America's Most Obese Cities By Rebecca Ruiz, Forbes.com
Nov. 14, 2007
We are heavier than ever.
Once considered an affliction of the lazy and indulgent, obesity now affects
about one-third of Americans. The epidemic has swept up the wealthy, middle
class and the poor; city dwellers, suburbanites and those in rural areas; and
people of all races and ethnicities.
The causes, researchers say, are numerous. These include a diet of
calorie-dense but nutrient-deficient food found in grocery and convenience
stores, public planning strategies that favor motorists over walkers and
cyclists, and simply bad habits.
And while the causes are many, the costs are enormous. Obesity's associated
costs add $93 billion to the nation's medical bill annually. Each year, 112,000
people die from obesity-related causes, and the condition is responsible for an
increased risk of chronic diseases like Type 2 diabetes, cancer and heart
disease.
To better understand the local and state implications of the obesity epidemic,
we ranked the nation's heaviest cities. In doing so, we discovered states with
multiple offenders, metropolitan areas with expanding waistlines and a high
representation of Southern cities. Worse yet, after claiming the title of the
most sedentary city, Memphis, Tenn., has also ranked first as the country's
most obese.
Behind the numbers To determine which cities were the most obese, we looked
at 2006 data on body mass index, or BMI, collected by the Centers for Disease
Control's Behavioral Risk Factor Surveillance System, which conducts phone
interviews with residents of metropolitan areas about health issues, including
obesity, diabetes and exercise.
In this case, participants report their height and weight, which survey
analysts use to calculate a BMI. Those with a BMI between 18.5 and 24.9 are
considered at a healthy weight, those with a BMI between 25 and 29.9 are
considered overweight, and those with a BMI of 30 or higher are considered
obese. About 32 percent of the nation is obese, according to the Centers for
Disease Control; Memphis ranked above the national average at 34 percent.
Though data is collected for roughly 145 metropolitan statistical areas, we
looked only at the country's 50 most populated cities and ranked the top 20.
Because of an insufficient number of survey responses, data from some cities,
including Sacramento, Calif., Columbus, Ohio, and Buffalo, N.Y., was not
included. Had we included every area on the list, the smaller cities of
Huntington, W.V., and Ashland, Ohio, on the West Virginia, Kentucky and Ohio
state borders, would have far outpaced every city on the list with obesity
rates of 45 percent. Of the 50 cities we did rank, Boston entered last, with
only 19 percent.
Noticeable Trends Many of the cities on the list have high poverty rates and
high frequencies of fast-food consumption.
In the city of Memphis, which does not include the outlying areas surveyed by
the CDC, 24 percent of residents live below the poverty line. According to the
U.S. Census Bureau, the national average is 13 percent. The same trend was
noticeable in the cities of Milwaukee (No. 17), Detroit (No. 5), and San
Antonio, Texas, (No. 3) where 26 percent, 33 percent, and 18 percent of
residents, respectively, live beneath the poverty line.
While fast-food consumption is a minor factor influencing obesity rates,
purchasing patterns often reflect larger health issues and habits in certain
communities. The average American had purchased fast food 16 days of the month
between January and September of this year, according to Quick-Track research
conducted by the consumer tracking group Sandelman & Associates. Thirteen
cities on our list, including Memphis, Austin, Texas, and Indianapolis, met the
national average or higher. Residents of San Antonio eat fast food 20 days of
the month, and had the highest frequency of the cities on our list.
The Causes Despite public health warnings about maintaining a frequent
exercise regimen, limiting fast-food consumption and avoiding weight gain,
there is no single cause of obesity, a fact that often frustrates experts,
legislators - and obese people.
Other factors contributing to our ballooning waistlines, says Marian Levy,
director of the master's of public health program at the University of Memphis,
include enormous food portions, declining exercise rates and cheaper, unhealthy
food. When asked about Memphis, however, Levy emphasizes a local culture built
around Southern hospitality.
"We express our caring about people through food," she says, describing
generous helpings of fried fish, chicken and okra often shared with neighbors
and friends. "We have to realize that if we truly care about people, we want
them to be healthful."
In Memphis, as in other cities on our list, reversing the obesity crisis can
seem like trying to plug a thousand holes in a sinking ship. Public health
campaigns are a start. Healthy Memphis Common Table, a nonprofit organization
trying to promote better fitness and nutrition choices, provides residents with
a list of exercise facilities and walking paths in addition to health tips and
testimonials about the benefits of weight loss.
Another tactic, notes Levy, is vending machine legislation that will require
schools pre-K through eighth grade to replace unhealthy foods and beverages in
vending machines, on school store shelves, at fundraisers and a la carte
cafeteria items with more nutritious alternatives. She hopes the legislation,
which is being implemented for the current school year, will improve the diets
of Memphis-area school children, 71 percent of whom receive a free lunch from
school cafeterias.
