
Going forward anyhow
The DHHR audit recommends more support for local communities. "This coming year will be a transition year," said Sen. Ron Stollings, D-Boone, chairman of the Senate Health Committee. He and Perdue plan to keep the audit on the Legislature's front burner all year.
The audit recommends that the huge, "unwieldy," understaffed and underfunded DHHR be split up and reorganized for greater efficiency. "We plan to hold hearings and take what action we can on it," Stollings said.
Public health should be expanded, the audit recommends, and communities should be allowed to apply for state health grants to do local projects. At this point, there is no such system.
GOHELP's million dollars may used to move the DHHR audit findings forward, Perdue said. "That may be the plan. If so, I hope we won't lose the coordination GOHELP was created to supply," he said.
"While they sort it out on the state level, I'll be working locally," Jeffrey said. "Once you see how much is going on, you can't help but believe these numbers can keep dropping, but it's going to be person by person, town by town. Maybe one town won't do it, but the next one will!"
Reach Kate Long at firstname.lastname@example.org or 304-343-1884.
"The Shape We're In" has been supported by a Dennis A. Hunt Fund for Health Journalism fellowship, administered by the California Endowment Health Journalism Fellowships at the University of Southern California's Annenberg School for Communication and Journalism.