Two years ago, a co-worker at the Alaska Department of Health and Social Services decided she didn't want to weigh over 200 pounds anymore. She thought the weight didn't feel or look good. More important, she realized it was robbing her of her health. It was killing her.
So she did her homework. She searched the Internet to figure out how many calories she should eat each day to lose weight at a healthy pace. She shrank the portions on her plate. She cut out the three cans of soda she was drinking every day.
These simple strategies paid off. She's lost almost 100 pounds. No expensive spas. No extreme dieting. And no Type 2 diabetes, perhaps the most costly complication of obesity.
That's an amazing accomplishment, but she took it one step further this fall. My co-worker quit smoking. This can be a difficult lifestyle change. I know. Almost 30 years ago, I quit using smokeless tobacco after seeing the devastation it caused my patients.
What many of us have done -- take charge of our nutrition and weight, and stop tobacco use -- draws attention to two important health priorities for Alaska.
This week is National Public Health Week, and Alaska's leading public health problems are easy to diagnose. Cancer and heart disease strike a one-two punch as Alaska's top killers.
A century ago, infectious diseases were the primary causes of disability and death. Thanks to public health measures such as immunizations, smallpox, measles and typhoid are not part of our daily lives.
Today, the primary and preventable causes of disability and death are tobacco use and obesity. Tobacco kills more than 500 Alaskans every year. But it is not a quick or painless death; tobacco devastates lives through disfiguring surgeries and illnesses that prevent people from earning a living and having a good quality of life. And it is costly: In 2007, tobacco- related illnesses cost Alaskans $314 million in direct medical expenditures.
Almost two out of every three adults in Alaska are overweight or obese. Extra weight comes with extra risk for high blood pressure and diabetes -- major contributors to heart disease -- as well as some types of cancer and other health problems.
Obesity costs all of us. In 2008, Type 2 diabetes alone accounted for $45 million in excess Medicaid expenditures in Alaska. About 1 in 10 diabetic Alaskans is unable to work -- more than four times the measure of lost productivity than among those without diabetes.
There are no easy answers to these challenges to our health and economy. The role of government in reducing health-care costs and addressing personal health is the subject of ongoing debate. People don't need or want to be preached at or told to do what they really don't want to do. Yet most smokers report that they want to quit, and many people at risk of diabetes want to be healthy and able to work.
Alaska has built a comprehensive and sustained tobacco prevention program with local and tribal health partners. Declines in adult smoking since 1996 represent some $300 million in averted medical expenses.
We are learning from this successful model to reduce obesity in Alaska. The state has been working with the Anchorage School District to address obesity among students with some success, demonstrating the potential for making a difference when all stakeholders work together. We need to approach obesity from many angles. We need to improve nutrition and opportunities for physical activity in each community. We need to work with teachers and school nurses to implement health and physical education programs that create lifelong healthy habits.
Health-care costs now account for more than 16 percent of the gross domestic product. These are really disease-care costs; less than 5 percent goes to maintaining health. The costs of poor health are amplified in an unhealthy economy.
Investing in prevention will pay dividends and is critical to achieving real health reform. This is an investment that we cannot afford to miss. But there is more at stake than just money. As a doctor, I know that all these numbers represent the well-being of real Alaskans -- perhaps you, me or someone we love.
Dr. Jay Butler is the Chief Medical Officer for the state of Alaska.
By DR. JAY BUTLER