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 kate_l...@hotmail.com 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.