Commonwealth Conversations: Public Health

Hot Deals on a Cold Day: Haymarket Fruits & Veggies.

Posted by:
Tom Lyons, Department of Public Health

 

I snapped this picture on my way into work this morning.  No matter what the weather, in good economic times and bad, the fruit and vegetable vendors in Haymarket Square can be found every Friday and Saturday barking out prices and offering great deals on a variety of good stuff. 

The market is set up every week at the corner of North and Blackstone Streets in downtown Boston.  Look at that price for strawberries!  One dollar?  I can pay 4 or 5 times that amount at the grocery store in my neighborhood.  I love this place --  even on the cold days -- because the bright colors remind me of spring.  I found a nice piece that NECN did on the Haymarket vendors back in July --  another good reminder that we’ll all be wearing short sleeves again soon.

Also ran across this great post on the NYT Well Blog about 20 healthy foods for under $1.  Use this as your shopping list and give Haymarket a try.  It’s easily accessible by MBTA or, if you’re driving, by taking the Government Center exit from I-93.

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Commonwealth Wellness Fund: Paying for Prevention

Posted by:
Commissioner John Auerbach, Department of Public Health

 

As you may have seen, Governor Patrick today announced his budget proposal for Fiscal Year 2010 which, along with several other initiatives, seeks to maintain core public services during a fiscal climate that we are quickly running out of adjectives to describe.

There is no getting around some of those understated descriptors  -- challenging, difficult, painful --  and you’ll find a lot of them in the Governor’s message to the residents.  But I was also struck by the word “opportunity” which was also part of the Governor’s announcement.  Opportunity is sometimes tough to see in a period of what can best be described as government retrenchment, but one such opportunity was the announcement of a proposed Commonwealth Wellness Fund.

The Governor today proposed that we lift the sales tax exemption on alcoholic beverages, candy and sweetened beverages.  There are plenty of reasons why this is good for public health.  Overweight and obesity are serious public health problems in Massachusetts.  More than half of our adults and one-third of the middle and high school students are either overweight or obese.  As a consequence, the percentage of adults in Massachusetts with type 2 diabetes has nearly doubled.  One way to address that problem is to reduce the consumption of high calorie foods without nutritional value, such as candy and soda.  Removing the tax exemption for these foods is an important step in discouraging their consumption, and adds a consistent public policy component to the many other elements announced as part of our groundbreaking Mass In Motion initiative.  In removing this exemption, Massachusetts will join seventeen other states that have refused to subsidize certain non-nutritious food.

And, while Massachusetts has done a good job addressing the problem of underage drinking, the Commonwealth still ranks as one of the states with the highest rates of underage drinking and adult binge drinking.  Youth, in particular, are very sensitive to even small price increases.  We believe that ending this exemption will help decrease underage drinking and frequency of use.  It may also delay the first use of alcohol for some teenagers.  Studies suggest that the likelihood of alcohol problems in adulthood increase with early-age drinking.

In any year, the proposal for a Commonwealth Wellness Fund would be considered a bold and innovative approach to serious public health problems.  But this year, there is an added reason why it’s a good idea; it’s imperative.  The Department of Public Health, like every other state agency, has undergone significant budget cuts already and will lose more funding from the state budget next year.  This current year, we’ve lost $30 million in funding, and the current economic crisis means that we will have to cut $40 million more next fiscal year.

The proposal for a Commonwealth Wellness Fund makes a statement.  It says that prevention  --  which is the core of what public health does  --  is important and in a tanking economy we need to find a way to pay for it.  Massachusetts has always been a leader in innovation in health care and public health.  The revenue generated for the Commonwealth Wellness Fund will support core public health activities, such as addiction and tobacco control services, health and wellness promotion, and violence prevention.  It will also support programs that seek to expand our health care workforce, which is critically important to the continued success of Health Care Reform.

The proposal will no doubt be controversial  --  all new ideas for revenue usually are.  But, if we believe that public health is important, if we believe that helping to prevent illness and injury is a better course than paying for costly care after people become sick, then we should support the Governor’s proposal.

In my thirty years in public health, I have never seen such dire times.  And, I’ve never been more convinced about the need for strong public health leadership.  Public health problems usually get worse during economic downturns, not better.  The Commonwealth Wellness Fund is not a cure for all that ails us, but it is an important step in stopping the bleeding of important public health services.  On the economic battlefield that we’re operating on, that’s called progress

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Walking (Hiking, Sledding, etc.) in a Winter Wonderland

Posted by:
Maya Mohan, Department of Public Health

 

Maya is the Physical Activity Coordinator for DPH, and a pretty good ice skater.

We’ve all heard that being active is good for you.  And, I’m guessing that you know about the good things it can do for you.  It helps you maintain a healthy weight. It makes your bones and muscles stronger. It lowers your chances of getting heart disease, diabetes and some kinds of cancer.  It can make you happier and smarter, and feel better about yourself. 

