Foundation president sounds alarm on state's drop in health rankings

6/8/2014

By JIM McLEAN

By JIM McLEAN

KHI News Service

WICHITA — Kansas Health Foundation President Steve Coen was blunt and to the point.

"Kansas is sick," Coen said in opening remarks Thursday at the foundation's 2014 Health Symposium. "Something has gone seriously wrong in the state of Kansas, and we've got to do something to get it back on track."

Coen's diagnosis was based on the 2013 health rankings compiled by the United Health Foundation, which listed Kansas as the 27th healthiest state in the nation.

At first glance, that ranking may not seem like a cause for alarm. The concern, Coen said, stems from the fact that as recently as 1991, Kansas ranked eighth.

"That is a huge drop in 23 years," he said.

Several factors are driving the decline. Kansans are getting heavier. Fewer Kansas children are being fully immunized against childhood diseases. And efforts to reduce smoking have lost momentum. The number of Kansans who smoke is going down, but at a much slower rate than many other states.

"There are eight anchors pulling us down. Four of those are directly related to smoking," said Jeff Willett, vice president for programs at the foundation, referring to a subset of the measures used to compile the health rankings.

"Smoking causes one-fifth of all premature death (in Kansas)," Willett said.

A renewed and sufficiently funded effort to reduce tobacco use in Kansas could reverse the state's "steady and continuous decline" in the rankings, he said.

"I believe it's the most winnable (public health) battle," he said, noting that surveys show that most smokers want to quit.

Reducing obesity will be harder, said Dr. David Kessler, a former head of the U.S. Food and Drug Administration.

Kessler was the keynote speaker at the symposium's opening session.

As FDA commissioner under presidents George H.W. Bush and Bill Clinton, Kessler laid the groundwork for the 2009 Family Smoking Prevention and Tobacco Control Act, which gave the agency authority to regulate the manufacture, distribution and marketing of tobacco products to protect public health.

Unfortunately, Kessler said, the same regulatory opportunities don't exist in the battle against obesity even though there is evidence that Americans are addicted to processed foods high in sugar, fat and salt.

Sugar is the biggest culprit, Kessler said. It triggers "thoughts of wanting" in the emotional center of the brain, causing people to eat even when they aren't hungry.

"I wanted to understand wanting. Not liking, wanting," he said, explaining what motivated him to dig into the research and write the book, "The End of Overeating: Taking Control of the Insatiable American Appetite."

Kessler said the food industry has spent the last several decades perfecting ways to create products that have the taste and texture that Americans crave. It's no wonder, he said, that Americans now enter their 20s an average of 18 pounds heavier than they did in 1970.

"We're living in a food carnival. What did we expect would happen?" he said.

With almost 30 percent of the population considered obese, Kansas has one of the highest rates in the nation, according to the United Health Foundation rankings.

Using the regulatory power of government to restrict food choices isn't the way to address soaring obesity rates, Kessler said. Instead, people need to be encouraged and empowered to overcome their cravings and make healthier choices.

One way to do that, he said, is to push back against the notion that we are powerless to control our food addiction.

"Just because it's not your fault doesn't mean you can't take steps to protect yourself," he said.

One of the most important steps we could take, he said, is to intervene early with children so that they don't develop insatiable appetites for sweet, calorie-laden foods. Restoring some old social norms - like eating only at mealtime - also could help, he said.

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