May 9th, 2008 by Dr. Val Jones in Celebrity Interviews, Health Policy
2 Comments »
This is a continuation of my interview with Mike Huckabee at the National Changing Diabetes Program conference in Washington, DC. In my previous post I asked Mike about his weight loss journey, and in this post I asked him some global questions about healthcare. My regular readers will appreciate that my digital voice recorder did not malfunction during this interview, though I did drop my Blackberry at one point out of sheer enthusiasm. Gov. Huckabee was the first to reach down and help me get it. What a gentleman!
Dr. Val: Your friend, Dr. Fay Boozman, said “We need to stop treating snake bites and start killing snakes.” Tell me what that means in practical terms.
Huckabee: Healthcare in America is reactive and is geared towards intervening in catastrophic situations, when what we should be doing is focusing on preventing them. The whole system is upside down. It’s like we’re focused on putting Humpty Dumpty back together again instead of keeping him from falling off the wall. Our healthcare system is based on a broken egg concept.
So the key thing that we have to change in healthcare is to focus our resources on prevention and a healthy lifestyle.
Dr. Val: You said that your hope was that “‘Healthy Arkansas’ will spread like a highly contagious but benevolent virus that could become the genesis of ‘Healthy America.'” Can you give me a virus update?
Huckabee: We did in fact launch “Healthy America” and it was the most successful Governors’ initiative in that we had more states participate in this than any other NGA (National Governors’ Association) initiative. Forty-three states launched state-based health initiatives for preventive health. Some were more aggressive than others.
We began the initiative because there was a new awareness of the need to change the healthcare model from intervention to prevention. The concept of Healthy America was to influence behaviors at work, at play, at home, and at school. These programs have been remarkably successful. For example, in the first year, the average productivity of state employees increased by $3400/year. And that’s not to mention the savings in healthcare costs. The average diabetic spends 8.3 days/year in the hospital. The cost of those days could pay for 7 years of diabetes counseling and medication. It’s as if the choice is between a new oil filter or a new engine – which do you think is going to be less expensive?
Dr. Val: Revolution Health is attempting to encourage behavior modification through social networking and online, physician-led programs. What do you think are the strengths and limitations of this approach?
Huckabee: First of all the strengths are more dramatic than you may realize. When we used the online approach in Arkansas, we did health risk assessments followed by online coaching for everything from smoking cessation to weight control. Online programs can be very successful because they’re instant and accessible 24 hours/day. The socialization becomes very important because peer pressure can be harnessed to challenge people to walk more steps or lose more pounds than the others in their group.
Online approaches aside, the key to improving health in America is to create an atmosphere of healthy behavior. This cultural change may take a generation to achieve, which is why most politicians don’t touch it. Politicians like to deal with issues that can be dealt with in an election cycle, not a generation.
However, America’s approach to littering, seatbelt laws, smoking, and drunk driving are four examples of real changes we’ve made in this country over time. The changes took place in three stages: attitude change, atmosphere change, then an action is changed.
Attitude change involves giving people information that changes the way they think about an issue. Atmosphere change means making unhealthy behaviors difficult to participate in (like taking away ash trays and putting up a no-smoking sign), and finally the government codifies into law the new behavioral norm.
The government is usually the last player, not the first, because people have to create the behavioral norm before the government can enact laws. If the government tries to mandate a personal habit, then the debate will not be over the merits of the approach, but over the personal liberties of people to do what they want to do. And in America, the government always loses that argument. So what you have to do is get enough Americans believing that taking care of themselves is the right thing to do, and then there will be the demand for government to put that into law.
We don’t have a healthcare crisis in America, we have a health crisis. And if we dealt with the health crisis we would resolve the healthcare crisis. The real reason we’re in trouble is because 80% of the money we spend on healthcare is a result of chronic disease. And that chronic disease is primarily the result of over-eating, under-exercising and smoking. It’s our lifestyle that’s killing us.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 8th, 2008 by Dr. Val Jones in Celebrity Interviews
4 Comments »
I had the exciting opportunity to interview Governor Mike Huckabee at a recent conference for the National Changing Diabetes Program. As most of you know, Mike lost 110 pounds through lifestyle interventions and has kept the weight off for over 5 years.
Since I’m leading a weight loss group, I was inspired to read his new book, “Quit Digging Your Grave with a Knife and Fork.” I really enjoyed his witty and down-to-earth, positive approach to health. If you can imagine Dave Barry and Norman Vincent Peele getting together to talk about weight loss strategies, you’d pretty much have Gov. Huckabee’s book. I highly recommend it.
As for our interview, I’ll split the Q&As into two posts. This first post is about Mike’s personal journey, the second is about his view of healthcare. One thing’s for sure, after meeting Mike Huckabee in person, I can say that I’ve joined the team of folks who wear the “I heart Huckabee” t-shirts. He is a softspoken, kind-hearted, honest man with a quirky sense of humor and a gift for parables and analogies. Enjoy his thoughts below…
Dr. Val: It seems to me that your weight loss journey began the day when you sat in a chair at the State Capitol, and it broke under your weight (in front of a group of government officials). Do you think that successful weight loss usually begins with an “ah-ha moment” like yours?