Many doctors even say that if exercise came in a pill, they’d prescribe it to all of their patients.  But you know what?  Knowing all this is just not enough to get us off the couch and moving.   And, that’s in the good weather!  When it’s nice out, it’s much easier to be active.  But, what are we to do in the awful weather we’ve had lately? 

Here are a few of my ideas on some fun things to do this winter (that also happen to be active… it’s a nice bonus, don’t you think?).

Eating Healthy on a Budget

Posted by:
Kara Ryan, Department of Public Health 

 

Kara is a Nutrition Education Specialist at DPH.

We all do our best to provide our families with good food.  But it can be tough to get what you need and still stick to your budget— and it may seem impossible to eat “healthy” on a budget. It takes some extra planning, but eating healthier doesn’t have to cost more.  

Here’s some tips that can help stretch your food dollars:

• Make your shopping list ahead of time. This may sounds really basic, but lots of people don’t take this simple step.  Making a list prevents you from buying the foods you don’t need.
• Look for store ads and coupons and join your store’s discount card program.
• Eat something before you go. Shopping while you’re hungry can tempt you to buy things you don’t need.
• Shop around the edges of the store first.  That’s where the healthier (and cheaper) food is.  The more costly, processed food is usually in the middle.
• Buy fresh fruits and vegetable in season, or check out the frozen vegetable section to see what is on sale.  Canned fruits and vegetables can also save you money (just make sure they don’t have too much sodium).  Fresh, frozen or canned—they’re all good for you!
• Choose store brands.  They usually cost less.
• Single serving snacks cost more (and are full of preservatives). Buy some re-sealable snack bags, and make your own single serving snacks like trail mix or peanut butter and crackers (whole wheat!).
• Lastly, try doubling up your recipes and freezing half for another meal.

Need assistance?

• If you are pregnant or have a child under the age of 5, contact WIC to see if they can help you.
• Contact your local school to find out if your children qualify for a reduced or free lunch and breakfast.
• Contact your local town about elderly feeding program, or ask if your church has a food pantry.
• You might also want to look into Food Stamps or contact Project Bread to find out about other resources in your area.

Following these tips can help you to eat healthy on a budget, and it can even help your waistline.  Do you have other tips? We’d love to hear about them.

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The Hungry Half-Hour: Getting Your Kids to Snack Healthy before Dinner

Posted by:
Dr. Lauren Smith, Department of Public Health

Lauren Smith is a pediatrician, the Medical Director for the Department of Public Health, and the mother of 3.

Dinner time, Monday through Friday, is my least favorite time of the day— well really it’s the 30 minutes leading up to dinner time.  That’s because after picking up my kids from their after-school programs, I only have about 30 minutes before we all turn into a heap of  hungry, grouchy people. 

Any parent who has thrown themselves between snack food and hungry kids, knows that can be a very tough task.  Keeping the kids from raiding the cabinets for something to tide them over is really hard .  Sometimes I just get worn down and give in.  And the fact that I’m hungry, and want to grab a snack myself, makes things even harder.  Usually, I am stopped because I know that telling them “you can’t have a snack because it would spoil your dinner” while I eat whatever I can get my hands on just won’t fly.  

Knowing that this pre-dinner period can get in the way of my good intentions to encourage healthy eating, I came up with some ways that we could get through it with our moods and healthy (relatively) diets intact.  I noticed my kids tend to grab the first thing they see, so if I put some carrot sticks, apple slices or small chunks of cheese on the counter, they grab those and run off as if they pulled one over on me.  If I can get them to help me fix dinner, they can munch on those things while helping. These “snacks” essentially become part of dinner instead of interfering with it.  This plan is not always foolproof. But, instead of setting my sights on “the perfect healthy snack” I focus on them being healthier (or at least less unhealthy).  And that makes me feel like we are moving in the right direction.

I'd love to hear about your plan for getting your kids to eat healthier snacks.  Tell us what works for you!

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What You Can Expect From This Blog

Posted by:
Tom Lyons, Department of Public Health

Hi everyone – just wanted to write a quick post about what you can expect from the blogging that we’ll be doing about Mass In Motion.  This blog will be great for guiding you to certain sections of the web site that supports this effort.   Our web site has tips for how you can eat better and move more at home and at work.  If you’re looking to start a workplace wellness program, or for information to help create a healthier community, we also can help with that.  

And, as the Commissioner said in his first post, we’ll soon have a calendar function that you can submit a listing for.  Our calendar will be a great place for some free advertising for health and wellness events that you’re organizing in your community (thousands of people per day visit the Mass.gov portal).  So if you’ve got upcoming activities that will get people eating better or moving more send us an email at dphcommunication@state.ma.us. 

