Jackson Free Press

The mind-numbing numbers just never seem to get better.

Last year, Mississippi ranked No. 1 overall for the unhealthiest citizens in the U.S. and No. 49 in the number of physicians per capita. A quarter of our 2-year-olds haven't received their shots, and the rate of babies dying in Mississippi is higher than anywhere else in the country. We're No. 2 for number of adults with diabetes; a third of adults are obese; a third has high blood pressure; and a third gets no exercise whatsoever.

We also smoke too much, drink too much and die too often "accidentally," including behind the wheel.

"Public Health in Mississippi Report Card for 2009," which lists those "worst firsts," is a first step in collaboration between the Mississippi Department of Health and the Mississippi State Medical Association.

"We want to start talking to the whole state about some of these bad habits that are ruining the state's health just as if an individual physician were talking to a patient," said Dr. J. Patrick Barrett, president of the MSMA.

The association's emphasis is on establishing a sense of personal responsibility for individual health and promoting healthy lifestyle choices by educating the public through easy-to-understand health information. Doctors will publish the information in the Mississippi State Medical Journal, and the association is counting on the media, in part, to get it to the people.

"It's a start," Barrett said. "We don't have all the answers, but I've never seen a problem get spontaneously solved until at least people start talking about it."

What isn't in the report card could be more significant than rehashing the bleak health numbers. Medicaid and most insurance companies, for example, do not cover medical treatment to combat obesity, nor do they cover smoking cessation programs.

"We're encouraging insurance companies to take another look at obesity programs, bariatric surgery and various other mechanisms to help get obesity under control," Barrett said. "We want them to start looking at it as another disease."

Today, insurance companies tend to look at obesity either as a "cosmetic" issue, or as the result of a bad habit, like smoking, and argue that they won't pay to treat either one.

"When 30 percent of the population is suffering from (obesity), we feel like at some point their argument … doesn't hold water," Barrett said. "If you're going to insure them, then you probably ought to cover what they need. If getting their obesity under control is their No. 1 most pressing need, then we think insurance companies ought to give it consideration and cover it."

Barrett also said that insurance companies should cover smoking cessation programs.

"It is counter-productive" not to offer that kind of coverage, he said. "Every person you could treat to stop smoking is one less person with lung cancer."

In addition to offering more complete coverage to those with insurance, the numbers of uninsured Mississippians and those living in poverty have a huge impact on the state's health statistics.

Numerous reports connect poverty with poor health, often because of the lack of healthy affordable food—processed food is cheaper than healthy, whole foods—especially in poorer areas of the state. Mississippi further inflates food costs by levying the highest grocery taxes in the nation, even though the state has the most people living below the poverty line.

Other studies show that uninsured people tend not to seek medical care except in emergencies, exacerbating and ignoring "silent" killers like high blood pressure and diabetes until the conditions become acute. At that point, they are harder and more expensive to treat.

"If you eliminated obesity and smoking, you'd eliminate about 50 percent of our medical problems," Barrett said. "In my opinion, cigarettes ought to be about $10 a pack, and $8.50 of that ought to be in taxes to go to funding Medicaid first, and smoking cessation programs and obesity programs next. The Medicaid population is more obese than the non-Medicaid population, so that population economically takes the hardest hit."

Nicolas Freudenberg, founder and director of the non-partisan, non-profit Corporations and Health Watch, also believes that relying strictly on personal responsibility is not enough to make the sea change required to impact poor health numbers.

The Web site Corporations and Health says that corporate practices in product design, marketing, distribution and pricing are major determinants of the public's health and rates of disease. When companies gear those practices solely toward maximizing profits and market share, while avoiding risk and externalizing costs, the result is often detrimental to the public.

Product design, Freudenberg writes, is more than just the size, color and shape of a box; it can also include decisions such as adding ingredients to prolong shelf life, and making products more addictive—like adding nicotine to cigarettes—or less safe to cut production costs.

Studies have linked successful advertising with spurring unhealthy, unproductive behavior, especially in children. Advertising increases patient requests for specific drugs, often contrary to doctors' recommendations, and increases consumer desire for all kinds of products that are not necessarily good for them or the environment.

"Commercial interests pervade public and private lives," Freudenberg said in a presentation to Montefiore Social Medicine in New York, adding that American companies spend more to promote unhealthy behavior than government or non-profits spend on promoting healthy alternatives.

In Mississippi, for example, tobacco companies spent an estimated $183 million in advertising last year, while the state spent $8 million for smoking cessation programs.

