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Health Department

Dr. Paul's Tennessean Guest Column - January 15, 2009
Make Healthy Living Easier

A recent report shows Tennessee's health ranking at 47th, the latest in a series of reports on our ill health. The most alarming result of our plummeting health is that the life expectancy of our children’s generation will be shorter than our own!

We can and must do better. Ill health doesn’t have to be ‘the new normal’. In some ways we were healthier two or three decades ago, so we ought to be able to reverse the trends if we know where to focus. Here are some points to consider.

First, medical care is important, but it isn’t our ticket to good health. Experts estimate that optimal medical care could reduce premature deaths by about ten percent. At the same time unhealthy behaviors such as tobacco use, poor diet, and physical inactivity cause about 40 percent of early deaths. We need to focus on changing our behavior.

Second, unhealthy behaviors are often intertwined with the culture and fabric of our society. We’d like to think that eating right and exercising is simply a matter of personal choice and responsibility, but in our society unhealthy choices are so much easier.

Unhealthy food and sugary soft drinks are everywhere. They’re cheap, tasty, heavily advertised, and quick. Healthier food is often harder to come by - it costs more money and takes extra time. In some neighborhoods, it is far easier to get a sugared soft drink and a bag of chips than a healthy meal.

Most of us know we ought to walk more, but our neighborhoods and daily routines are designed for automobiles, not pedestrians. In some neighborhoods, lack of green space or concern about safety keeps children inside so they don’t get normal amounts of activity and play.

It seems like we have built a highway to ill health, while the road to healthier living is narrow and uphill all the way. Motivational programs don’t stick. Health clubs are busy for a week or two after New Year’s Day, but quickly go back to normal.

How can we do better? We must look for ways to make our environment and culture healthier - to make healthy choices easier. We need to make our food environment richer in healthy foods, and make our physical environment more conducive to walking, biking, and playing.

For our epidemics of poor diet and physical inactivity, we are not yet succeeding, but state and local governments, businesses, schools, and community organizations are starting to make changes. We are beginning to see more physical activity and healthy foods in schools. Smart employers are looking beyond individual wellness and making the workplace more supportive of healthy living. Nashville has made great strides in increasing sidewalks, bikeways, greenways, and parks. Activists are working to make fresh foods available in all parts of town. Some restaurants are offering right-sized portions to support frequent diners who don’t want to gain weight.

These examples are just a start. There is much progress yet to be made, but we can succeed in becoming healthier if find ways to create and sustain conditions where healthy choices are easier.

William S. Paul, MD, MPH
Director of Health
Metro Public Health Department of Nashville/Davidson County