My Hawaii Monitor column this week at Civil Beat (“Hawaii Monitor: Let’s Tackle the Public Policies Promoting Obesity“) was a result of my participation in a recent panel put together by the folks who have organized the two “Value of Hawaii” volumes.
I was very impressed by the presentation made by Dr. Keawe’aimoku Kaholokula, chair of the Department of Native Hawaiian Health at the UH Medical School. I learned a new word in the process–“obesogenic,” referring in this case to social and environmental factors which promote obesity.
Kaholokula traced several types of research that have been identifying those environmental factors. We’re all recognizing that obesity is a condition that has huge collective costs, yet we tend to look at it as a problem of individual choice.
“Before focusing on lifestyle choices, we have to give people those choices,” Kaholokula said. “People don’t choose to be unhealthy and die early. They are forced into early death by economic and environmental circumstances.”
In any case, beginning to conceptualize obesity as more than a collection of individual lifestyle choices seems to me very important, as it allows us to begin to identify social policies that can contribute to alleviating this crisis.
I suggested a few, but obviously this is fertile ground for planning.
The city and state could be upgrading recreational and park facilities in underserved neighborhoods to eliminate ethnic and income differentials. And how about safer sidewalks and streets to make walking more inviting? Could zoning regulations prohibit fast food outlets from opening near schools, just as we regulate other kinds of businesses? How about tax breaks for grocery stores that operate in neighborhoods that otherwise lack access to fresh fruits and vegetables? Do schools in your neighborhood offer an hour of physical activity to students daily, as called for by the Institute of Medicine, or are those programs victims of budget cuts?
I’m afraid the column didn’t get much traction from readers. It’s just not as sexy a topic as the latest political maneuvering. Too bad. It’s a pretty vital issue.
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Little doubt about the relationship of open space and the general health of a community. In Kaka’ako there are few new neighbor parks and open spaces planned despite an increase of 30,0000 residents projected through 2030. The loophole is that each condo provides private recreation space for its own residents and that alleviates the need for open space for the public at large. Clearly a sweetheart deal for developers who otherwise would have to buy and develop true public facilities. Long term, this does not augur well.
Whoops, I forgot the link I wanted to offer. Here is an interesting look at the obesity issue from McKinsey:
http://www.mckinsey.com/Insights/Economic_Studies/How_the_world_could_better_fight_obesity
I have a lot of skepticism about any justification for a “Department of Native Hawaiian Health at the UH Medical School” other than the fact that they can get gobs of federal and philanthropic grants for allegedly studying our favorite minority. As we know, nearly every “Native Hawaiian” has other ethnicities in his ancestry, and most of them actually have most of their ancestry from elsewhere. So whatever troubles the Department of Native Hawaiian Health is studying could also, and perhaps primarily, be attributed to other ethnic groups. That applies whether we’re discussing genetic troubles or social/economic troubles.
“Studies” showing that “Native Hawaiians” have the worst statistics for all bad things have a fundamental flaw because they allocate one full tally mark to “Native Hawaiian” whenever anyone with even a smidgen of Hawaiian ancestry has the bad thing, and they do NOT attribute a tally mark to any of the other ethnicities that are components of that person’s ancestry. The correct way to do the “studies” would be to allocate 1/8 of a victimhood tally mark to “Native Hawaiian” diabetes if a diabetes victim has 1/8 Hawaiian ancestry, and 1/2 of a tally mark to “Chinese” ancestry if the victim has 1/2 Chinese ancestry, and 3/8 to Caucasian if the victim is 3/8 Caucasian. But such fractional tally marks are never done, because (a) It is politically incorrect to ask a “Native Hawaiian” for the percentages of his ancestry; and (b) Doing data analysis the right way would probably show that ethnic Hawaiians are no worse off than other groups, and that would make it hard for the Department of Native Hawaiian Health to keep getting grants to sustain its staffing level.
It’s interesting that every suggestion Ian makes in this blog entry, such as prohibiting fast food outlets near schools, or increasing exercise in schools, or making fresh fruits and vegetables more easily available in low income neighborhoods — all those suggestions have been made regarding populations on the mainland, and especially regarding African-Americans — they are not in any way specially tailored to or based on ethnic Hawaiians.
HCDA and their developer cronies have been doing everything possible in their power to eliminate any open space for all the thousands of units being built. I really hope these heartless folks are shown the door quickly with the new Guv.
Poor Kakaako. After 30 years of inadequate sewers and storm drains, crazy driving conditions, all ignored by HCDA, and suddenly its density shoots off the charts, but only along Ala Moana Blvd. and the “rail”. What about the rest of Kakaako? And, as Richard Gozinya points out, where are the “new neighbor parks and open spaces “? A school, public pool, playground, walking path, skateboard park – no, nothing positive added, even for the new high rise residents. Retail rents will be sky high, I guarantee you. We WILL, however, have a Whole Foods Grocery store, high end boutiques and accessory shops. But no corner produce stores, bakery, or other neighborhood shops which make older communities so livable and interesting. And healthier. Ultimately, many of our young never to be-millionaires will live sandwiched in between Ala Moana Blvd.’s Million $$ high-rises and those along Kapiolani Blvd. And their health? Who has even thought about that. There will be no reasonably priced grocery store, no neighborhood parks for the kids baseball team (drive to somewhere else), no aquatics teams, no masters swimmers, no playgrounds, no soul. Sorry I ramble. and watch this slow motion disaster.