Still, "there's not going to be a silver bullet," Levy says. "There has to be
a simultaneous change at the environmental level, in schools, communities and
families."
The Solutions It's that community-wide change in lifestyle that experts say
will result in fewer cases of obesity.
"You see cities taking this on in a range of different ways," says Leon
Andrews, the project director of the Institute for Youth, Education and
Families at the National League of Cities. Andrews is currently overseeing a
one-year project in which six cities, including our third most obese, San
Antonio, receive assistance in combating childhood obesity and promoting
community wellness.
Andrews identified five ways cities could specifically address childhood
obesity, as well as larger community health issues. These included improving
public space and utilizing parks and recreation areas to encourage physical
activity, as well as pursuing healthy food alternatives through community
gardens and farmer's markets.
"More cities are becoming aware of [obesity] and looking to play a role in
improving the situation," Andrews says. He also pointed out that city leaders
often preferred to follow a successful example as opposed to chart a new
course: "They definitely want to be the second, but may not want to be the
first," he says. Regardless, it's clear that rising rates of childhood obesity
- 17 percent of children and adolescents ages 12 to 19 are overweight - has
prompted cities like Birmingham, Ala., San Diego and Richmond, Va., all on our
list, to become more proactive in terms of obesity prevention.
Others, such as Walter Willett, a professor of epidemiology and nutrition at
the Harvard School of Public Health, believe our salvation lies mainly in
ridding the grocery store of food he calls "not fit for human consumption."
Among the items he would like to see purged, he says, are the "shelves of sugar
water, the breakfast cereal section, dominated by refined starch and sugar, and
white bread and rolls."
According to Willett, a healthier diet, in combination with increased levels
of physical activity and environments that promote exercise, would drastically
improve the country's obesity problem. "If we do this right," he says, "we'll
improve our quality of life in many different ways."
1. Memphis, Tennessee.: 34%
Researchers have found that residents are aware of the area's obesity problem,
currently affecting 34% of its population. Among the causes they blame: high
rates of poverty and a culture of Southern hospitality and food that values
certain types of dishes--many of them fried--over healthier choices. Memphis
actually sits on the western edge of a web of Southern cities along with
Birmingham, Ala., and Atlanta, that also landed on our list.
2. Birmingham, Alabama.: 31.3%
As the second most obese city, 31.3% of Birmingham's residents have a BMI of
30 or higher. Since 2001, a local non-profit organization called Jones Valley
Urban Farm has tried to promote healthy eating habits with community gardening
plots. The organization also offers educational programs for grade-school
children in an effort to battle the city's high childhood obesity rates.
3. San Antonio, Texas: 31.1%
Arguably the home base for calorie-rich Tex-Mex cuisine, this Texas city comes
in a close third as the most obese. City officials, however, have taken note,
and are exploring solutions. A team of municipal and school leaders was
recently chosen by the National League of Cities to receive technical
assistance for one year in combating childhood obesity and adopting wellness
initiatives. The league will provide San Antonio and five other cities with
experts versed in healthy eating and active living as well as fighting obesity.
4. Riverside/San Bernardino, California.: 30.8%
Those living in the city of Riverside and the surrounding metropolitan area,
located about an hour east of Los Angeles, are likely victims of a car-centric
culture. But despite efforts to promote safe streets and bicycle riding, the
obesity epidemic is only getting worse: 30.8% percent of Riverside residents
are obese, a 5% increase from 2005. The percentage of people neglecting regular
exercise is also creeping upward, now standing at 30%.
5. Detroit, Michigan: 30.4%*
Parts of this beleaguered city, where 33% of residents live below the poverty
line, may qualify as a "food desert," a term used to describe urban areas
devoid of healthy, fresh food choices. That may explain why 30.4% of its
population, and that of the surrounding area, is obese. Still, it seems the
state also suffers from unhealthy eating habits and physical inactivity:
Michigan was recently ranked the ninth heaviest state in the nation by the
research group Trust for America's Health. The state already promotes healthy
living through an initiative called "Step Up Michigan," but the epidemic might
require a more aggressive intervention.
*Figures for the Detroit Metropolitan Statistical Area were not available; we
combined the area's two Metropolitan Divisions to approximate the obesity rate
for the Detroit MSA.
6. Jacksonville, Florida 29.8%
Perhaps this city's humid climate drives its residents, 29.8% of whom are
obese, indoors. In an effort to lessen the area's obesity rate. the city has
launched a public health initiative called Healthy Jacksonville, which allows
participants to get involved in a community-wide challenge for improved fitness
and health. A primary motivator for the city was the $357 million price tag, as
measured in 2003, of obesity and overweight health issues in its residents.
7. Nashville, Tennessee.: 28.8%
Nashville's obesity crisis is worsening: At 28.8%, the percentage of residents
who are obese increased roughly two points last year, while the number of
overweight residents rose to 39%, up from 35.5%. The city has tried combating
the rising numbers with various health initiatives, including a mile-plus walk
with the mayor and day-long events encouraging the use of nearby greenways.
