Start your own sports league: When Braxton County Schools said they couldn't afford to offer soccer, Braxton parents decided to do it themselves. Jennica Barker is one of about 20 parents who coach a soccer league for more than 200 children at a Flatwoods field they lease from the county. Barker's four kids all play in the league. "It gives me another way to be with them," she said. All over West Virginia, parents have started similar groups for sports and healthy activities not offered in their schools: rowing, canoeing, mountain biking.
Teach kids what's in food: "I think I'm going to cry," East Bank Middle School seventh-grader Kaylee Hull said last spring when she saw how much fat is in six chicken nuggets: 20.5 grams. "It looks so gross," she said. Physician assistant Mary Grandon, who runs the school-based health center at the school for Cabin Creek Clinic, showed Hull's class one tube after another to show how much fat is in fast food. State Department of Education spokesmen say to counter child obesity, schools are emphasizing healthy eating and awareness of food advertising.
Have a community conversation: Every Thursday, 25 to 50 people gather at C.J. Maggie's restaurant in Buckhannon for a $5 noon meal and a session of Create Buckhannon. Anyone is welcome. As they eat, they plan ways to make their town healthier and more prosperous. "We're just citizens, not an official group or a 501(c)(3)," organizer C.J. Rylands said. They have created a park, a weekly summer music festival and market and a city plan and are now working on safe biking and walking, among other things. For more information, type Create Buckhannon into an online search engine.
Challenge the community to walk: Last year, in Williamson, teams of 10 competed to see who could walk the equivalent distance to Los Angeles first. "Friendly competition makes it fun," said Vicki Lynn Hatfield, competition organizer. Many communities have their own version. This summer, West Virginia University Extension Service is challenging all counties to its second "Summer Steps" program. The Williamson "lunchtime walk tool kit" can be found at www.scribd.com/doc/134080876/Lunch-Walk-Tool-Kit. Summer Steps info: http://livewellwv.ext.wvu.edu.
Organize anti-diabetes classes: How do you keep from pigging out at a buffet or church supper? How do you exercise when the weather's bad? In Roane County, seniors traded tips during a diabetes prevention class at the Amma Senior Center. Dozens of people are being trained statewide to lead such classes by Marshall University and the Bureau of Public Health. "We hope to have a statewide schedule next year," said bureau employee Chuck Thayer. Want a class in your community? Contact Jessica.firstname.lastname@example.org or visit www.selfmanagementonline.org.
Ask if your school cooks use processed food: As of the end of 2012, hundreds of school cooks from 27 counties had been trained to cook more nutritious meals from scratch instead of reheating processed food. The state Office of Child Nutrition plans more trainings for the other 28 counties, says office director Rick Goff. Cooks who have successfully made the transition train cooks who are new to the game so they can share tips and best practices.
Encourage after-school exercise: Last year, the West Virginia Statewide Afterschool Network (http://wvsan.ext.wvu.edu) board voted to require its 380 programs to keep students physically active (not sitting) at least half the time. "Studies show that active kids do better in school, and we have these students with us five days a week," said director Chris Kimes. "We can have a big impact on their health." Here, teens at Beckley Stratton School's after-school program play ball with the GenMove, a multi-game exercise program.
Promote mountain biking: Several school systems, including Wirt County, shown here, have made mountain biking part of a physical education curriculum that concentrates on physical activity students can enjoy all their lives. The fast-growing West Virginia Mountain Bike Association lists 23 races in West Virginia this summer, including events for children and beginner's classes. North Bend State Park offers introductory classes and a mountain biking program. Visit www.wvmba.com/ridewv.
Help get schoolkids moving: Most schools provide little time for physical education or activity during the school day, so the Department of Education is urging teachers to get kids moving during class too. All over the state, teachers, like Sutton Elementary's first-grade teacher Susan Schiefer, are finding ways to do that. Here, Schiefer's students dance as they identify vowels and consonants in a game she devised. Many schools would welcome volunteers to organize activities at recess and before school.
