Christine Davies, farm project coordinator at Community Hospital Anderson, said “some of our goals are to improve access to food and to provide education to the community on how to grow and use fresh produce.” John P. Cleary | The Herald Bulletin
By the numbers
37: Percentage of adults in Madison County who are considered obese, according to the 2016 Community Health Needs Assessment compiled by St. Vincent Anderson Regional Hospital. The statewide average is 33%.
29: Percentage of adults in Madison County who are considered “physically inactive,” according to figures from the Madison County Health Department. The statewide average is 25%.
69: Percentage of Madison County adults reporting adequate access to locations for physical activity. The statewide average is 75%.
7.1: Madison County’s food index, a 0-10 scale that measures factors contributing to a healthy food environment. The statewide average is 7.5, with most counties falling between 6.9 and 8.2.
ANDERSON — Madison County’s well-documented problems with health outcomes and overall quality of life include indicators of an issue for which there are few easy solutions.
The county’s overall obesity rate, according to the recently issued Robert Wood Johnson Foundation report, is 37%. According to information from the Centers for Disease Control and Prevention, 34.6% of all adults in Indiana’s rural areas are considered obese.
Although the Johnson Foundation report didn’t include specific numbers for those living in unincorporated areas, county health officials believe the area’s rural obesity rate is even higher.
“If Indiana is the 10th most obese state (according to the report) and Madison County is even more obese than the state, that’s alarming,” said Stephenie Grimes, administrator with the Madison County Health Department. “We still have places where we should be better at providing access to healthy food.”
In many instances, poor food choices and economic insecurity go hand in hand. According to the Johnson Foundation’s County Health Rankings & Roadmaps, 10% of individuals who are considered low income do not live near a grocery store.
“You only buy what you can afford,” says Alexa Farrar, a clinical dietitian at St. Vincent Anderson Hospital. “I think we’re set up, we’re hard-wired as humans to go toward those unhealthy options.”
Farrar generally works with patients who have already been diagnosed with diabetes, heart disease and other conditions connected to obesity. At that point, she says, the options become more reactive — mitigating the effects of obesity, rather than preventing it.
“I think a lot of it comes back to education,” she said. “We’ve got to get some of these individuals connected to sources that will provide them with healthier choices. There are food pantries that are open at different times, different days of the month. We’ve got to supply them with those fresh fruits and vegetables that they need.”
Jam-packed schedules also frequently contribute to decisions to forgo healthier, home-cooked meals as well.
“We’re just so much busier these days, and it can be easier to grab something from McDonald’s,” said Elizabeth Hart, coordinator of volunteer and mission services at St. Vincent.
Farrar said practical ideas like getting food in “to-go” boxes, or ordering smaller-sized french fries and drinks, are ways people can reduce their calorie intake if they choose to eat out.
But a lack of good food choices is only one part of the problem, officials say. Residents who live in the country often may not get enough exercise due to a lack of sidewalks and access to hiking and biking trails. Statewide, 25% of adults aged 20 and older reported no leisure-time physical activity, according to the Johnson Foundation’s County Health Rankings. In Madison County, that figure is 29%.
“Definitely a lack of physical activity plays a big role in the obesity problem,” said Jenny Martin, a nutrition care coordinator at Community Hospital Anderson. “There is a lack of parks in most rural areas. Screen time is also an issue. Overall, physical activity has taken a back seat for people and is not considered a priority for many.”
The nature of work for many rural residents — especially farmers — has also evolved. Advances in technology have automated many chores, meaning even jobs commonly thought of as labor intensive may not be providing people with ample exercise. But officials point to solutions like online workout guides and other resources as ways to overcome inactivity.
“We try to encourage people that there are exercises you can do around the house, in the yard,” Farrar said. “Depending on where you are, running is a very cost effective way to exercise as well. All you need is a decent pair of sneakers and you can do it just about anywhere.”
Efforts are also being made to improve low-income residents’ access to healthier foods. Community Hospital’s Community Farm, for example, is developing partnerships with several local organizations, including Second Harvest Food Bank of East Central Indiana, to make fruits and vegetables more readily available.
“Some of our goals are to improve access to food and to provide education to the community on how to grow and use fresh produce,” said farm project coordinator Christine Davies.
The county this week launched a health assessment survey aimed at collecting and analyzing data from patients at local hospitals. Grimes said officials intend to compile the data into a comprehensive plan that will involve several entities — hospitals, qualified health centers and the health department itself — in crafting or adjusting programs to address food choices and physical activity options, among other issues.
“It’s not really the typical assessment where we’re asking what’s wrong with our community,” Grimes said. “We know what’s wrong. I know we might get some feedback that’s hard to swallow, but we need to hear it in order to know how to help.
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