IBJOpinion

HARTON: Our environment provides another path to better health

Tom Harton
April 24, 2010
Back to TopCommentsE-mailPrintBookmark and Share

Tom HartonNews flash: Our bad habits are contributing to the growing cost of health care.

On any given day, you can read or watch numerous reports on the topic. Almost as regularly, there are accounts of insurance companies or others with a stake in our collective health launching, expanding or otherwise singing the praises of a wellness program. Such programs have been around since the 1970s. At a cost of billions of dollars annually, they are meant to help us identify our health problems before they become serious and to encourage us to modify our harmful behaviors.

These are worthy goals. No doubt about it. And there is a return on the investment. One recent study showed that medical costs fall more than $3 for every $1 spent on wellness programs. But something doesn’t add up. Overall, the cost of care isn’t falling and our bad habits aren’t going away. Trying to change behaviors one person at a time isn’t working well as a stand-alone strategy. The war for good health needs to be waged on a broader front—one that changes our surroundings, not just our minds.

What we need is a ground offensive—literally. Our built environment—the streets, sidewalks, buildings and other improvements that surround us—is getting more and more attention for the role it plays in obesity, diabetes, respiratory ailments—even mental health disorders.

We’ve abandoned the village, both urban and rural, that societies have embraced since the beginning of time. Over the last 70 years or so, we’ve built a nation of wide roads, narrow or non-existent sidewalks, and long distances that have trapped us in our cars and isolated us in our homes. The (fat) bottom line is that we spend a lot more time sitting than we do moving around. We are connected with the world via the Internet, but separated from physical activity and our neighbors by pavement, metal and glass.

Academics and public health advocates are awakening to the problem. But the concept of improving health by improving our built environment remains far removed from the mainstream. Why else would we continue spending millions to change individual behaviors while largely ignoring what drives those behaviors?

WellPoint spent $564 million last year on wellness and associated programs—a mere 1 percent of the premiums it collects, but still a big number. Yet there is not a single representative from WellPoint or any other insurance company on the board of an important local organization you’ve probably never heard of: The Alliance for Health Promotion.

The alliance is a 25-year-old not-for-profit that grew out of the Marion County Health Department. Its 4-year-old signature initiative—Health by Design—tries to build awareness of the connection between design and good health and promotes policy changes aimed at improving the built environment.

Health by Design could become the city’s biggest ally in battling poor health by literally changing the landscape, but it limps along on a county-funded budget of $125,000 a year and one full-time employee, Executive Director Kim Irwin. It does boast 200 community partners—many of them professional associations and groups like the Hoosier Environmental Council. Irwin says those partners sometimes fund specific initiatives, but they don’t pay dues.

In spite of its meager funding and skeleton staff, Health by Design is mixing it up in the halls of power. Its Complete Streets legislation in this year’s General Assembly would have dictated that road projects accommodate all users—not just cars and trucks. The bill passed the House in watered-down form but didn’t get a hearing in the Senate. It was opposed by the Indiana Department of Transportation.

It’s puzzling that a community—a country—full of smart people who are trying to rein in health care costs can’t get fully behind public policy changes that would improve our health. Alternative transportation, zoning changes and incentives for urban infill development would all contribute to denser, walkable communities where exercise is a way of life, not an entry on someone’s to-do list.

Those changes wouldn’t be free, but they’d be cheaper in the long run than what we’re relying on today—teaching people from now until the end of time how to live healthy in a sick environment and hoping they comply.•

__________

Harton is editor of IBJ. His column appears monthly. To comment on this column, send e-mail to tharton@ibj.com.

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT

facebook - twitter on Facebook & Twitter

Follow on TwitterFollow IBJ on Facebook:
Follow on TwitterFollow IBJ's Tweets on these topics:
 
Subscribe to IBJ
  1. I am a Lyft driver who is a licensed CDL professional driver. ALL Lyft drivers take pride in providing quality service to the Indianapolis and surrounding areas, and we take the safety of our passengers and the public seriously.(passengers are required to put seat belts on when they get in our cars) We do go through background checks, driving records are checked as are the personal cars we drive, (these are OUR private cars we use) Unlike taxi cabs and their drivers Lyft (and yes Uber) provide passengers with a clean car inside and out, a friendly and courteous driver, and who is dressed appropriately and is groomed appropriately. I go so far as to offer mints, candy and/or small bottle of water to the my customers. It's a mutual respect between driver and passenger. With Best Regards

  2. to be the big fish in the little pond of IRL midwest racin' when yer up against Racin' Gardner

  3. In the first sentance "As a resident of one of these new Carmel Apartments the issue the local governments need to discuss are build quality & price." need a way to edit

  4. As a resident of one of these new Carmel Apartments the issue the local governments need to discuss is build quality & price. First none of these places is worth $1100 for a one bedroom. Downtown Carmel or Keystone at the Crossing in Indy. It doesn't matter. All require you to get in your car to get just about anywhere you need to go. I'm in one of the Carmel apartments now where after just 2.5 short years one of the kitchen cabinet doors is crooked and lawn and property maintenance seems to be lacking my old Indianapolis apartment which cost $300 less. This is one of the new star apartments. As they keep building throughout the area "deals" will start popping up creating shoppers. If your property is falling apart after year 3 what will it look like after year 5 or 10??? Why would one stay here if they could move to a new Broad Ripple in 2 to 3 years or another part of the Far Northside?? The complexes aren't going to let the "poor" move in without local permission so that's not that problem, but it the occupancy rate drops suddenly because the "Young" people moved back to Indy then look out.

  5. Why are you so concerned about Ace hardware? I don't understand why anyone goes there! Every time ive gone in the past, they don't have what I need and I end up going to the big box stores. I understand the service aspect and that they try to be helpful but if they are going to survive I think they might need to carry more specialty parts.

ADVERTISEMENT