Huckabee: I don’t think it’s always the case that people have that level of epiphany. Most people who are overweight know it – every time they bend over to tie their shoes and can’t, every time they need a seat belt extender on the airplane, etc. they realize that there’s a problem. Unfortunately, though, their response is often one of helplessness. They believe that they just have to live with their weight problem instead of believing they can do something about it.
Sometimes an epiphany can make people really angry, and cause them to say – “I don’t care what I have to do, I need to change.” Most people have made numerous attempts to lose weight and have tried many different diets, but they don’t understand the real problem. It’s a lifestyle issue, not a program issue. Diets fail because they have a beginning and an end. You’ve got to see this as change not so much of the menu but of your mind. Don’t focus on losing weight – that’s a big mistake. Focus on the things that make you healthy and then the weight takes care of itself. You may never be the skinniest person, but you’re better off healthy than you are skinny.
Sometimes I find that when people make weight loss their goal they lose weight but they’re not healthy because they haven’t done it in a healthy way. They haven’t combined activity with the weight loss. They’ve just starved themselves, and that’s not health.
Your health is like a dashboard. If the only thing you ever look at is your speedometer, and you don’t look at the oil gauge and the water gauge, you can get into serious trouble. You think, “hey, I’m going the speed limit” but that’s not the point. That’s how fast your car’s going, not how well it’s running. Health is the same way – you can’t just focus on weight, you’ve got to look at your cholesterol levels, hemoglobin A1C, blood sugar, and blood pressure as well.
After I broke the chair I went to see my doctor and he ran some tests that confirmed I was a diabetic.
Dr. Val: What did your doctor say to you at that point?
Huckabee: My doctor gave me a talk that changed my life. A lot of doctors simply say, “you’re a diabetic, here’s some medication, try to lose some weight and do some exercise.” But my doctor looked me in the eye and said, “you need to understand that if you don’t make a lifestyle change, you’re in the last decade of your life, and let me describe the decade…”
Quite frankly if he had just said that I was in my last decade I might have said, “Hmm, that’s not good, but you know what? I bet a drug company will solve this problem for me in the next few years. That way I can eat what I want and do what I want and just take a pill and everything will be fine.”
But that’s not what he told me. Instead he told me the truth, and he said “let me describe the decade…” And in great detail my doctor began to explain what diabetes would do to my body, organ by organ – my vision, my extremities, my heart. He made it sound like a slow, lingering death. And right then and there I vowed to come up with a different exit strategy for my life.
I gave up sweets and fried foods and began to exercise. You have to understand that this was a huge turning point for a southern boy. I used to say that exercise is for people who have nothing better to do with their lives than to get on a treadmill and play the role of a hamster. But I became one of those people that I used to make fun of – I’ve already completed four marathons. But most importantly, I haven’t needed any medications in 5 years and my doctor says that it’s as if I never had diabetes at all.
Dr. Val: You wrote, “If you really hate yourself when you’re fat, you’ll also hate yourself when you’re thin.” What did you mean by that?
Huckabee: Well, you have to be honest and tell people that their weight is a reflection of their personality. There is something inside of them that let them get completely out of control. It may have been a feeling of inadequacy, or some guilt – every person is different. But usually something is underlying the weight problem. It may be the fear of not having anything to eat next week. But something has to give a person that reckless abandon. Just because you change the physical aspects of your life, doesn’t mean that your emotional, mental, and spiritual aspects are going to change.
Dr. Val: How do you get to the bottom of what’s driving unhealthy behaviors?
Huckabee: I know that for me it was when I started to ask myself, “why is it that I’m triggered to overeat?” Some of it was childhood memories – it was the comfort that food brought. As a child, the few privileges I had were related to food. So food was always a reward. I received affirmation from dessert and would indulge myself to re-experience those childhood memories. I know that sounds awfully elementary but these things get imprinted on us. When we’re adults and someone is cruel to us or something bad happens, we affirm ourselves with food so that we can feel as if we’re a good person again. But once you come to terms with this, you regain control. You can tell yourself you’re alright and you don’t need food for comfort or affirmation.
**Up next, Mike speaks out about healthcare**This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 30th, 2008 by Dr. Val Jones in Humor
2 Comments »
As my regular readers know, my husband has a really dry sense of humor. Couple that with a kind heart filtered by a data-driven mind and you get some fairly “harsh” sounding statements that are meant well, but come out oh so horribly wrong. I’ve heard that many men have struggled with “foot-in-mouth disease”… and so for you ladies who love them, and men who can relate, this one’s for you.
What not to say when you’re jogging
So, I’m not a natural athlete – but I try really hard to stay in shape and have been working extra hard recently because I’m leading a weight loss group here at Revolution Health. I like being outdoors so I figured that jogging would be the right sort of endeavor for a slightly uncoordinated person like me. Of course, hubby is part-human, part-gazelle, so running is right up his alley. I’m probably more part-human, part-water buffalo (if we stick with the African theme here) so let’s just say it’s a bit harder for me to keep up with hubby. Nonetheless I was brave enough to ask to run with him – I thought it would motivate me as well as get both of us out in nature.
