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Hall County tips the scales
Community health is linked to our personal well-being, local experts say
Eating fruits and vegetables is one way to lose and keep weight off, experts say, like peaches from Phillip Echols’ stand at the downtown farmers market on the square. Echols and his daughter April Simpson, center, sell peaches Friday to Priscilla McKinnon, center right, and her daughter Martha, who often coaches her mother on healthy eating and exercise, Priscilla McKinnon said. - photo by NAT GURLEY

Local health care experts are concerned the nation’s growing obesity problem will affect more than just individual health but the health of the community as a whole.

A study released earlier this year by the Healthcare Initiative Consortium, a subset of The Greater Hall County Chamber of Commerce’s Vision 2030, suggested the local problem is much worse than many realize.

The study found that between 75 and 80 percent of adults in Hall County are overweight or obese.

Gale Starich, dean of the college of health and science at Brenau University and researcher in the study, said the purpose behind the study is to collect baseline data so researchers will be able to see how and if community health initiatives help improve community health overall.

The study pulled data from nearly 22,000 adult patients who received health screenings at Health Smart, North Georgia Physicians Group Primary Care Clinic at the Hall County Health Department, The Longstreet Clinic Adult Primary Care Practices and Good News Clinics in 2011. The study sorted patient data into insured and uninsured categories and analyzed how many patients suffered from co-morbidity diseases like diabetes and hypertension.

“We’re actually kind of an interesting community in that we’re trying to work on health issues in our community,” Starich said. “When you’re trying to develop health issues like the Healthsmart (expo) and farmers markets and more safe places for walking and those kinds of things, you have to have some baseline data to compare against.”

Vision 2030, is a comprehensive plan that addresses quality of life for residents of Gainesville and Hall County that includes improvements in the community’s health. Part of the plan includes creating a culture of wellness, and the consortium aims to get people and businesses more involved in managing health. The plan also calls for providing more walkways in the area so people have more safe opportunities for recreation and exercise.

Starich said the physical health of individuals influences how people perceive the quality of life of the community overall.

“Community health has an impact in terms of just community activities — people taking part in baseball leagues, soccer leagues and fun runs,” Starich said. “One of the things we know about quality of life indicators for communities is that a community’s health turns out to be a really important driver in how folks feel about their community and how they interact.”

The logic is when people don’t feel well or become fatigued by obesity, diseases or pain, they’re less likely to get involved with the various activities of a community simply because they don’t feel up to it.

The expense

Individual finances associated with illness also play a large role in a community’s overall well-being.

Sheenagh King, registered dietitian and bariatric program manager of The Longstreet Clinic Center for Bariatric Surgery, said an obese community will experience a higher rate of disease and more sickness, which will influence overall health care and insurance costs. Obese employees miss time at work due to illness and spend larger portions of their take-home pay on medical treatments and doctor visits.

“The health condition is a very expensive condition,” King said.

Obese people spend $1,400 more on medical costs than people at a healthy weight, according to the Centers for Disease Control and Prevention. In 2008, U.S. medical costs relating to obesity reached up to $147 billion.

Health care professionals are concerned about costs increasing even more if the number of obese people continues to rise.

“In our community, our rate of obesity is higher than the data based on the state average,” King said. “That’s a concern. The study that was done is hard data that is pulled out of medical records.”

According to the CDC, 29.6 percent of adults were obese in 2010.

A person is considered to be overweight if they have a body mass index of 25 or more. Obesity is defined by having a BMI higher than 30. People who are more than 100 pounds overweight are considered morbidly obese.

Being overweight or obese puts a person at risk for a slew of health conditions including hypertension, diabetes, heart disease, stroke and sleep apnea.


Dr. Alex Nguyen, bariatric surgeon and the medical director of Northeast Georgia Physicians Group Bariatric Weight Loss Center, said people tend to think of obesity in overly simple terms.

Nguyen said obesity isn’t always a matter of eating too much and exercising too little. There are often long-standing family habits, plus metabolic and genetic factors at play.

Nguyen said fat cells in the body act as a kind of endocrine organ and produce hormones and cytokines that cause inflammation. That inflammation often brings on more conditions, creating a vicious cycle of obesity and disease.

Obesity’s co-morbidities can become life threatening if they’re uncontrollable or untreated.

“(Obesity) inhibits your metabolism and predisposes you to heart disease, diabetes, metabolic syndrome,” Nguyen said. “The issue with that is that when people allow themselves to deal with all that adipose tissue for so long, that’s when the damage is done. People don’t realize you need to intervene sooner before all these other diseases manifest and it’s uncontrollable.”

While the conditions can usually be controlled with medications, weight loss can essentially cure the diseases and many patients are able to stop taking medications all together.

Traditional weight loss with diet and exercise has been successful and is typically the preferred method for patients and physicians. However, some people find success with bariatric surgery. Patients who have surgery are sometimes able to stop taking diabetes medications within days of their surgery.

“We’ve noticed through observational research that patients who end up losing weight decrease their blood pressure, cholesterol, insulin, glucose intolerance and diabetes,” Dr. Heather Westmoreland, cardiologist with the Northeast Georgia Heart Center, said. “They have a much lower risk of coronary heart disease after losing 100 pounds or so.

Childhood obesity

The consortium plans to take a “community snapshot” every two years and is in the process of analyzing pediatric data to get a clearer idea of how childhood obesity looks in the county.

While the population of obese adults is currently a concern for the health care community, many are worried about what is to come in future generations.

In 2007, Georgia ranked second in the nation for number of obese children. Since that time, several initiatives aimed at educating children about health choices and increasing physical activity have begun throughout the state, like the Georgia SHAPE program.

The Georgia Department of Public Health announced in April the state now ranks at No. 17 in the nation, according to a report by the Data Resource Center for Child and Adolescent Health.

Dr. Chandra Miller, pediatrician at Longstreet, said she hasn’t seen much of a decline in the number of obese children she sees in her practice, but she has noticed a few families making improvements in their health.

“When you see a little improvement you think ‘Yeah, I’ll keep doing what I’m doing because some people are listening and doing it,’” Miller said. “I don’t think we’re as discouraged as we were before.”

While the state’s children have experienced some improvement, health care officials are still concerned and working to improve overall health in children.

“The problem with childhood obesity is more and more kids are growing up obese,” Nguyen said. “Sixty percent of those kids will be obese adults. It’s just a fact. The problem is, I think, a lack of education for teachers and parents.”

King said in order to save lives, the obesity problem needs to be addressed in “all different areas” and hopes an increase in education will prevent the younger generation from a short life of poor health.

“The stats on childhood obesity are alarming,” King said. “It’s not just in our state but in the South of the United States of America. We’re treating the obese population right now, but we have more obesity coming if we don’t do something.”