Friday, September 29, 2006

Obesity state by state; process and outcome in Arkansas

Report cards are out. They contain no real surprises but there was a curious finding in my state. Although Arkansas, as expected, is one of our more obese states (13th in the nation) it received one of the best report cards----one of only two states to earn a B (no state got an A). Why this gap between process and outcome? Arkansas’s vigorous anti-obesity initiatives (and its good report card) can be attributed largely to the efforts of Gov. Mike Huckabee, who believes the measures will just take time.

But the battle of the bulge in Arkansas may be difficult. Arkansas clearly is in the obesity belt. It’s a culture war. It may not be as bad here in my neck of the woods, the culturally transformed rapidly emerging retail capital of the world, as it is in more rural pockets of the state as suggested in this county by county analysis.

Huckabee’s personal story is noteworthy. A few years ago our morbidly obese governor, barely able to make it to the top of the capitol building stairs, lived in fear that he would be met there, breathless, by media, and be unable to give an interview. When he turned up with type 2 diabetes his doctors said, in effect, “diet or die.” Thereupon the former Baptist minister “got religion” about his health and embarked on a comprehensive program of nutrition and exercise, shedding over 100 pounds. Later he decided to share his success and put his state on a diet.

That may strike some people as ironic. Huckabee’s a Republican. He’s a conservative. But he doesn’t fit the mold of libertarian conservatives who complain about the “fat police.” In the minds of some who think his health initiatives too intrusive Huckabee is chief of the fat police. A Little Rock restaurant owner told the New York Times concerning Huckabee’s weight loss “it’s fine for him….But he ain’t got to make the whole state lose weight.”

According to the New York Times the Arkansas anti-obesity measures, some of which exceed federal requirements, include exercise breaks for state employees, strict guidelines for school lunches, and the reporting of BMI on school report cards. But perhaps more remarkable than all that is the example set by the governor. His speaking engagements and writings (such as Quit Digging Your Grave With A Knife And Fork) recount many testimonials, and he has completed the Little Rock marathon.

It’s nice to see my state get a good grade in something. Will it translate into better health outcomes? I remain to be convinced.

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