In late March, Gov. Patrick Morrisey stood with Health and Human Services Secretary Robert F. Kennedy Jr. and declared, “The Make America Healthy Again movement starts right here in West Virginia.”
“We’re cleaning up our foods, promoting exercise and putting nutrition back into SNAP,” the governor said. “I’m committed to Secretary Kennedy’s vision for America and raising health standards here in the Mountain State.”
As part of his efforts, Morrisey committed to walking a mile a day, and he asked other West Virginians to join him for the “Mountaineer Mile.”
He’s also promoted efforts, such as prohibiting SNAP recipients from using their food stamps to pay for soda.
But if state officials truly want to be successful, they could also enact policies public health experts recommended nearly a decade ago, as part of a 2016 state obesity plan.
They could also turn to the state’s Physical Activity Plan, first released in 2015 and then revised.
Drawing from the two reports and insights from researchers and community leaders, here are five ways the state can help West Virginians live healthier, longer lives.
1. Let local people lead
Both reports suggest supporting and funding the efforts of local organizers, because different communities have individualized needs.
When West Virginia University and other partners began working on the Healthy Harrison project to make citizens of the county healthier, they were focused on well work sites.
But local organizers saw more need in schools and pivoted. Now, all students in Harrison County have access to a web-based program, where they set their own wellness goals.
Participating kids choose to set goals in three categories: mind, move and eat.
“The move goal can be as soon as you get home from school, you’re going to put on your tennis shoes,” said John Paul Nardelli, executive director of the nonprofit program.
They’ve noticed that more kids have become interested in the program over time. He said with government funding, they could expand to other schools.
Bethany Gibbs, chair of West Virginia University’s School of Public Health Department of Epidemiology and Biostatistics, noted that those in rural areas might prefer different kinds of programs than those in the city. For example, people in a city might want sidewalks.
Those in a rural area might prefer hiking clubs to have better security on trails or a fitness class at a local school.
She suggested that state officials let local people take the lead by offering seed funds, matching grants or grant writing training.
“The same solution is not going to work for every community,” she said.
According to Gailyn Markham, a spokesperson for the Department of Health, since the 2016 report, state officials have been collaborating with local groups on some community projects, such as the installation of walking trails across the state.
2. Increase kids’ access to healthy food and activity
Healthier food options, such as community gardens at schools, are among the recommendations of health experts like Elizabeth Claydon, associate professor in the WVU School of Public Health Department of Social & Behavioral Sciences.
State officials also made that recommendation in the 2016 report.
Claydon said while schools require some healthier foods in vending machines, all available options should be nutritious.
The state had already undertaken projects like health education courses, subsidized farmers markets and farm-to-table projects at schools, which were recommended in the 2016 report.
But federal officials recently cut funding for farm-to-table projects at schools and kids’ free farmers market and health education programs. The state could find other ways to fund these programs.
“Getting kids excited about different foods, and having that access to different foods is really important at that young age, so they can see the different options, and they can experience what it’s like to grow their own food,” Claydon said.
Legislators could also mandate that kids have twenty minutes of recess daily, a Centers for Disease Control and Prevention recommendation.
School policies could be revamped to expose kids to outdoor activities like walking on trails that they could continue for the rest of their lives.
3. Support and promote breastfeeding and nutrition education for mothers
Breastfeeding is associated with lower risk of childhood obesity, possibly due to hormones and the higher protein content in breastmilk than is present in formula.
Lawmakers could enact policies that encourage breastfeeding. Measures could include a law requiring lactation rooms in state buildings, training for health care providers on the benefits of breastfeeding and paid medical/family leave.
Claydon advocates for more prenatal and postnatal education, including help for people with eating disorders.
Mothers with disordered eating are more likely to have overweight children.
“When a fetus is in utero, it relies on the mom to provide all the nutrition,” she said. “And so when a mother is malnourished, and that could be because of an eating disorder, it could be because of poverty, then the genes of the fetus can actually change in response to that malnourished environment.”
4. Treat weight management as a health issue
Insurance providers aren’t consistent when it comes to the types of weight counseling they offer.
Lawmakers could require health insurers to pay for three or more sessions of diabetes management education and wellness programs for the general public.
“You cannot learn how to eat healthy in three to four hours,” said Ranjita Misra, professor emeritus of the WVU School of Public Health.
Health care providers could also participate in state-supported weight management and anti-stigma training.
Dr. Jamie Jeffrey, vice president of the West Virginia chapter of the American Academy of Pediatrics, noted that obesity is a chronic disease.
“But most lay folks, our patients, our community, the people that live next door to us and our professional providers still see obesity as an adjective,” she said. “And that is wrong.”
Researchers also noted that people need education in their communities when they leave providers’ offices, like healthy cooking classes, church-based fitness groups and public education.
5. Educate the public
Misra said patients are bombarded with inaccurate information about wellness online. She suggested health officials and other experts design a statewide education, unified campaign with experts across the state, which includes social media posts.
She said they likely aren’t turning to state government websites for health information.
“Social media is a powerful information channel, but it has become a powerful disinformation channel too,” she said.
And in person, local leaders who people already trust, such as faith leaders, would be best suited to be trained to help educate, she said.
Materials could include information about the definition of nutritious food, places to engage in physical activity and reducing risk of chronic disease.
Claydon, who studies weight stigma, said focus on healthy behaviors is more likely to result in wellness than emphasis on weight.
“Having policies, creating healthy communities, creating a healthy relationship with food and body at a young age, all of those things help,” she said. “Shame and stigma never do.”
