The recession is making us sick
THE RECESSION is hurting more than our wallets, it is also hurting our health.
“Recession obesity’’ is the term du jour for the unhealthy side effects of people who lose their jobs and health insurance, then drop their gym memberships, delay medical care, and eat cheaper but less healthy meals. One discouraging sign of the times: The consumption of fast food is actually increasing during the downturn - because it’s cheap and it’s filling.
Massachusetts residents are particularly vulnerable to these unhealthy trends. As the Boston Foundation and the New England Healthcare Institute pointed out in their 2007 report “The Boston Paradox: Lots of Health Care, Not Enough Health,’’ the Bay State’s population is comparatively old, with significant health disparities and weak income growth, and with more than half of all residents either overweight or obese.
Combine all of this with increasing unemployment and we have a recipe for accelerating the vicious cycle of rising (but preventable) chronic disease driving ever-higher healthcare costs. Chronic illness currently costs Massachusetts $34 billion annually, a drain that is crowding out investment in other priorities that are also key to good health like education, public safety, and environmental protection.
But it doesn’t have to be this way; we can do something about it, and we should start now.
Much chronic disease could be prevented if we could find ways to eliminate the unhealthy behaviors causing these illnesses. Poor diet, inadequate physical activity, smoking, alcohol abuse, and poor sleep habits are all behaviors that create risks for obesity, diabetes, hypertension, heart disease, and stroke.
But how to change these behaviors, which are so often entrenched and driven by financial circumstances? The Commonwealth’s successful campaign against smoking offers an excellent model.
Like the anti-smoking campaign, programs to change unhealthy behaviors must reach into all the places that influence health - home, work, school, community, and media. They must provide consistent messages and involve incentives and education. Finally, they must target not just the high-risk population but the lower-risk friends, families, and neighbors of those at risk.
Thankfully, when it comes to promoting healthy behaviors, there are programs to build on, including the state’s new “Mass in Motion’’ campaign, Blue Cross Blue Shield of Massachusetts’ “Jump Up & Go!,’’ the “Healthy Living Cambridge Kids’’ program, and innovative worksite programs at
But these programs must be linked, expanded, and reinforced across all facets of life.
Several opportunities to accomplish this are outlined in a new report by the Boston Foundation and NEHI, “Healthy People in a Healthy Economy: A Blueprint for Action in Massachusetts.’’
Among them:
Schools: Legislators and educators should work to bring more nutritious foods and more physical activity into schools.
Municipalities: Transportation and housing policies should embrace “smart growth’’ and promote physical activity over reliance on automobiles.
State government: The Commonwealth should end the sales tax exemption on snack foods and soft drinks.
Payers: Massachusetts payers should work together to create common standards for the design and implementation of wellness benefits.
Employers: Companies should work with the state to promote proven practices in employee health management.
Food Industry: Supermarkets and restaurants should identify opportunities for health-oriented food labeling.
Physicians: Healthcare providers should work with payers to identify new options for reimbursing physicians for promoting healthy behaviors
Philanthropies: Grant-making organizations should help identify and support best practices in health promotion.
Media: Opinion leaders should serve as important partners in efforts to communicate positive messages around diet and fitness.
Can we do this in the midst of the worst recession in decades? We may be short on money, but we should never be short on leadership. Now is the time for committed leaders from all sectors to forge partnerships that go well beyond the precedent-setting coalition behind the Massachusetts health reform plan.
President Obama and congressional leaders recognize this, making health promotion and wellness key tenets of some national health reform proposals.
But health promotion and prevention are the missing links in the Commonwealth’s strategy to provide good, affordable, and sustainable healthcare for all. It is time to forge those missing links - and to ensure that the recession does not expand our waistlines just as it pinches our wallets.
Wendy Everett is president of the New England Healthcare Institute. Paul S. Grogan is president and CEO of The Boston Foundation. 