On the eve of one of America’s most indulgent holiday feasts, the state’s surgeon general paid a visit to Franklin County to promote healthy weight.
Dr. John H. Armstrong, a Tampa trauma surgeon who was appointed surgeon general in April 2012 by Gov. Rick Scott, made an enthusiastic pitch to students Nov. 26 on behalf of the state’s Healthiest Weight Florida initiative, launched in January 2013.
“A snap of the fingers isn’t going to solve this problem,” said Armstrong, after ticking off a series of alarming statistics of how fat Floridians have become in the last couple decades.
“It will take an investment over a decade,” he said. “It’s the sum of small choices that will really make a difference.”
Armstrong paid an afternoon visit to the Franklin County School, escorted by Franklin County Health Department Administrator Marsha Lindeman, and Operations Manager David Walker. As state surgeon general, Armstrong oversees Florida’s 67 county health departments, as well as offices for Children’s Medical Services, Medical Quality Assurance, Disability Determinations and public health laboratories.
Senior Bria Walker introduced Armstrong to an audience in the media center of her fellow members of the school’s chapter of SWAT (Students Working Against Tobacco).
Armstrong opened his subject of weight loss by congratulating the students on their work against tobacco, and recounting his own experience of getting his dad to quit smoking.
“Tobacco kills. Tobacco cuts life short,” he said, and then told how he was in first grade when the U.S. Surgeon General’s report on the dangers of smoking first came out.
“I took the message home,” said Armstrong, now in his early 50s. “Dad was a smoker, he smoked a lot.”
Armstrong said he reveled in retelling the dangers of smoking at the dinner table (“A new danger every day”) and even went so far as to flush his dad’s cigarettes down the toilet, a step he did not recommend to the students.
The upshot of the story was that Armstrong’s father quit smoking cold turkey, and he has had no signs of the cancer and heart disease that often afflict smokers.
Armstrong said his dad recently mentioned “out of the blue” how his children helped him to quit smoking. “It told us how important kids are in getting messages home that matter,” said Armstrong.
“There’s another challenge we face that’s cutting lives short, the challenge of weight,” continued the surgeon general.
He said statistics statewide indicate that only about one-third of Floridians are at healthy weight. One quarter are obese, and the rest are overweight. Based on his current trend, by 2030, almost 60 percent of the state’s residents will be obese.
“Six of 10 students will be overweight or obese by the time they graduate high school,” Armstrong said.
While he did not elaborate on the economics, the state’s website notes that the costs of care for chronic diseases from obesity alone - diabetes, heart disease, high blood pressure, and arthritis - are estimated to be $34 billion over the next 17 years. It says that over the next 20 years in Florida, obesity could contribute to 2.4 million new cases of type 2 diabetes 6.2 million new cases of heart disease and stroke, 5.3 million new cases of hypertension, 3.3 million new cases of arthritis, and nearly one million new cases of obesity-related cancer.
Armstrong, a Princeton grad who completed medical school at the University of Virginia in 1988, said that when he became a doctor 25 years ago, 10 to 12 percent of his colleagues had a challenge with their weight. “Now, 33 percent are obese,” Armstrong said.
He said the state’s initiative is designed to encourage Floridians to make choices of their time and energy that favor weight loss.
“Adults on average spend four-and-one-half hours a day in front of the television screen,” he said. “The problem with being inactive is that your body remembers, slowly.
“How can we reshape environments?” he asked. “We can do it if we recognize we can support each other to make healthy choices. We’re working with communities to reshape what is the norm.”
Armstrong said cultural change can have a dramatic impact, noting that in the 1960s, eight out of 10 men smoked cigarettes, and today it is nowhere near as prevalent.
The state’s Healthiest Weight initiative covers a variety of priorities, including boosting the practice of breastfeeding, promoting improved nutrition and physical activity in early care and education as well as for students during the school day and after school programs, ensuring all foods and beverages in schools meet or exceed dietary guidelines, increasing access to high-quality, affordable foods, and promoting health professional awareness and counseling of patient body mass index (See inset box).
Armstrong boiled down the priorities for students to three basic steps: To substitute water for sugary sodas and other drinks, to substitute “Fresh from Florida” fruits and vegetables for processed cereals at breakfast and chips at lunch; and to increase physical activities by taking stairs instead of elevators, and going for walks.
He even took a moment to show off the pedometer that he wears on his belt. ““You begin to think differently when you’re in motion,” he said.
“I know it sounds really old-fashioned but it’s the old fashioned that’s going to work,” he said. “We’re not too busy. We’re making different choices. I urge you to take this message home to your parents.”
In response to questions from the audience, Armstrong took a dim view of the new fad of electronic cigarettes, which he described as “nicotine-delivering devices.
“That’s a dangerous drug that contributes to blood vessel disease,” he said. “I believe it’s been introduced to hook people on nicotine.”
Following a small reception in which fruits and vegetables were served, Armstrong and the health department officials headed for a tour of the school’s dental clinic, where the surgeon general met the staff.
At the legislative delegation hearing Monday evening, Lindeman told State Sen. Bill Montford (D-Tallahassee) and State Rep. Halsey Beshears (R-Monticello) that the clinic has served 461 patients since it opened, 366 of them age 17 or younger, and provided a total of 3,200 services.
“We're still struggling a little bit filling the schedule with our Medicaid population,” she said. “The need is larger than is accessing it right now. Access is contributing to the lack of use. We thought the doors would blow open when we opened the clinic and they have not.
“It’s the only one like it in the state,” said Lindeman. “We are talking right now about how to get more services. We’re looking at additional funding or to open more chairs in Apalachicola.”
She said that in addition to the Medicaid population, “we’ll take any child, regardless of the ability to pay.”
Montford responded that “if you have it available to them, it may be a question of fear of the dentist. Rep. Beshears and I have that as a priority of ours.”