Shortly after Fayette County qualified in 2004 for one of 40 Centers for Disease Control fitness and wellness nationwide grants, Kelly Loomis attended a PTA meeting to encourage support for the program.
The topic was healthy eating. When Loomis recommended substituting whole-grain bread for white bread at family meals, a parent protested.
"I was startled," said Loomis, the coordinator of HealthierPA-Fayette. "I couldn't imagine why a parent wouldn't want their children to eat healthy foods. It took a little while to digest it."
Loomis realized the CDC program -- its goal was to prevent or manage risk factors for heart disease, stroke, diabetes, cancer, obesity and arthritis -- had come to a watershed moment.
"We were focused on schools and children," Loomis said. "We thought we could start with young people. But this showed we had to look to parents as well as children."
From then on, the focus became more holistic. "It's about changing the behavior of an entire community," said Loomis, a 32-year-old nutritionist.
That was nearly a million dollars and five years ago. In the meantime, there have been some slight changes for the better. Fayette County's youth obesity rate has held steady at 31 percent while there has been a slight percentage decrease, 69.7 to 66.7, in obesity in the population as a whole.
The statistics for diabetes also offer a glimmer of hope, with the average number of days spent in the hospital for diabetes-related causes was 5.7, down from 6.1 in 2003.
"It's not much, and some people wouldn't think it's a gain at all," Loomis said. "I'm optimistic. It's been a slow process, but I think -- with prevention measures and partnerships in place -- we're on the right track."
The CDC thinks so, too. The agency included the county in its follow-up to Steps to a Healthier USA, a program known as Achieve, which kicks off this summer in 43 communities nationwide.
No one expects the task to be easy. Then-Surgeon General Richard H. Carmona summed up the challenge locally and nationally in 2003: "Benjamin Franklin was absolutely right back in the 1700s. An ounce of prevention is worth a pound of cure. But more than 200 years later, prevention is still a radical concept to most Americans."
High disease rates
CDC and Fayette County have developed a bond over the last five years.
The federal agency first recognized Fayette County in 2004 for its Steps to a Healthier USA program. One of two designated communities in the nation, Fayette was selected because of its higher-than-average rates for obesity, diabetes and heart disease.
The county had an advantage when it came to CDC funding: a strong tradition of community organizations led, in this case, by the Fayette Community Health Improvement Partnership, an offshoot of a state Department of Health initiative.
According to Walter Vincinelly, superintendent of Albert Gallatin School District, both the state and CDC made a fortunate decision.
"Steps (Fayette) came along just at the right time," Vincinelly said. "(Loomis) has been a tremendous asset for us."
Under the gun to switch to healthier cafeteria foods and to upgrade vending machine offerings, the school district was implementing solutions to its problem.
"I'm not saying we wouldn't have gotten where we are today without (Loomis). But I do think it would have taken longer," Vincinelly said. "She was able to pull all of these elements together. The (school's) Health and Wellness Committee took off after she came on board."
Healthier Fayette has been active with employers, encouraging companies, for instance, to allow workers to take exercise breaks. More than a dozen firms signed up. Loomis and her staff of two encouraged communities as diverse as Masontown and Uniontown's East End to form committees to promote fitness and wellness activities.
Monica Vinluan, a program director for YMCA-USA, said it was these kinds of successes that spurred the Y, one of four national nonprofits partnering with the CDC on Achieve, to select Fayette as one of its 10 designated communities for 2009.
Community involvement
The Achieve program differs from Steps in one important aspect.
While Steps was focused on narrow, self-contained measures, such as working with one school district at a time to substitute fruit drinks for soft drinks in vending machines, Achieve has a broader agenda. According to Vinluan, it intends to skip across institutional barriers to encompass whole communities. In short, Vinluan said, Achieve will attempt "systemwide" changes.
Richard Roman, CDC's associate director of healthier community programming, said the Achieve goal remains the same as Steps' -- to reduce the incidence of diseases that are impacted by physical activity and healthy eating -- but with a difference structure: a 10-member panel of community decision-makers who will develop a wellness-fitness assessment and a plan of action.
The panel members will be drawn from private businesses, the nonprofit sector and government. Loomis said an example would be a county-wide decision to compel residential developers to install sidewalks because studies show that sidewalks encourage walking and exercise.
Steps volunteer Patty Tobal has witnessed action at the community level.
Tobal, of Hopwood, a village on Old Route 40 at the foot of Summit Mountain, said Loomis helped to energize an existing community group into expanding its health and wellness activities. First came new sidewalks, then signage directing walkers on a stroll through the historic community. Hopwood was the first of several communities to host a walkers' night out. More than 125 people turned out, far more than anyone expected.
Roman said the new format will not diminish the physical exercise and nutrition-awareness programming that Loomis has been working toward for five years. CDC figures the programming will remain in place and possibly be expanded.
"What we want with Achieve is to see if we can get a bigger bang for our buck," Roman said.
Roman admits the agency is moving into uncharted territory and wants communities "to think out of the box."
Achieve communities will need to prioritize, because Congress is expected to fund the five-year undertaking one year at a time. Roman said the Fayette program likely will receive $75,000 the first year.
This troubles Jim Towey, president of St. Vincent College, who recently served on a Robert Wood Johnson Foundation Commission that studied healthy-living choices and concluded that "to build a healthier America, it's essential to put improving health front and center on the national agenda."
But that goal is not achievable, Towey said, as long as the government shortchanges such programs while directing money and attention to health insurance reform. Less than 4 cents of every health-care dollar spent is devoted to prevention and public health, the CDC has estimated.
"Americans are in serious denial. What's required is a massive education program," Towey said.
Towey blamed the lack of action on Capitol Hill. "There is no political clout on the wellness and prevention side," he said. To see more of the Tribune-Review or to subscribe to the newspaper, go to http://www.pittsburghlive.com/x/tribunereview/. Copyright (c) 2009, Tribune-Review, Greensburg, Pa. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
Copyright (C) 2009, Tribune-Review, Greensburg, Pa.