All posts by Dr. Michael Forster

Michelle Obama will visit Clinton next week, celebrating Mississippi’s success in reducing childhood obesity (if only a little), and punctuating the point that progress is possible if we take the right approach.  That approach is prevention, and focuses on kids in school – where one hopes that essential life lessons are still learned, and lifelong habits of health acquired. 

Kids in Clinton schools are eating better and exercising more, and benefit from a supporting community that “owns” the issue of childhood health.  Now how about that as a revolutionary recipe for success?  A great start, but not enough, to be sure.  Not some, but all Mississippi schools need to be serving nutritious meals all the time.  Not some, but all schools need vigorous programs of health and physical education.  Not some, but all schoolchildren need the support of caring communities (and not just parents, too frequently cued to be scapegoats for larger and systemic problems). 

And beyond those school-based factors, we need everywhere in place broader policies that promote health, well-being, and the prevention of chronic disease.  Policies that curtail consumption of unhealthy food and drink, that encourage biking and walking, that in general – as state health director Dr. Mary Currier has put it – “make the smart choice the easy choice.”

So-called “soft” drinks make an indisputable ”hard” contribution to obesity.  Packed with mega-calories, primarily in the form of high-fructose corn syrup, soft drinks are responsible for packing on the pounds of growing numbers of overweight and obese Americans, and especially kids.  (According to one Centers for Disease Control survey, fully one-quarter of kids’ daily calories come from added sweeteners.)  Curbing sweet-drink consumption, most liklely through a combination of education and regulation, is one key to a much-needed prevention approach to obesity and the myriad chronic diseases associated with it.

So it’s good news that health advocates and public health officials from cities across the country (none in Mississippi, unfortunately), led by the Center for Science in the Public Interest, are pushing the Food and Drug Administration to limit sweeteners in sodas and other beverages. 

Behemoth beverage manufacturers like Coca-Cola and PepsiCo are feeling the heat and hope to stay on the positive side of public opinion by emphazising their own efforts to develop new sweeteners and health-related products and packaging.  That too may be good news if they are sincere, and not just trying to sweet-talk their way out of culpability for perhaps “the” greatest health threat the nation knows.

A couple of weeks back I ragged on Mississippi for ”flunking health again.”   This time it’s another distressing report on the state of Mississippi children by “Kids Count” – done annually by the national Annie E. Casey Foundation – that’s giving me serious Sunday heartburn. 

Dismal data abound on a wide range of indicators related to education, health and safety, employment, and more; it’s a long list.  Most disturbing to me is the poverty rate for children, since poverty is a linchpin indicator of so much else that’s bad.  Fully 37.5% of Mississippi kids under 5, the most vulnerable of all, live in poverty, with the percentage dropping only 7.3% for kids 5-17.  Worst of all, 15% of all Mississippi children live in “extreme poverty,” i.e. in families whose incomes are less than half of the (pathetically low) federal poverty line.

We (or at least our political leadership) fantasize that charter schools, and not adequate funding, will turn around our struggling education system.  We worry that we simply can’t afford to get in bed with the federal government to expand Medicaid, despite the crying need for coverage.  In the meantime, far too many of our children and young people are suffering far, far too much.

On the heels of yesterday’s local “Issues in Aging” conference, presented by the Pinebelt Association for Families and co-sponsored by USM’s School of Social Work and the College of Health Center on Aging, comes this important bit of aging-related news – a larger number of Americans are working longer into the “golden years,” postponing their withdrawal from the active workforce. 

The percentage of Americans 65 and older in the labor force increased from 12.1% to 16.1% over the twenty-year span from 1990 to 2010 – representing substantial and steady, if not dramatic, growth.  Men lead women in overall labor force participation, 20.8% to 12.5%, but older women’s presence in in the workplace grew faster than men’s, 4% to 3.2% – paralleling the broader trend of proportionately heavier women’s workforce participation. 

The phenomenon of postponed retirement rolls together good and bad news.  The good news is that growing numbers of Americans are healthy and able enough to remain active workers, and motivated to do so by a range of satisfactions associated with work, including the opportunity for continued social and economic contribution.  Less favorable if the flip-side of the coin – Fewer older Americans can financially afford to retire, event though they would very much like to.

The state just received another report card from the Mississippi State Medical Association and the Mississippi Department of Health, and unfortunately it looks a lot like report cards from the past four years running – a big fat “F.”  As hard as we might look to applaud signs of improvement here and there, the facts are cold and daunting – Mississippi retains the worst ranking in the country on the critical indicators of obesity, diabetes, cardiovascular disease mortality, infant mortality, teen birth rate, and physician access. 

It just doesn’t do any good either to deny reality or to get huffy about how we’re “tired of everybody looking down on Mississippi.”  Pulling ourselves out of the deep health hole we’ve dug ourselves into is going to require taking a seat squarely on a new three-legged stool – (1) a  real commitment and shift to the disease prevention and health promotion paradigm; (2) a comprehensive strategic plan that incorporates new public policies, and doesn’t rely on the easy dodge of laying the blame on “personal responsibility”; and (3) serious, long-term investment in the implementation of evidence-based measures that work. 

“It would be nice to get us off the bottom,” says our hard-working state health officer, Dr. Mary Currier, whose Department of Health is grossly underfunded.  If only wishing could make it so!  As Dr. Currier knows only too well, moving the needle for Mississippi is going to take an enormous amount of (properly focused) work, and not an inconsiderable investment of resources.