We’ll also use posts as a news round-up of sorts to share interesting, and relevant, stories that we come across.   Sometimes the stories might be about this campaign, like today’s editorial in the Boston Globe, or Saturday’s page one story in the Metrowest Daily News (and yes, even this  op/ed piece in Sunday’s Globe – don’t worry, Jeff, we’re not looking to take away your Freedom Fries).  Other times, we will link you to stories pulled from various health blogs;  here’s an interesting one from the NY Times’ Well blog that talks about the 11 healthy foods that you aren’t eating

We’ll also provide you tips from our own DPH experts in nutrition and physical activity, and post written, audio and video content from guest experts as well.

Have any ideas of how we can make this blog useful to you?  Let us know.  We’re listening.

Weighing in on BMI

Posted by:
Commissioner John Auerbach, Department of Public Health

We have had a few comments about the proposed BMI regulations.  Some of the writers raise concerns that I thought might be best addressed in a clarifying post.  

It may come as a surprise to some that all public schools have been legally required -for some years- to measure the height and weight of students in grades K-12.  The school nurses either do this measurement themselves, or they use the information on height and weight sent in by pediatricians.

Using the height and weight measurements that are already taken, school nurses will now calculate students’ BMI.  This process doesn’t involve the students themselves.  It is done with a computer program or a desk calculator.

The notification of the BMI results for each child will be sent home to their parents in a confidential manner via the mail— not given to the child to deliver to the parents.  And the regulation will set guidelines for presenting the information in a sensitive and supportive manner.  We will work with the Massachusetts Chapter of the Academy of Pediatrics and the Massachusetts School Nurse Organization to develop these guidelines and the model packets.  So no parent need worry that their child will be teased as a result of the process.  

And parents will be informed that the BMI information collected on students is intended to be a screening tool and not a diagnosis of under or overweight.  The information being sent home to parents is meant to facilitate a dialogue between parents and their primary care provider.  We will also let parents know of available state and/or local resources to address any questions or concerns they may have.  It is not meant to tell parents their child is "fat".

Finally, parents have the right to decline their child's participation in the screening. 

I hope this helps to answer some of the concerns that we have heard.  This blog will be a real asset to the Department.  It provides a wonderful vehicle for us to hear from you and to respond more directly to address your concerns.  We will continue to monitor the comments on this issue and provide other posts as needed.

Welcome to Mass in Motion!

Posted by:
Commissioner John Auerbach, Department of Public Health

Welcome to the Massachusetts Department of Public Health's Mass In Motion website.  Today we are delighted to unveil this website and the accompanying components of the first comprehensive and multi-faceted campaign to reduce the state’s trends toward overweight and obesity and to decrease the risk of chronic diseases like diabetes among the residents of the Commonwealth.

This initiative incorporates a wide variety of proven approaches: from  menu labeling at chain restaurants to workforce wellness activities; from school-based healthy meal programs to broad community mobilizations that will change the modes of transportation and access to supermarkets and farmers' markets.  No single step is by itself sufficient to combat the epidemic of obesity and its surprising twin, malnutrition, and all their accompanying health risks.  Instead we need multiple overlapping efforts that will create the supportive environment we need to promote healthy eating habits and physical activity.

We begin this campaign in the midst of a serious economic downturn. Some might wonder if this makes sense as money is tighter for everyone.  Our answer is that this is the exact time we need this kind of endeavor.  In fact, Mass in Motion was designed with the new economic realities in mind.  How?  Well, first of all, the lower your income the more likely that you will be both overweight and undernourished—the seeming contradiction that occurs when the cheapest and most accessible foods are the ones with the highest amount of calories and saturated fat.  At a time of recession, more people are likely to be eating poorly, not exercising, and gaining weight. 

This effort is also timely because our state is in the midst of implementing invaluable but costly health care reform, and rapidly expanding the number of people who have health insurance.  For the long-term viability of such an ambitious goal, we need to keep the cost of health care under control.  The very best and most cost-effective way to do that is to promote good health rather than treat diseases like diabetes and heart disease that our new program can stop in their tracks.  One might even think of Mass in Motion as the ideal type of cost containment.

Over the coming weeks and months you will see lots of new elements of our campaign.  For example, on this web site we will soon have a calendar of local community wellness events, so you'll be able to find out what is happening in your own neighborhood.  And soon we will be releasing a grant program to funds 10 cities and towns to mobilize all municipal departments to work in sync to create conditions where the default behavior is a healthy one. 

Please join us in this effort.  Check this web site regularly for the latest information, videos and updates. Investigate what you can do in your home, your children's schools, your workplace, and your community to promote your and your loved ones' health.  We need your help to maximize the effectiveness of this undertaking.  You may think that a small, beginning step is all that is possible at the moment.  Go ahead and take it! We know from experience that it is often the small, steady and supported steps that make the difference in changing the patterns that develop over decades.  Our Mass in Motion is designed to help you take those steps, and more, by changing the environment and the policies that affect us as all.