The block by block fight against obesity

A message from Lillian Shirley, RN, MPH, MPA, Director of the Multnomah County Health Department

Oregon has a weight problem that public health experts are charting with frustration and alarm. A decade ago, one in six Oregon adults was obese. Now, the Centers for Disease Control and Prevention reports, it is one in four.

Our weight gain is driving up chronic disease rates and costs. An obese person pays an average of $1,400 more a year in health care. 

Yet, Oregon did not become overweight overnight. It took decades of complex changes in what we eat and how we move. There is no single, simple fix. No one knows better than Multnomah County health workers battling obesity in the community, block by block. 

When a county health worker moved his office into Cesar Chavez Elementary School to organize the North Portland community around healthy eating and active living, he didn't just bring brochures. He listened to parents, children and teachers, then found partners to plant a community garden, teach cooking classes and promote walking. 

In 2010, Multnomah County took the concept county-wide. Working with a federal grant, public health workers teamed with Portland, Parkrose, David Douglas, Centennial, Reynolds, Riverdale and Gresham-Barlow school districts to adopt new nutrition guidelines, boost student activity and link with local farmers to provide fresh produce. They're adding bike racks, planning safe walking and biking routes, and installing more water fountains.Children in county-supported after-school activities are seeing similar changes as the Schools Uniting Neighborhoods (SUN) community schools revamped their guidelines. 

When families in neighborhoods with high rates of obesity-related disease described barriers, public health workers fanned out to corner stores where moms shop but can't find healthy staples like apples, low-fat yogurt or skim milk. Store owners described their dilemma: lack of buying power, an uncertain market, limited refrigeration. So, Multnomah County is offering mini-grants to help owners who voluntarily want to offer healthier, culturally appropriate choices. 

Public health workers are building an atlas to pinpoint where the lack of sidewalks, transit routes and parks discourage exercise. They've teamed with Gresham and Portland planners to prioritize transportation projects over the next 20 years to boost people's options. 

They're meeting with vendors to provide healthier food at public events. Partners from faith communities are getting the deep fryer out of their kitchen or planting a garden. Thousands of older people who eat each day through Loaves and Fishes are enjoying fresh produce instead of pre-packaged food. 

As individuals, we can all eat more fruit and vegetables and drink more water. We can get moving. But together, Multnomah County is working to assure that people at every stage of life, in every neighborhood, have the opportunity to also eat healthful food and live more active lives. 

This column appeared on OregonLive.com on Monday, August 1, 2011

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