Largely preventable health conditions hamper U.S.

For a person accustomed to grim health data, one prediction still tends to be jarring:

The current generation of American children may be the first not to live as long as their parents.

Much of this projection is linked to the increase in health conditions such as obesity.

These medical deficits in the U.S. health system were highlighted Thursday at an Atlanta conference and in national media reports.

Tyler Norris, a senior adviser on Total Health at Kaiser Permanente, cited the life expectancy warning as he spoke to an Atlanta audience about the burden of obesity and diabetes.

Kaiser is one of the sponsors of the upcoming HBO documentary “The Weight of the Nation,’’ in which experts such as the CDC director, Dr. Thomas Frieden, talk about the urgency of addressing the obesity problem. (Here’s a link to the trailer.)
More than two-thirds of adults in the U.S. are overweight or obese.

Of course, it’s partly what Americans eat. Many people consume too many ‘’cheap, empty calories,’’ Norris told the Connections conference, sponsored by Healthcare Georgia Foundation.

Lack of exercise and the increase in sedentary jobs are other major factors contributing to obesity.

Norris presented several ideas to reduce to the problem, including providing more biking and walking routes; promoting breastfeeding; and serving better food in school cafeterias.

In Georgia, state officials are readying a major obesity initiative, which will join other programs under way. The state’s children have the second-highest obesity rate in the nation.

Meanwhile, the New York Times and USA Today published articles in Thursday’s editions on a report comparing countries on premature births. The report found the U.S. faring poorly –- similar to developing countries —  and trailing Western European and Scandinavian countries and Japan.

Factors driving up the U.S. rate include the number of older women having babies; higher use of fertility drugs, which raise the risk of multiple births; and increased rates of medically unnecessary Caesarean deliveries and inductions “done at the convenience of the doctor or mother,” Christopher Howson of the March of Dimes said in USA Today.

Prevention is needed, such as improving health care access, bringing down rates of smoking, and reducing unnecessary C-sections and inductions, Howson said.

The Times points out that U.S. hospitals have great success in saving premature infants. Still, high rates of premature birth are a main reason the United States has higher infant mortality than many other rich countries.

Data from The Trust for America’s Health show that Georgia is fourth-highest among states for preterm births, and fifth in infant mortality.

Another speaker at the Atlanta conference underscored the role that health disparities and inequalities play in the quality of care and costs that the U.S. system incurs.

African-Americans have twice the infant mortality rates as whites, noted Brian Smedley, director of the Health Policy Institute of the Joint Center for Political and Economic Studies, a Washington think tank.

Minorities also have lower life expectancy, Smedley said.

These disparities are costly. Thirty percent of direct medical spending for African-Americans, Asian-Americans and Hispanics are excess costs due to health inequalities, Smedley said.

A big part of the problem is geography. Many cities have communities residentially segregated by ethnicity. High-poverty segregated communities,  Smedley said, tend to exclude people from good schools, housing, transportation and jobs.

Black and Latino neighborhoods have fewer parks and green space, and fewer gyms, recreational centers and swimming pools, he said. They have more so-called food deserts, areas high in fast-food businesses and low in those that offer more nutritious fare.

These disparities play out in health status. New Orleans, Smedley noted, has two neighborhoods that have widely differing life expectancies: 55 years in one, 80 in another.

Such health gaps may get wider, he said.

Smedley cited initiatives that can help narrow these gaps, including enhancing housing mobility; encouraging business development in distressed communities; expanding public transportation to high-job areas; bolstering preschool programs; improving schools; and reducing financial barriers to higher education.

Families that move out of distressed areas report better health, less stress and mental health problems, Smedley said.

Still, socioeconomic status is not the only factor that matters, Smedley said. Minorities receive a lower quality of care, even when income and insurance status are taken into account, he said. “Race still makes a difference.’’