Public health strategies must focus on reducing harm from corporate practices, Freudenberg says, and government must reassert their will to protect the public from special interests.

Jacquelyn Agho, a program manager with the non-profit, non-partisan Mississippi Health Advocacy Program, says that the public's involvement with policymaking is integral to the process.

"People know to eat right and exercise," she said. "A lot of these (health issues) have a public policy aspect to them, as well. We feel that the more you connect people to the policymaking process—when you get them more engaged—legislators and policy-makers listen."

The MHAP has been working for six years to get Mississippi legislators to pass higher cigarette taxes, for example, which is now getting broad public support, putting pressure on legislators to act. The organization also advocates for lowering grocery taxes and Medicaid reform, most recently fighting against the face-to-face re-enrollment requirement for Medicaid recipients.

When citizens get involved in the process, they speed legislative action, Agho said. "They have the ability to make (legislators) pay attention and make them accountable."

Previous Comments

ID

144522

Comment

Ronni This is a great article. I am getting my PhD in Psychology and research in the area of preventive medicine - one of my goals is to come home and engage in that work. This must be addressed more. Thanks John

Author

John Sawyer

Date

2009-03-10T07:45:07-06:00

ID

144524

Comment

....yes personal responsibility is important, but how often do we hear that in certain political circles as a reason for government or corporate inaction? i believe MS politicians just hope that all the poor, fat, depressed people would just die and solve the problem....

Author

lanier77

Date

2009-03-10T08:20:20-06:00

ID

144525

Comment

My wife quit smoking several years ago before we met, and we both walk nearly every day to keep fit. These are personal choices we made to keep our bodies healthy for as long as possible. Honestly, how hard is that for most people in this state to do? I realize cigarette smoking is highly addictive and much harder to quit, but are there enough programs out there to help people who are serious about kicking the habit?

Author

Jeff Lucas

Date

2009-03-10T08:41:26-06:00

ID

144546

Comment

I've been doing a lot walking lately, too. I walk on my breaks at work (or on the treadmill if the weather's not cooperative) and now that daylight is in effect until past seven, I'll start going walking in the evenings too. Also, I've been working in the yard the last couple of days and that's a good way to get some exercise. I work with someone who stopped smoking just over two weeks ago. I hope she keeps it up. But I do believe it's all about motivation. Me personally, as I'm hitting the mid-30s, it's getting more important for me to get more active. I haven't and still don't always make the healthiest choices, but hopefully, I will get into that mindset of doing things to take care of myself better. After all, I don't want to lay dying in a hospital room all doped up and wired to machines when I'm old and gray.

Author

golden eagle

Date

2009-03-10T13:32:14-06:00

ID

144563

Comment

Happiest States.... "and the bluegrass state of Kentucky was 49th, with Mississippi 48th on the list." I told you all we were depressed.

Author

lanier77

Date

2009-03-11T08:37:27-06:00

ID

144564

Comment

A healthy diet and exercise are critical, as the traditional Southern/soul food cuisine is hell on an aging metabolism. Sedentary lifestyles are also bad on the body, both for kids and adults. Kids who spend more time in front of the TV and video game systems or on the internet than outside playing are at greater risk for childhood obesity and diabetes.

Author

Jeff Lucas

Date

2009-03-11T08:50:48-06:00

ID

144565

Comment

At the forum last night, a guy in the audience tried to ask a health question, which was a good one ultimately, but he framed it by saying that "99.9 percent" of the candidates on the panel were overweight or obese. Of course, this caused great frivolity. Truth is, from my own quick survey, I think only half of them are. Certainly, it raises an important topic, though. Our health care costs are so high in this state because we eat such crappy diets and don't exercise enough. Many of us struggle to do more at least, while others simply don't seem to care. Dot Benford actually made a very good point when she pointed out that our African American neighborhoods are filled with fast-food joints and little other places to eat. And that grocery stores have pulled out of so many, leaving few fresh fruits and vegetables easily available. Thank goodness for McDades in Westland Plaza. STill, this is a conversation we need to have as a community. Some of the panelists seemed much more interested in it than others, including Amos, Crisler, Horhn, H. Johnson and Whitlow.

Author

DonnaLadd

Date

2009-03-11T09:08:26-06:00

ID

144584

Comment

As much as I hate being in agreement with Dot Benford, she indeed has a great point. Thanks to the dominance of supercenter and warehouse groceries like Super Wal-Mart, Costco, and Sam's who build primarily in suburban areas, the inner city is presented with fewer and fewer *local* choices for fresh, healthier food products.

