One in 12 Americans has diabetes, according to the Centers for Disease Control and Prevention, and the human and financial costs of this growing epidemic are devastating. Diabetes is the leading cause of blindness, non-traumatic lower-limb amputation, and kidney failure. In addition, two-thirds of people with diabetes will die from cardiovascular disease or stroke. The rising prevalence of diabetes is fueling increases in healthcare expenditures and insurance premiums, costing $18 billion each year in California alone.  

Rates of diabetes are highest and have risen the most rapidly among people of color and in lower-income communities. In California, 15 percent of Native Americans/ Alaska Natives, 10% of African Americans, and 8 percent of Latinos have diabetes compared to 6% of Caucasians. Diabetes prevalence is 8.4 percent among adults living in lower-income communities compared to 5.8 percent among adults in higher-income communities.

The number of Americans with diabetes increased by 15 percent in two years to 24 million, according to the Centers for Disease Control and Prevention. About 8 percent of the population now has the disease, mainly Type 2 diabetes, which is linked to obesity and sedentary living, the agency said in a report using data from 2007. A quarter of people ages 60 and older had diabetes, the agency said. The number of people worldwide with diabetes will double to 366 million by 2030, according to the World Health Organization, which calls the disease an epidemic. Most people with diabetes have resistance to insulin, which the body uses to convert blood sugar to energy. The C.D.C. report was its first update of the prevalence of diabetes since 2005, when it reported that about 21 million Americans had the disease. — New York Times

Healthy eating can reduce the incidence of obesity and diabetes, and local food environments influence the options available to individuals and families. A recent study demonstrates that people who live near an abundance of fast-food restaurants and convenience stores, compared to grocery stores and fresh produce vendors, have a significantly higher prevalence of obesity and diabetes. To help reduce the prevalence of diabetes, federal, state, and local lawmakers are urged to enact public policies to make healthy foods more readily available.

Bad, unsurprising news of the day: The number of Americans with diabetes rose to 24 million last year, according to new CDC estimates. It’s bad for obvious reasons; it’s unsurprising because the disease disproportionately affects the obese and the elderly, whose numbers are growing.The new figures represent an increase of three million over two years. One small piece of good news: The percentage of diabetics unaware they have the disease fell to 25% from 30% during the period, the CDC said. Awareness is key because good management can reduce diabetes-related risks such as heart attacks and strokes.Huge racial and ethnic disparities persist in diabetes rates. Nearly 12% of black Americans have diabetes, compared with 10.4% of Hispanics and 6.6% of whites. — Wall Street Journal

The tool at walkscore.com has been touted by hipsters, realtors, and advocates alike for its usefulness in calculating how “walkable” a neighborhood is. The basic premise is that a high walk score indicates a good neighborhood because of its proximity (in walking distance) to grocery stores, restaurants, shops and other amenities. I agree wholly with the site that “buying a house in a walkable neighborhood is good for your health and good for the environment.”

However, there’s a significant challenge with this tool.

The walk score tabulation does not distinguish between grocery stores and liquor stores, nor does it recognize a full-service restaurant separate from a fast-food joint.

Yes, my North Oakland (Calif.) community gets a promising score of 75 out of 100–technically “very walkable.” But let me tell you, my neighborhood is rife with liquor stores—six in a half mile radius–and a KFC, Carl’s Jr. and McDonald’s are within blocks of each other and me. In fact, I’d have to walk at least 20 minutes to a full-service grocery store or produce market.

Using the Retail Food Environment Index (RFEI) recently highlighted in the PolicyLink “Designed for Disease” report, I fall into the 28 percent of California adults who can’t even calculate how bad their food environment is because my home falls into the dismal category of having absolutely no access to produce or fresh food in walking distance.

The people at WalkScore do recognize the and highlight the positive health effects of living in a walkable neighborhood– and the limitations their data sets put on the score accuracy of a particular neighborhood. Most of the problems do seem to come from the way Google Maps organizes its data, rather than anything that WalkScore is doing.

The potential of this tool to highlight inequities is quite high. While no doubt cool, this tool needs a bit of a redesign to get to a neighborhood’s true “walkability.”

Check it out yourself (this is the map around our PolicyLink headquarters in downtown Oakland–apparently a “walker’s paradise”) :

For decades, advocates have been spinning their wheels trying to reduce health disparities. Health-care is a necessary but insufficient weapon in this battle, leading many to pursue environmental or place-based approaches to promoting health such as increasing access to healthy foods, improving air quality, and contributing to land use planning.

