story by Kim Souza
ksouza@thecitywire.com
Arkansas seldom ranks first in any category among the other 50 states, but when it comes to adult obesity the Natural State is at the top of the list, according to a new report by the Robert Wood Johnson Foundation (RWJF).
The report found that Arkansas had the highest adult obesity rate at 35.9%, and one of three states with West Virginia and Mississippi where at least 30% of its adults are deemed obese. In 1980, no state had a rate above 15%, and in 1991, no state had a rate above 20%, which is a major concern to health professionals.
The RWJF report indicates that Arkansas's adult obesity rate of 35.9%, rose from 21.9% in 2000 and from 17% in 1995. The rising obesity rates raise the cost of healthcare for everyone according state officials.
OBESITY COSTS
Roughly 9% of all medical expenses could be saved if the obese population were at normal weight, according to Dr. Joe Thompson, director of the Arkansas Center for Health Improvement. He said in 2013 that $13.4 billion was spent on health care in Arkansas each year and the savings in state would $1.2 billion annually.
Health officials agree that Arkansas’ obesity rate is a liability. Nearly 13% of those deemed obese have also been diagnosed with diabetes. Arkansas ranks No. 5 for adults with diabetes. With the rising number of obesity in children and teens, the adult onset diabetes is projects to reach 381,937 cases by 2030, growing 44% since 2010, according to the foundation report.
Obesity-related heart disease in Arkansas is expected to increase more than three-fold to 838,734 cases by 2030. At last count in 2010 there were 187,061 heart disease diagnoses in the state. Obesity-related cancers are expected to balloon to 116,050 cases by 2030. That would be an increase of 144% since 2010, according to the foundation report.
Thompson and his organization advocates for healthier lifestyles, which is the only real solution to this growing epidemic. He said in 2013 that obese employees cost the state’s employers more than their smokers.
“We need daily exercise and good nutrition like never before. A slow health epidemic over the past two decades has started to rock our families and our communities and this region’s wealth, health and productivity,” Thompson said.
On a national scale, the foundation reports that obesity related job absenteeism costs $4.3 billion a year. Employers also see lower productivity from obese workers, due in part of to their being absent. That cost is deemed to be $506 per obese worker each year. The number of medical claims rose dramatically for employers for their obese workers ($51,091 per 100 employees) compared healthy-weight workers ($7,503 per 100 employees.)
A 2013 study of on Arkansas’ state employees revealed 32% were obese, 21% were physically inactive and 12% were smokers. The related annual heath care costs for these groups rose more for the obese group than the smokers. It cost the state $2,400 a year for a healthy person with none of these three risks. That cost rose to $3,679 for someone obese, to $3,643 for physically inactive and to $3,081 for the tobacco user.
It cost the state $2,400 in 2013 for a healthy person with none of these three risks. That cost rose to $3,679 for someone obese, to $3,643 for physically inactive and to $3,081 for the tobacco user.
BARIATRIC INTERVENTION
Dr. Joshua Roller, a bariatric surgeon affiliated with Northwest Health System in Springdale and Sparks Hospital in Fort Smith, said diabetes costs employers $10,000 annually. He said knee replacements which are common among the obese cost $40,000 and an open-heart surgery is roughly $110,000, but too often bariatric surgery, which can help the obese return to a normal weight is not covered by Arkansas’ largest employers.
“ObamaCare Arkansas also does not cover bariatric surgery and here we are with the largest obesity problem in the country,” Roller said. “Successful bariatric surgery can reverse diabetes 75% of the time. Diabetes is the sixth leading cause of death in the U.S. today. High cholesterol and hypertension which can lead to heart-attacks are reversed 80% of the time with bariatric surgery.”
Roller said diet and exercise are great, but realistically for those with a body mass index at 40 or higher it gets increasingly difficult to exercise. He said too often patients seek him out because they want to get on the kidney transplant list and end their grueling three-days a week dialysis ritual brought on by diabetes. He said no one with a BMI greater than 35.9% can get on the transplant list so they have to lose weight effectively to be eligible for transplant.
Roller urges Arkansas employers to cover bariatric surgeries in cases where chronic diseases like diabetes can be reversed.
U.S. STATISTICS
U.S. adult obesity rates remained mostly steady ― but high ― this past year, increasing in Kansas, Minnesota, New Mexico, Ohio and Utah and remaining stable in the rest, according to foundation report. Colorado had the lowest obesity rate at 21.3%.
“Efforts to prevent and reduce obesity over the past decade have made a difference on the national level,” said Jeffrey Levi, executive director of RWJF.
He said stabilizing rates in many states is an accomplishment, but there isn’t time to celebrate given rates remain alarmingly high in too many regions like the South.
“We’ve learned that if we invest in effective programs, we can see signs of progress. But, we still haven’t invested enough to really tip the scales yet,” Levi added.
CHILDHOOD OBESITY
The Arkansas Center for Health Improvement’s annual research on childhood obesity is also alarming. For the last school year, the Body Mass Indicator study conducted on public school children across the state between the kindergarten and grade 10 indicate 21.5% are obese. Another 17% are overweight. The foundation report ranks Arkansas high school children the second most obese in the nation at 17.8%
The Center for Disease Control estimates roughly 20% of U.S. kids are obese, and the highest rates are found in the South.
Thompson said most have been educated about the effects of tobacco use but smoker health care costs pale in comparison to those for obese adults and children. He said major behavior changes from the 1970s through today are to blame. Walking or riding bicycles to school were common, three channels of television and limited cartoons to watch on Saturday meant kids spent more time playing outside and less time be entertained by computers or video games.
Thompson said portion sizes and food choices in the family diet are also to blame and must be addressed for any long term solution.
Obesity prevention advocates across the state continue to challenge employers, cities and schools to attack the problem at the community level focusing on environmental factors. Thompson advocates that all neighborhoods should have mandatory sidewalks with easy access to fresh food markets and healthier nutritional options.
“Changes that affect the structural and cultural components of a neighborhood can improve generations, not just an individual.” Thompson said.
The RWJF executives agree that prevention among children is key. It is easier and more effective to prevent overweight and obesity in children, by helping every child maintain a healthy weight, than it is to reverse trends later.
"In order to build a national Culture of Health, we must help all children, no matter who they are or where they live, grow up at a healthy weight," said Risa Lavizzo-Mourey, president and CEO of RWJF. "We know that when we take comprehensive steps to help families be more active and eat healthier foods, we can see progress. Now we must extend those efforts and that progress to every community in the country.”