Author

Jeff Lucas

Date

2009-03-11T11:54:44-06:00

ID

144587

Comment

Gosh, she has a great point. Prime example, Church's Fried Chicken. There are 6 restaurants located primarily in minority neighborhoods within the city limits of Jackson (the one on N.State closed down). The corporate office is located in Ridgeland, but I don't think that they have a single Church's in that town or Madison. There is 1 restaurant in Pearl. When Church's developed their marketing plan, who did they target with their unhealthy menu - poor people and minorities. And I admit full disclosure because my family ocassionally grabs a box of Church's. It's greasy, the pieces are "questionably" large, and everything else on the menu is fried.

Author

lanier77

Date

2009-03-11T12:35:57-06:00

ID

144589

Comment

Funny thing about Church's, lanier, is when I lived in Mobile in the 1990's, I was surprised to find that Church's restaurants were just as prominent in white neighborhoods as they were in the minority neighborhoods (but not in the affluent white neighborhoods, which is key). And whites were in the line for their chicken as much as blacks. But that is the only city where I've found that to be true.

Author

Jeff Lucas

Date

2009-03-11T13:13:50-06:00

ID

144592

Comment

Grocery stores and other stores are loathe to close a profitable location. So there is a reason why those stores close. When the Kroger store on Raymond road closed it's doors I remember Marshand Crisler on the news saying the only thing that had changed was the demographics of the neighborhood. He was wrong. The main things that had changed were the profitability of that particular location and the fact that Kroger had just built a new store not very far away in Byram. So some of that bluster is for political grandstanding purposes. People have the power to vote with their dollars and choose what they eat. Why some people make foolish choices is hard to understand sometimes. Eating any kind of factory farmed meat, fried or not, is unhealthy for people and the environment so it's better not to do that.

Author

WMartin

Date

2009-03-11T14:50:58-06:00

ID

144594

Comment

As I understand it, WMartin, corporate grocery stores will close profitable locations that aren't profitable enough to make up for losses in other places. (Much like corporate newspaper chains like Gannett lay people off at papers making a decent profit due to shareholder value issues.) And during the Days of Greed, they opened stores "nearby," like in Byram, and were then able to close stores in other neighborhoods. Thus, the problem with all the corporates buying them up in the first place. And all the more reason to cheer the McDade family for opening in Westland Plaza. None of this is simply a matter of people making foolish choices. In fact, massive studies have been done about why/how the cheap food available in poor neighborhoods, and not due to the choice of people who live there, is what is leading to obesity and health problems. In the South, certainly, many people like their fried chicken, but the difference in neighborhoods often is that there are many more options in whiter neighborhoods. Also, transportation can make it hard for people in poor neighborhoods to get to better food options. It's a serious issue. And by the way, Wal-Mart is a huge part of the problem, and a big reason many grocery stores have shut down. No one who cares about their community should set foot in a Wal-Mart.

Author

DonnaLadd

Date

2009-03-11T15:14:50-06:00

ID

144597

Comment

When we're talking about people with limited money to spend on food, they frequently choose highly processed, high-carb, high-fat, more filling foods over fresh, healthy foods simply because they're cheaper. After all, a $15-$20 bucket of Church's can feed your family of five or six. That's hard (or impossible) to match with healthy, fresh meats and vegetables. Foods from factory farms and mega-corporations are cheaper, even if they're less healthy for people and the environment (due to shipping, pesticides, etc.). Until the balance tips in favor of healthy and/or locally produced goods, all the education in the world will have an extremely difficult time making inroads on the problem, especially for the poor. It's interesting to note, too, that stores like Fresh Market in Ridgeland offers hardly any organic produce any more. When they opened, it seemed like half of the produce was organic. Mississippians, it seems, are just not willing to pay the extra price for healthier alternatives--not even those who can afford to.

Author

Ronni_Mott

Date

2009-03-11T15:35:43-06:00

ID

144598

Comment

It's a serious issue. And by the way, Wal-Mart is a huge part of the problem, and a big reason many grocery stores have shut down. No one who cares about their community should set foot in a Wal-Mart. No argument there, as a matter of fact I'll give you an Amen! I got to disagree with your assertion about foolish choices. Because at least SOME of the matter is people like to eat food that is bad for them. If people didn't spend their money at Church's chicken. There wouldn't be any Church's chicken to sell crappy fried yard bird. No matter how much they advertised it or how cheap they sold it.