8. Oklahoma City, Oklahoma: 27.5%
Mayor Mick Cornett has been working with city leaders to improve local health
on a number of fronts. One reason? A whopping 27.5% of Oklahoma City residents
are obese. Among other strategies, the city has promoted healthy living by
passing a bond measure to build gyms at 47 inner city schools and increasing
the number of bike paths. They've also tried to lure high-profile stores like
Trader Joe's and Whole Foods while also looking at ways to decrease high rates
of fast food consumption.
9. Kansas City, Mo.: 26.9%
Well known for its barbecue, Kansas City has a big appetite. Like other cities
on this list, where a culture of food is closely intertwined with a way of life,
that may contribute to high levels of obesity. In Kansas City, 26.9% of
residents have a BMI higher than 30, which qualifies them as obese. At least
many are vocal about improving parks and recreation services, as well as making
sidewalks more walkable. When polled by the city government last year, improved
parks and sidewalks ranked at the top in terms of what residents most wanted.
10. San Diego, Calif.: 26.7%
The glitz of downtown San Diego belies pockets of poor neighborhoods where
access to fresh fruit and vegetables is limited. Other factors contributing to
the obesity rate of 26.7% may be car commuting and a large Hispanic population,
whose members often have higher incidences of obesity than non-Hispanic whites.
To counteract the trend, San Diego County has invested in preventing and
reversing childhood obesity by forging collaborative relationships between
public and private entities.
Michael Moore schiet met ‘SiCKO’ op Amerikaanse gezondheidszorg
Michael Moore’s nieuwste documentaire ‘SiCKO’ schopt deze keer niet alleen president Bush tegen de schenen, maar stelt, over de politieke grenzen heen, de Amerikaanse gezondheidszorg aan de kaak. “We zijn het rijkste land van de wereld. We besteden meer aan gezondheid dan elk ander land. En toch hebben we de slechtste gezondheidszorg van het Westen. Komaan mensen, we kunnen beter dan dat”, spreekt Moore de pers toe op het internationale filmfestival in Cannes.
De nieuwe film van Michael Moore brengt de gezondheidszorg in de Verenigde Staten in kaart, of liever gezegd, het gebrek eraan.
50 miljoen mensen in de VS hebben geen enkele vorm van ziekteverzekering. Zij die wel verzekerd zijn, kunnen evenmin op hun beide oren slapen. “In onze wetgeving staat geschreven dat iedere organisatie moet instaan voor een zo groot mogelijke opbrengst voor de aandeelhouders. Het gevolg daarvan is dat de verzekeringsmaatschappijen zo weinig mogelijk medische hulp aanbieden om zo de winsten hoog te houden”, aldus Michael Moore.
‘SiCKO’ gaat dan ook in de eerste plaats over de Amerikanen die wél een ziekteverzekering hebben, maar die nog steeds niet kunnen genieten van een eerlijke gezondheidszorg.
Middelvinger: 60.000 $, Ringvinger: 12.000 $
Een tekenend en schrijnend voorbeeld uit de documentaire is het verhaal van Rick. Hij verloor de topjes van zijn ring –en middelvinger toen hij hout aan het zagen was. Wanneer hij in het ziekenhuis aankwam gaven ze hem de keuze: zijn middelvinger in ere laten herstellen voor 60.000 dollar of zijn ringvinger, voor 12.000 dollar. Voor beide vingers te restaureren had Rick echter niet genoeg geld, dus het werd enkel de ringvinger. “Het is een verschrikkelijk gevoel om verplicht te worden je lichaam in te delen in prijscategorieën”, aldus Rick’s vrouw.
Michael Moore trok voor de documentaire met verschillende mensen, waaronder Ground Zero reddingswerkers, naar Guantanamo Bay op Cuba in de hoop een medische behandeling te krijgen voor de patiënten.
Hun toegang werd geweigerd en de groep trok verder naar Havana, waar ze in het centrale ziekenhuis gratis werden verzorgd.
De Amerikaanse overheid onderzoekt nu of Moore de VS-handelsakkoorden schond door naar Cuba te reizen. De filmmaker verdedigt zich: “Het was niet de bedoeling om naar Cuba te reizen, maar naar Guantanamo, wat Amerikaans grondgebied is.”
De originele kopie van de film is verstopt op een geheime locatie buiten de Verenigde Staten om een in beslagname ervan tegen te gaan.
Michael Moore toonde zijn nieuwste documentaire al op het internationale filmfestival van Cannes, waar hij na het grote succes van ‘Fahrenheit 9/11’ met open armen werd ontvangen. Ook ‘SiCKO’ kon rekenen op een grote appreciatie.
Bron: Teun op http://www.indymedia.be
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