Prevention

The White House Kitchen Garden is frozen under, but, this Black History Month, first lady Michelle Obama is once more using food to address the epidemic of childhood obesity that has gripped the country and, she said in a recent speech to the United States’ Conference on Mayors, “never fails to take my breath away.”

Remember a couple of weeks ago I told you about the junk mail I was getting inviting me to have all sorts of unnecessary imaging tests done of my blood vessels to SAVE MY LIFE for a mere $139 ($149 if I throw in the osteoporosis risk assessment). Well, the artery scanners are back in my mail box with a Secret Weapon. This time the letter was signed by figure skating icon Peggy Fleming. "As an Olympic champion and breast cancer survivor, I've always understood the importance of taking steps to take care of my health."  She explains everything I want to know abou 6-lead EKGs (are they anything like triple lutzes?). In her work for Life Line Technologies, she signs herself "Olympian, Preventive Health Advocate."

Jeffrey Levi, executive director of Trust for America's Health, writes on the RWJF blog about public health and prevention elements in the Obama administration's proposed budget. Not a huge amount of new money given the economic circumstances but touching on a lot of the right priorities, including money to follow through on the new law that gives the FDA greater authority to regulate tobacco and a small ($10 million) investment in workplace wellness for U.S. government employees. We'll try to find out a bit more about that wellness initiative in the future, but probably not today as Washington hunkers down for big snowstorm (which as you may know Washingtonians treat like a four month Arctic expedition.) Here's what Levi found:

A series from The Los Angeles Times this week on the serious health issues -- and enormous healthcare costs  -- associated with obesity contained a curious omission: the concrete steps that state and local governments here in California have taken to mitigate them.

Though largely unaddressed in the LA Times articles, the weight of evidence lies behind the assertion by Dr. Deborah Cohen of RAND that:  “Much obesity is the result of genetics and the environment. Yet we're blaming individuals when the food environment is the problem.” 

We have written before about an interesting and ambitious initiative to improve care of low-income people with chronic diseases here in D.C., and some of the people involved allowed me to sit in on a brain-storming session earlier this week. The topic was self-care. How to get patients invested in, and capable of, managing their own chronic diseases. 

One of the public health steps within health reform legislation that hasn't gotten much attention is covering smoking cessation in Medicaid. The Senate will cover it for pregnant women under Medicaid, which itself will be expanded. The House goes further, covering smoking cessation for all Medicaid beneficiaries. 

The Campaign for Tobacco Free Kids is pushing for the House approach. The group's president Matt Myers said in a statement this week:

The final health care reform legislation should require comprehensive coverage of smoking cessation treatment, including medication and counseling with no cost-sharing requirements, for all Medicaid recipients, as the House-passed legislation would

Not clear yet when we’ll get the next installment of CBO estimates for the Senate (maybe today, Monday) but while we were reviewing the Senate bill as it now stands ... we noticed this “Sense of the Senate.” (A sense of the Senate can sometimes be a nonbinding way of symbolically bridging ideological differences -- here it’s sort of Senate wish list.)

A new report released this morning by a group of public health organizations (Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Action Network, American Lung Association and the Robert Wood Johnson Foundation) shows that states take home more tobacco-related revenue than ever before but have actually decreased annual funding for smoking cessation programs.

Dr. David Kessler, as you've probably heard, is out with a terrific best-seller called "The End of Overeating: Taking Control of the Insatiable American Appetite."

The cover grabs your attention: very pure white glossy background with a carrot cake and carrots.

I don't like carrot cake. But as I told Dr. Kessler, if the cover picture were an Oreo, I wouldn't be able to have his book in my house.

I got to know Kessler while I was covering tobacco back in the late 1990s, but hadn't seen him in quite a few years until he spoke at a conference of health writers I attended last week.

He was the luncheon speaker: the healthiest of the box lunch options, the one I chose, was vegetables -- drenched in salad dressing -- on a white-bread roll, an apple, and two chocolate chip cookies in plastic wrap. I didn't want to eat them until Kessler began talking about how smells triggers cravings and my friend Ivan sitting next to me unwrapped his cookies. But, concentrating intently on the dress I wanted to wear at a college reunion this weekend, I ignored Ivan and the cookies, and listened to Kessler. Luckily, they weren't Oreos.

Anyhow, David happened to be heading to Washington this week, and we ended up having a longer and more provocative conversation about fat, policy, parenting, Oreos and social norms than either of us expected.

Hmm. New America is doing a flu shot clinic (seasonal, not swine) at the office this week, I believe for the first time.

Apparently, only two of us in the health policy program (you know, the ones who write about prevention and wellness) have signed up for this free service.

Maybe everyone else already got theirs.