Now, lawyers across the country are joining this pursuit. A Boston hospital is using lawyers to demand accountability and fight for healthier living conditions for poor families. In Los Angeles, organizers are helping tenants living in unhealthy housing find legal counsel and press landlords to improve their rental properties. Strategies such as these are gaining traction and have been shown to reduce illness as well as time spent in a clinic or hospital for those who can least afford to be there.

Check out the embed player below for a recent story on Marketplace about the practice:

[MP3]

Below is an excerpt from a post I wrote for the Robert Wood Johnson Foundation’s Commission to Build a Healthier America Leadership Blog. To read the full post, click here.

The type of community we live in clearly has a tremendous impact on our health. That is why I am so excited and inspired to be a part of the Robert Wood Johnson Foundation’s Commission to Build a Healthier America. By shining a light on the way our economic, social, and physical environments affect our health, the commission is helping to expand our national discussion on health beyond just health care.

Those key environmental effects are never more clear than in the neighborhoods loaded with unhealthier food options. In an era when we are acutely aware of the effect of our diets on our overall health, we are leaving millions of Americans adrift in neighborhoods where healthy eating is next to impossible. For many people, food “choices” are really nothing of the sort. People must first have a broad and healthy set of food options in order to be able to make healthy choices.

To learn more about the Commission and its mission, visit www.CommissionOnHealth.org

With food prices climbing and the economy on shaky legs, more and more Americans are taking the food security of their families and their communities into their own hands.

An insightful piece in today’s NY Times (”Urban Farmers’ Crops Go from Vacant Lot to Market“) shows how innovative residents of low-income communities are using training from local nonprofits and even some funding from city coffers to help kick-start urban farms.

I know that these urban farms have really helped invigorate my neighborhood of Bedford-Stuyvesant in Brooklyn. In fact, a 60-person delegation from the UN Commission on Sustainable Development is coming this weekend to Bed-Stuy to visit a couple community gardens, like the Bed-Stuy Farm (photo from their site).

Also, it’s worth pointing out that the Times’ story was written by Tracie McMillan, one of the best and most tenacious reporters when it comes to issues of food access and low-income communities. Visit her site to check out some of her recent work.

The Kern County, California, NBC station has a great piece on the report PolicyLink released yesterday about the connection between your food environment and your risk for diabetes and obesity. The report, Designed for Disease (pdf), was a joint project from PolicyLink, the California Center for Public Health Advocacy and UCLA’s Center for Health Policy Research.

To see how other media outlets like the LA Times, PRI’s Marketplace and the Sacramento Bee covered the study, click here.

Are our food options making us sick? According to a new report released today by PolicyLink, the balance of healthy-versus-unhealthy retail food options in your neighborhood is directly tied to your risk for diabetes and obesity.

The groundbreaking study, Designed for Disease: the Link Between Local Food Environments and Obesity and Diabetes, was released jointly with the UCLA Center for Health Policy Research and the California Center for Public Health Advocacy. It examines the correlation between the health of nearly 40,000 Californians and the mix of retail food outlets near their homes.

The key finding: people living in neighborhoods crowded with fast-food and convenience stores but relatively few grocery or produce outlets are at significantly higher risk of suffering from obesity and diabetes.

The findings are the latest in a growing batch of evidence that the obesity epidemic is at a crisis level. As PolicyLink Vice President of Research Victor Rubin said for the release of the new report:

“Clearly the obesity crisis in California can no longer be seen only as a fight over personal choices. Public policies drive the universe of food options from which we can choose. Families who live in communities with choices limited to high-calorie foods and beverages face substantially greater health risks. Policy makers at the state and local level can save lives by giving Californians healthier food options.”

The results lend even more weight to a recent USA Today lead editorial, which argued that the obesity epidemic is literally killing Americans at a younger and younger age — and disproportionately targeting poor Americans.

Everyone knows how to lose weight: exercise more and eat less, fatty foods in particular. But fast food, eaten on the run and in vast quantities, has too often replaced the leisurely sit-down dinners with healthier foods of years past. Further, obesity is increasing worldwide, and among the poor more than the affluent. Broad social changes underlie the trend, and so it will not be easily reversed. But where it is worst, among the poor, better access to preventive health care plainly is part of the answer.

A century ago, poorer Americans were more likely to have their lives shortened by hunger and malnutrition. It would be a tragic irony if the obesity epidemic has a similarly devastating and unequal impact.

The editorial builds off the stunning findings of this Harvard University report.

For more information on how to help build healthier communities, visit the PolicyLink Center for Health and Place. Also, check out a great blog about this subject from the Grassroots Leadership Network.