Brad Wright of Wright on Health hosted the most recent Health Wonk Review with a golf theme to celebrate last weekend’s Masters Tournament. One of my favorite posts in this edition of the HWR come from Brad Flansbaum, writing at The Hospitalist Leader. Brad’s eye opening article about the availability of vegetables and how easy – or hard – it is for a person to adopt a healthful lifestyle based on location, culture, and one’s life history.
We know that it’s much easier to find vegetables in relatively affluent places than in poorer regions. And we know that habits regarding food and exercise are deeply ingrained starting in childhood – it’s not easy to change those habits. We also know that discussions about lifestyle factors affecting health are all too often relegated to just a few minutes during an office visit, if they’re even addressed at all.
But Dr. Flansbaum obviously makes the issue of diet far more of a priority with his patients. He has a questionnaire for his patients regarding their experience with vegetables, and he went as far as to roast some brussels sprouts for a patient who had never tried them. She thought they were great and asked for the recipe!
I would love to see a future of healthcare that includes more ACO-style collaboration between medical providers and health insurance carriers to make sure that doctors are rewarded for spending extra time and effort focusing on issues like diet and exercise. Although I doubt most doctors are going to start roasting veggies for their patients (Dr. Flansbaum is pretty awesome for doing that!), it would be great to see lifestyle issues getting the time and attention they deserve during medical visits.
Dr. Flansbaum shares a photo of a produce stand – overflowing with fruits and vegetables – that sits just blocks from his hospital. He notes how easy it is for commuters in his area of NYC to pick up whatever fresh produce they want on their way home from work. But when he makes a trip to a patient’s side of town, the produce stand is noticeable different – it’s all fruit, with no vegetables. And it’s the only stand he found in that area of town. In addition, there are plenty of fast food outlets, fried food, processed food… but little in the way of truly nutritious options.
Dr. Flansbaum’s article is a must-read if you’re interested in the socioeconomic factors that contribute to obesity and “lifestyle” health risks. Colorado has the distinction of being the least-obese state in the US (although we recently passed the 20% mark in terms of the percentage of adults who are obese). I’m sure this is due in large part to the state’s relatively affluent population, the plethora of outdoor activities available (combined with 300 days of sunshine each year), and the plentiful food choices available. Of course there’s a bit of a chicken-or-the-egg question too… are there plenty of healthful food choices available here because the people who live here demand them, or are there healthy people here because of all the good food options we have?