Author

WMartin

Date

2009-03-11T15:37:56-06:00

ID

144601

Comment

I'm not saying people don't make foolish choices. Of course they do. I'm saying it's not all about that, and other forces bear blame, too. Often people can only afford to make foolish choices, or they haven't been taught anything different. And often, corporate food companies are changing their products to make them more dangerous -- as in deadly trans-fats -- because it's cheaper for them, or helps them make more profit. It makes sense to regulate trans-fat: they're poisonous. Or, take chickens. Years ago, non-organic chickens (and dairy products) weren't so dangerous because the animals weren't being shot full of as much junk to fatten up the birds and make those huge breasts. People who say their grandparents ate fried chicken all their lives and didn't die until they were in their 80s don't understand how much more poisonous today's fried chicken is, between the transfats and the crap fed to those birds. How many people in our state think the world would end if they didn't have meat at every meal? (Frankly, that's true with people in some national groups I'm involved with, too! But, the point is that in Mississippi, our daily diet tends to be hideous. And people get in their heads they can't change.)

Author

DonnaLadd

Date

2009-03-11T15:53:19-06:00

ID

144602

Comment

Wow, those are such great points. I really love the discussions here. I learn a ton. I was gonna quote/ italicize them but it was like your whole post. I do think if the demand for healthier foods was greater the price would go down as the supply rose to meet it. But I understand what you are saying about the situation as it is.

Author

WMartin

Date

2009-03-11T16:10:43-06:00

ID

144603

Comment

Agreed on the demand, too, WMartin. It's a quandary, but one we need to tackle. Even crime can be traced back to health issues, poor diets, lack of exercise, etc. Certainly laziness can be, as we all know. I'm glad the young man asked about it last night, albeit it in a very gauche way. ;-)

Author

DonnaLadd

Date

2009-03-11T16:26:05-06:00

ID

144604

Comment

And back on Wal-Mart, if I may. It makes me simply blind with rage — OK, breathe, Donna — to hear that progressive advocates, such as an organization locally I'm involved with, buys food and supplies at Wal-Mart or Sam's Club. Is there such a connect that people have to go somewhere to get something a few cents cheaper when they know that a corporation is so bad for the very people they purport to serve? I'm sorry, it's wrong. In our company, it is against the rules to buy anything for us at Wal-Mart or Sam's. You've got to walk your own talk. I will go to a Target or Kroger sometimes -- but only after I get what I can at McDade's, Rainbow, etc., or even Walgreen's because, by damn, they have long maintained drugstores in urban areas and downtowns. And that deserves our business as a result. But I go to local drugstores like Brent's and the one Josh Hailey's daddy runs in Maywood (forget the name at the moment) for actual prescriptions! In other words, we don't have to be hardcore purists to prioritize trading firt with businesses that support our community. Start with McDade's—they easily fill office needs!

Author

DonnaLadd

Date

2009-03-11T16:35:14-06:00

ID

144613

Comment

I had to go to a Sam's for work recently (it was not my choice) and I thought my head was going to explode. But, I realized that was probably the first time in at least 10 years that I have been to a Sam's, so there's that. I swore off Wally World a few years ago and really do not miss it at all. I know that some grocery items are probably cheaper there, but I don't care. I also recently discovered that the Piggly Wiggly on Meadowbrook has some really great deals, so I will definitely be going back there as well as McDade's. We do also use McDade's for work and Mr. McDade has been awesomely generous to us over the years, so that is my first choice whenever possible.

Author

andi

Date

2009-03-11T21:19:16-06:00

ID

144617

Comment

I probably hate Sam's more than Wal-Mart itself. Maybe because each and every time I've gone there, it's always crowded. I'm also weening myself off of Wal-Mart for anything now. There's a Target two miles up the street from me and I can usually get in and out of there in little time.

Author

golden eagle

Date

2009-03-12T07:41:43-06:00

ID

144619

Comment

I would encourage people to go to Kroger also when they can after our local merchants. Kroger is a union shop that offers good pay and health benefits to their workers. They did close that store on Raymond road but they built one in Byram and still maintain the Terry road location.

Author

WMartin

Date

2009-03-12T07:48:43-06:00

ID

144627

Comment

[quote]Kroger is a union shop that offers good pay and health benefits to their workers.[/quote] Heh. The pay isn't that great, and the health benefits only materialize if you make it out of probation. Further, My wife gets much, much better bennies than Kroger could or would hand out.

Author

Ironghost

Date

2009-03-12T09:30:34-06:00