Big And Getting Bigger

Our View: Maryland's Obesity Epidemic Calls For Some Thoughtful Intervention

December 01, 2009

For those of us already feeling guilty about eating too much - and too richly - over the holidays, here's something else not to be thankful for: Maryland is fat and getting fatter.

Not pleasantly plump. Not a little soft around the edges. But at heightened (or perhaps more accurately, broadened) risk of heart disease, cancer, stroke and many other life-shortening maladies.

The latest findings from the health insurer-supported United Health Foundation's annual survey of health care statistics should give Marylanders pause. While the state's overall health is slightly improved from a year ago (the state ranks a middling 21st among states compared to an underachieving 22nd last year), the obesity rate is high and expected to grow higher.

Obesity isn't the only challenge recognized in the nonprofit's survey, of course. An exceptional violent crime rate, a high incidence of infectious disease and the region's polluted air were also considered risk factors.

But a state that has seen a 122 percent increase in the obesity rate in just two decades is facing nothing less than a health crisis, and that should cause alarm. That the state's experience reflects America's national trend of growing girth offers little comfort.

Just 12 percent of Marylanders were obese in 1990, but the rate had jumped to 26.6 percent by 2008. The foundation projects that at the current rate, at least 35 percent in Maryland will be considered obese by 2013, putting the state in the bottom dozen worst in the nation and a far cry from the states with the lowest obesity rates. Less than 22 percent of Colorado's population is expected to be obese by then.

There are many reasons behind the state's poor showings. Surely one factor is the higher obesity rates of African-Americans and other minorities. According to the federal Centers for Disease Control and Prevention, the causes of the problem can be complex and include everything from genetics to community design (whether, for instance, there are sidewalks to enable walking to work or school).

The consequences, however, are clear enough. Not only do health risks increase, but obesity can be costly: It reportedly adds about 9 percent to the nation's health care expenses. That's tens of billions of dollars spent each year. In Maryland, the United Health Foundation estimates that obesity adds more than $7 billion (or nearly $1,100 per person) to annual health costs.

This may not be news to doctors and others who have long advocated for the public to adopt a healthier diet and to exercise more, but a more holistic approach to public policy is needed. From taxing sugary soft drinks to encouraging "smart growth" and walkable communities, the state needs to both enable and encourage a healthier lifestyle.

Just as reducing smoking rates required more than the U.S. surgeon general's report of 4 1/2 decades ago, getting people to eat better and exercise will require more than educating them. We need the proverbial (and not so proverbial) carrots and sticks of positive and negative reinforcement that are the hallmark of all successful weight-loss programs.

For all the fretting about Maryland's business climate, the more essential question is whether the state is people friendly. Surely, one of the most prosperous and best educated states in the nation, with some of the best health care providers in the world, can do better.

Readers respond

It seems in our modern world that the more information we receive about what keeps us healthy, the less healthy we become. I put myself at the head of the line as a cigarette smoker. It's not like I don't know the harmful effects of my habit.

Sean Tully

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