We jogged every other day for a few days together, and I was huffing along doing my very best to keep pace and also not die. Hubby was quiet the entire time until one day he looked down at me thoughtfully and said,
“Have you ever considered doing a sport you’re good at?”
I was flabbergasted. I gave him “the look.”
“Well, I just mean that this is obviously quite difficult for you and you might enjoy something that’s more suited to…”
I looked at him, beet red, sweaty and incredulous. “More suited to WHAT?”
“Well… um… perhaps you’d like to hike?”
“Hike where? All the land around us is flat. Do you mean WALK?”
“Sure, walking might be a good option for you.”
And so ended my jogging routine with hubby. I’m vaguely looking for a running partner who’s more my speed. But perhaps I’ll just default to having my husband walk next to me while I jog?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 25th, 2008 by Dr. Val Jones in Expert Interviews
5 Comments »
In my quest to bring the best possible health advice to the Revolution Health community I am actively pursuing interviews with credible sources. At the top of the list is America’s #1 doctor, the Surgeon General. I recently had the opportunity to sit down with Vice Admiral Richard H. Carmona, M.D., who served as Surgeon General from August 2002 to August 2006. He addressed a range of health issues facing Americans today. I am posting the interview in segments; the following post is part of that series.
Dr. Val: Obesity rates continue to rise each year. Does obesity lie at the core of the chronic disease crisis and if so, what can America do to reverse this trend?
Dr. Carmona: Obesity is absolutely at the core of the chronic disease crisis. When we look at the relationship of obesity to other diseases that plague society today (such as asthma, cancer, cardiovascular disease, and diabetes) obesity increases the incidence of each of them, and can even accelerate some of them. Losing weight is not about trying to emulate models in fashion magazines, it’s about being healthy.
If we could only address one major public health issue as a nation, I would focus on the obesity crisis. Weight loss could have the greatest impact in decreasing the chronic disease burden in America.
Dr. Val: So what can we do about obesity?
Dr. Carmona: That question is simple on the surface but incredibly complex when you begin to analyze it carefully. First of all we have to identify the variables that contribute to this problem, because it’s a multi-factorial issue. The socio-economic determinants of heath are inextricable from the health status of individuals and communities. That means that if you’re poor and have less education, you’re going to experience health disparities. You can’t afford to buy healthy food, you don’t live in a neighborhood where you can walk at night and get exercise, and so on. So understanding all the determinants of health to address obesity is important.
Let me describe just one significant variable contributing to the obesity epidemic: the sedentary lifestyles of children. Thirty years ago it was commonly believed that physical education in school was not important, because kids played during all the hours that they are out of school. Parents reasoned: ‘Why should I pay a teacher to have my kids play ball at recess? I’d rather have her teach them math and science.’ So there was a sweeping trend to discontinue physical education at school. Now, however, kids spend too much time on playstations rather than on play grounds – or they watch over 4 hours of TV a day. They’re sedentary at school and at home.
Other variables that influence obesity rates in kids include the accessibility to fast food, the increased rate of single parenthood, and the change in cultural traditions around meal time. For wealthier families, easy access to large volumes of food of every possible kind can create an environment where people overeat.
The solution to the obesity crisis is not “one-size fits all.” The approach to obesity must be tailored to the cultural and socio-economic sensitivities of the sub-population that you’re trying to reach.
Ultimately we need to change behavior – walk a little more, eat a little less, buy some healthy foods. But targeted interventions must be culturally sensitive and socio-economically relevant. For example, the government is funding programs to make healthy foods more accessible to underserved areas, and physical activity programs are being reinstated in schools. But the effects of these programs are not going to be seen for many years because it takes time for the culture to catch up. Also, the approach must be comprehensive. If we were able to get all of our children enrolled in a daily game of baseball (to increase their physical activity), that would not solve the problem of fast food and video games.
There needs to be a community approach, so that no matter where the child turns they’re getting positive reinforcement of healthy behaviors. That’s part of what I’m doing with the national non-profit health organization that I’m president of now – Canyon Ranch Institute.
***
The Surgeon General series: see what else Dr. Carmona has to say about…
Cost Savings Associated with Preventive Health
Consumer Directed Healthcare and Health Literacy
Complementary and Alternative Medicine
Preventing Chronic DiseaseThis post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 14th, 2008 by Dr. Val Jones in True Stories
4 Comments »
My husband has perfected the art of dry humor. He is very thin and naturally athletic and I tease him a lot because I’m not as thin or naturally athletic (ahem – yeah, I’m jealous). So we have a running joke about him being skinny.
Today I needed to find my sister’s mailing address really quickly, and realized that the only place we had saved it is my husband’s Gmail contacts list. To retrieve them I’d have to use his login and password (which I could guess at, but didn’t really want to do without his permission first). Unfortunately I couldn’t get through to him at work, so I just went ahead and logged in (correctly guessed his password) and retrieved my sister’s address.
I emailed my husband apologizing for hacking into his Gmail account without his permission. This was his response:
“That’s ok. I’m the only skeleton in my closet.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
