Editor’s note: This commentary is by Elisabeth Fontaine, M.D., of Swanton, and Jennifer Laurent, of Burlington. Fontaine is the medical director of Life Medicine at Northwestern Medical Center and of RiseVT. Laurent is the principal study investigator for the RiseVT study and an associate professor of Nursing at the University of Vermont.
[A] new study conducted in Franklin and Grand Isle counties projects a concerning trend for the health of our kids and the future cost of health care. While Vermont is often touted as one of the healthiest states in the country, this new body mass index measurement study measured heights and weights of each participating first, third, and fifth grade student in Franklin and Grand Isle counties and found that 41 percent of the 98 percent of students who participated were either overweight or obese. As clinicians, we know these kids are already — at such a young age — at much greater risk for developing type 2 diabetes and high blood pressure in the next 15-20 years.
Eighty-six percent percent of today’s health care costs involve the treatment of chronic illnesses such as heart disease, diabetes, strokes, etc., which are often related to obesity. In 1990, roughly 11 percent of Vermonters were obese; today that rate has almost tripled. At this rate, we are heading for a health care disaster. As our nation continues to grapple with how to handle high health care costs, it behooves us to look at how we can create environments for people that can reduce obesity rates and keep heart disease and type 2 diabetes at bay.
The way our towns, businesses, schools and culture have developed, living a healthy lifestyle isn’t easy. But we can change that and we are already changing that in Franklin and Grand Isle counties through the initiatives of RiseVT. When your environment and community supports you, it can look like this: Your kids go to school where everyone eats (teachers and school staff too!) fresh, healthy food and scratch cooking in the cafeteria; and they all have their own water bottles to fill up at water bottle filling stations; and on the weekend they can, for instance, borrow snowshoes from the library to go out with their friends and family on the new trails your town has groomed; and at work adults are encouraged to take walking breaks and catered or cafeteria food is all healthy and culturally appropriate; and policy initiatives support livable wages and supports that help families afford groceries, child care, housing and transportation. This is just a snapshot of the sort of full spectrum wellness services, systems, and infrastructure that can make the healthy choice the easy choice — small changes in diet and physical activity can really add up to make a big difference in preventing chronic disease as well as keep individuals healthy both physically and mentally.
For us, as Vermonters, researchers and medical practitioners, knowing the state of our kids’ health is a necessity. The data collected by the measurement study used standardized protocol to glean important and valuable information about the health of the kids in our region, while making sure all heights and weights were kept anonymous, giving the authors a high level of confidence in the results. RiseVT – Franklin & Grand Isle Counties, the University of Vermont, and the Vermont Department of Health’s St. Albans District office worked together to make this BMI measurement study possible. This is an example of how the RiseVT model works — it relies heavily on partnerships to amplify the works and skills available across sectors that can help us toward a common goal of improving the health of Vermonters, and therefore lowering health care costs.
How might these results look in other counties? Our guess is that, with the exception of Chittenden County, differences in income, race, education and employment don’t vary substantially from one county to the next and therefore we could expect similar results across Vermont. This information should also focus our attention on the importance of population health initiatives like RiseVT, which is now expanding statewide. If we don’t do everything within our ability to address population health issues — such as overweight and obesity — and encourage living healthy at an early age, the costs going forward may make today’s costs look meager by comparison. Efforts like RiseVT will need the support of our hospitals, the Green Mountain Care Board, and state government to make the necessary investments for the future health of Vermonters and to halt rising health care costs.