Create a farmers market: Since 2008, the number of farmers markets in the state has approximately doubled, to 87, according to the West Virginia Farmers Market Association, making fresh food much more available in many areas. Markets range from year-round heated buildings to seasonal truck-tailgate sales. Philippi's market, open four days a week, raised more than $23,000 for 98 growers in 2010. Morgantown, which averages more than $11,600 per month, offers cooking classes. See videos of several markets on West Virginia Farm and Food Coalition website.
Look at funding sources: Two foundations, the Claude Worthington Benedum Foundation and the Sisters of St. Joseph, have together poured more than $35 million into West Virginia health projects in the past 10 years. "I'm not sure what we would do without them," said Don Perdue, chairman of the House Health committee. Kim Tieman (left), of Benedum, and Sister Jane Harrington, of the Sisters of St. Joseph, turn up frequently at health care meetings, in this case, an anti-smoking meeting.
Build hiking/biking trails: Charleston City Council passed a resolution supporting creation of 100 miles of trail. It has some good models. Using trail maps from six counties, the Mid-Ohio Valley Health Department partnered with the West Virginia Mountain Biking Association to connect all six counties' trails. In Cabell County, Huntington is creating the citywide Paul Ambrose Trail to Health, pictured. http://paulambrosetrail.org. More information on Charleston's plans are at www.cityofcharleston.org/landtrust. Photo courtesy of Rahall Transportation Institute.
Start a diabetes coalition: With the help of Marshall University, 12 counties have created diabetes coalitions. They range from relatively inactive groups with occasional awareness events to Mingo's coalition, which secured a $2.5 million grant through Duke University to canvass all households to locate people who are diabetic or pre-diabetic and don't know it. Coalitions allow a county to combine efforts, seek grants and pull interested people together. For more information, email email@example.com.
Run through the middle of town: Glenville has created an extensive physical activity program, sparked by a grant from West Virginia On the Move. "We are making running very visible, so it's becoming a normal part of life around here," said chief instigator Jeff Campbell. This year, they have more than 300 people signed up. West Virginia On the Move has given 110 community groups, schools and organizations an average seed money amount of $4,000. That small amount has sparked projects statewide, from playgrounds and church exercise programs to walking challenges and hiking trails. Visit www.wvonthemove.net or gilmercountyontheMOVE on Facebook.
Make sure your town has Face to Face: In this program, about 3,700 West Virginia diabetics keep their diabetes under control by working with a pharmacist who advises them about exercise, diet and good medication management. The program, offered to state government employees and their families, is proven effective in research studies. South Charleston pharmacist Kate Dotson helped retired schoolteacher Mary Ann Wilder keep her blood sugar in the normal range for years. Visit www.peiaf2f.com.
Get community development training: About 70 West Virginia towns now work with the Main Street and Blueprint Communities programs. Both programs have added healthy lifestyle components to their training for towns and small cities. "The two go hand in hand," said Main Street director Monica Miller. "Companies want to locate in a place with a healthy workforce and active lifestyle." Here, Marlinton residents talk with their Blueprints coach, Josie Kuda. For more information, type "Main Street West Virginia" or "Blueprint Communities" into an online search engine.
Agitate for bike lanes: Wyoming County Clerk Bugs Stover says he feels a lot safer from timber trucks while biking on paved shoulders. For five years, the Department of Highways has paved shoulders as part of a new design standard. Stover is grateful. The 2013 Legislature passed a "complete streets" law that encourages DOH to consider bikers and pedestrians in new plans. DOH plans to build hundreds of miles of bike routes through the state, says DOH biking specialist Perry Keller. Visit http://mountainstatewheelers.org or search West Virginia Connecting Communities.
Support school breakfast: People who eat a healthy breakfast are less likely to be obese, studies show. West Virginia now offers three ways for students to eat breakfast: traditional sit-down, in the classroom or "grab and go." Kermit K-8 School in Mingo County serves all children three ways. "We've had far fewer discipline problems and less tardiness and truancy since this started," says Principal Dora Chafin. Statewide, 38 percent of children ate school breakfast in 2012-13.
Help people enroll for health insurance: West Virginians for Affordable Health Care is training hundreds of volunteers to help people sign up for the health-care exchange when, starting in October 2014, as many as 200,000 West Virginians become eligible for health insurance, depending on how far the state expands Medicaid. Many West Virginians will then be able to afford the early checkups that can prevent diabetes, obesity and other risky conditions. See www.wvahc.org for more information.
