Do we want fries with that shake?
Written by Ardena L. Flippin, MD, MBA   
Burgers, fries and shakes
Attention to health care reform is really revving up and the final model hasn’t been determined. But one thing we do know is that secondary to access, prevention will be a major focus. My question is, How do we make the American people know that “prevention” involves behavioral change?

A perfect example of the lack of behavioral change is the fact that “during the past 20 years there has been a dramatic increase in obesity in the United States.”  ( Obesity and overweight for Professionals:  Data and Statistics:  U. S. Obesity Trends 1985-2007).  We are more aware now that “physical activity and nutrition are related to multiple health problems during youth and to chronic diseases in adulthood.”  [Sallis J.F., et al, Preventive Medicine, Volume 31, Number 2, August 2000, pp. S112-S120(9)]. 

My impression is that the American people think that once a reform program is designed, agreed upon and implemented that they need do no more than sit back, let doctors take care of them and “get healthy”.  My concept of health is some sacrifice, moderation, physical exertion even when we don’t want to, eating more fruits and vegetables and taking advantage of the medical care to which we have access. 

In other words, preventive health involves the patient taking more responsibility for their health, and I don’t think that this is being taught and emphasized enough to the American public.  Even more than adult health and living longer with chronic disease, I’m concerned about child/adolescent health and the issue of childhood obesity and what this portends for health care reform and the future of any health care system that is constructed.

A study in JAMA determined that even though obese adults are “healthier” in terms of lowered prevalence of cardiovascular risk factors (high cholesterol, high blood pressure levels) and decreased mortality, these individuals do not have reduced disability.  (JAMA. The Changing Relationship of Obesity and Disability, 1988-2004, November &, 2007 – Vol. 298, No. 17).  If adults with chronic disease are living well into their 80’s and 90’s, how do we rationalize that there will be an improvement in future health care expectations for the current generation of children diagnosed with obesity? 

No degree of health care reform or improvements in medical care can solve our health concerns if we, as American adults and children, don’t:

· Recognize that we must take responsibility for our own health

· Choose to be our own health advocates

· Identify what we must do to change our behavior and adopt as healthy a lifestyle as we can.


1. Obesity and overweight for Professionals:  Data and Statistics:  U. S. Obesity Trends 1985-2007)

2. Sallis J.F., et al, Preventive Medicine.  Interventions in Health Care Settings to Promote Healthful Eating and Physical Activity in Children and Adolescents. Volume 31, Number 2, August 2000, pp. S112-S120(9)

3. JAMA. The Changing Relationship of Obesity and Disability, 1988-2004, November &, 2007 – Vol. 298, No. 17 

About the Author

Ardena L. Flippin, MD/MBA is a professional speaker who focuses on the healthcare crisis facing corporations today.

Dr. Flippin, a Chicago resident, is a retired board certified emergency medicine physician.

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