"The Healthiest Community" by Allen Weiss, MD, MBA, President & CEO

The Healthiest Community

June 15th, 2013 - Imagine living in a community where the life expectancy was 10 years longer than predicted—a Mecca for health, quality of life, and well-being.

Around the world today there are recognized communities known as “Blue Zones” where folks live well and long. Lower incidences of cancer, heart disease, and mental deterioration are common threads.

Collier County already has some of these characteristics, objectively verified by independent outside sources:

  • Longest life expectancy in the U.S. for a woman—85.8 years
  • 2nd longest life expectancy for a man—80.7 years (Marin County, California on the other side of the Golden Gate Bridge from San Francisco is better by 0.8 of a year.)
  • 5th lowest rate of obesity, according to the Gallup organization (Boulder, Colorado is first, probably with a much younger population.)
  • Ranking in the past four years as 1st, 1st, 4th and now 3rd healthiest county of the 67 counties in Florida, according the Robert Wood Johnson Foundation’s study conducted by the University of Wisconsin
  • Among the lowest cardiac mortality in the nation, presumably due to the NCH Save-a-Heart program instituted in 2000

With these wonderful yet objective findings, we should both congratulate ourselves and also ask, What can and should we be doing to improve our quality of life? How can we become a Blue Zone?

Dan Buettner, National Geographic writer and author of The Blue Zones, uses evidence-based practices gleaned from groups and cultures which have been successful in living longer, healthier, and better lives. Southwest Florida has many of the attributes and resources to move from a good position to a great leader in our country—and the world, I believe.

Where should we start? Diet and exercise are two keys to prevention, so much more effective than repair.

Concerning diet, Americans eat on average the equivalent of 22 teaspoons of sugar per day, according to the book Salt, Sugar, and Fat: How the Food Giants Hooked Us by Michael Moss. Most of this sugar we consume comes embedded in the food we eat, the majority of which is processed or in liquid form. Nationally, we have become so accustomed to sweetness that our brains reset our taste buds to crave higher levels.

Babies like sweet tastes, which is probably very reasonable because babies need calories to support their rapid growth. However, as we grow up, we get more and more accustomed to sweeter and sweeter foods. As a result, our set point or “bliss point” increases, causing us to desire more sugar or its equivalent. Liquid forms of sweetness—namely, soft drinks—are particularly habituating because the body cannot easily discern when we have had enough. Decreasing the consumption of sugar decreases the incidence of diabetes.

Salt, similar in our overuse, is potentially noxious. Interestingly, entire countries have been able to “cure” their salt habit, and thus we can learn from others. A case in point is Finland, whose citizens were consuming two teaspoons per day of salt on average. This over- consumption led to an epidemic of heart attacks and strokes. By decreasing the consumption of salt by one third, the rate of heart attacks and strokes dropped 80%.

Lowering our salt consumption will be a challenge because we have a set point for salt which is similar to sugar. Lowering our salt by just a half teaspoon per day would decrease heart attacks by 11%.

Reducing fat is another huge opportunity. Fat content gives food what is known as “mouth feel,” making food taste attractive. Just think about how rich ice cream melts in our mouths; that is the sensation of mouth feel. Food chemists have the ability to create similar pleasurable sensations with low-fat foods, which would help lower our cholesterol and triglycerides. Reversing heart disease and obesity should create enough motivation for all of us who desire to live in a community known for longer lives.

Many restaurants are placing calorie counts on menu items. Preparing foods at home, avoiding pre-packaged foods, using spices instead of salt, and having fresh fruit as a dessert are some common-sense approaches that would make long-term contributions to our health.

Exercising by walking for 30 minutes a day decreases the chances of a heart attack by at least 50%. Exercise helps prevent mental deterioration, increases a sense of well being, and helps burn calories. What a concept! Although starting is hard for most people, exercise can easily become a positive addiction once past the first few months of a diligent routine.

The endorphins that are released when exercising (known as a “runner’s high”) stimulate the brain’s receptors in a positive manner and give a sense of comfort and pleasure. Many people, me included, have creative thoughts, solve troubling problems, and feel generally better after a good session of exercise. I have said many times, “This could be better than Psychiatry—and less expensive!”

Can we as a community create enough walking paths so everyone feels comfortable taking a daily stroll? Our county has a wonderful and varied park system; yet many of our attributes are underutilized. We have a climate which encourages year-round outdoor exercise. Even in the summer months, early and late in the day the sun is not direct and the temperature is tolerable. The rest of the year, with the right gear, you can be outdoors all but a few days.

Smoking cessation is another enormous opportunity. Tragically, about 19% of Americans continue smoking, with more and younger inner-city teenagers getting hooked. By having employers hire only non-smokers (as NCH did almost three years ago), the rates go down. NCH is now down to fewer than 11% smokers, and those folks were “grandfathered” in. The simple truth: stop smoking, and you add an average of 10 years to your life.

Physicians across the country are down to a smoking rate of 4% and nurses to 15%. Banning smoking in the public, as other countries have already done, would help. Having all employers hire only non-smokers would quickly change our standards for the better. Smoking is a difficult habituation, no doubt. But we need to take a stand so that we don’t continue to encourage addiction of the young.

Population health is a concept whose time has come to Collier County. The aim of improving the health of an entire population is not unrealistic, particularly when we have the awareness, education, collaboration, ability, and motivation to change. Economic health and population health are two sides of the same coin. The view that our region’s commerce is intimately connected with our sense of well-being is both insightful and progressive.

Adding useful, happy, and healthy years to our lives is a real possibility as a community. We have most of the building blocks in place.

Collaborating with our community leaders in providing educational resources to motivate everyone—from citizens of all ages to employers of all sizes—to improve our quality of life is a big long-term goal.

Using our existing, attractive environment for year-round outdoor activities together with focus on sensible diet and smoking cessation would make Southwest Florida the perfect place for starting a journey to become the next “Blue Zone.”

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.