See about a school-based health center: Parents can help bring a school-based health center to their community. West Virginia started with 14 school-based health centers about 15 years ago. Today there are 88, serving 107 schools in 32 counties. In the past two years, 32 have opened. In Calhoun County, nurse practitioners such as Lisa Coleman (shown) travel to three schools, from a modern high school clinic to a grade school office in a portable building. For more information, visit www.wvsbha.org.
Find ways churches can help: The West Virginia Council of Churches recently set up an obesity projects, but individual churches are ahead of them. Many churches have decided weight reduction and disease prevention are part of their mission. Some, such as Gassaway Baptist Church, build gyms. Others are using the "Walk to Jerusalem" program. Mingo County's Little Dove Baptist Church adopted the Arthritis Association's Walk with Ease program for "Fitness and Fellowship," stretching, then walking around the church building -- 15 times around is about a mile.
Get out on the river: "West Virginia has beautiful rivers, and I've got grandparents on both sides who died of heart disease, so I'm determined not to get it. Paddling is great exercise," said Brent Samples, hitting the New River in April. The West Virginia Wildwater Association, based in Charleston, organizes paddling trips all over the state and sponsors workshops for beginners and rolling lessons at the South Charleston rec center. The website www.wvwa.net often has impromptu paddling trips anybody can join.
Let people use public buildings after hours for healthy activities: This Zumba class was offered at Braxton County High School rent-free on the condition that students could attend for free. In many counties and towns, public buildings and gyms are available after hours for activities ranging from yoga to square dancing. The county or city signs an agreement with the user. In Braxton, for instance, the high school is active after hours with team practice, college classes and now exercise classes. For sample joint-use agreements, type "joint use" into a search engine.
Get kids raising food: In Fayette County Schools, grade-school children grow salad ingredients and potatoes. For the past three years, Fayette kids have created raised beds, planted them, tended them, then ate from them. "You never saw kids like salad so much," said food services director David Seay. Nobody is tracking school gardens, but in 2012, similar school gardens were raised by children in at least a dozen counties, including counties where children raised container gardens.
Start a Girls on the Run affiliate: The volunteer-run after-school program for elementary-age girls, involves more than 600 girls in six West Virginia counties so far. New to the state, the program includes a strong character-building component. Girls train for their own 5K event after eight weeks of twice-a-week running for fun. For information on the national program, visit www.girlsontherun.org. West Virginia program: www.mountainstategotr.org.
Ask your grocery for a healthy checkout aisle: In 2011, three Parkersburg-area Walmart stores agreed to take candy and movie magazines out of one aisle and substitute fruit and toys that promote healthy activity. "Customers liked it. We had good sales," said Parkersburg store manager Kevin Ohse. "That's the bottom line." Now most West Virginia Walmarts have permission to open healthy checkout aisles. The Cross Lanes Walmart has opened the Charleston area's first healthy lane.
Do a walkability or bikeability assessment: In a walkability assessment, volunteers -- or sometimes professionals -- use a checklist to inventory their community's walkability or bikeability, including things like sidewalks, crosswalks, hazards and bike lanes. In this photo, two volunteers help assess Clendenin under a grant from KEYS for Healthy Kids. Checklists are available online: type "walkability assessment" or "bikeability assessment" into a search engine.
Combine walking and politicking: If you want to talk with the mayor in the Logan County town of Man (population 759), you can "Walk with the Mayor" on Saturday mornings. Most Saturdays, 10 to 15 people walk and bend the mayor's ear. Once a year, for "Man on the Move" day, a sizeable part of the town turns out to walk. This year, 120 people came out to walk.
Help make a school fitness trail: The children at Lincoln County's Midway Elementary School hit their new school fitness trail surrounding the school for at least 15 minutes a day, as a matter of policy. "It helps keeps them alert and ready to learn," said Principal Cheryl Workman. Nobody keeps track of the number of fitness trails at schools statewide, but they're multiplying fast, according to health coordinator Mary Weikle. Many are built by parent groups or community volunteers.
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.