The Vermont Department of Health has solicited public input on the goals of Healthy Vermonters 2020. Here’s our complementary take, introducing an approach to removing the largest barrier to health in Vermont. (Our full input can be found here: Our comments on Healthy Vermonters 2020.)
OVERVIEW Obesity is the most pressing health issue we face today. The cure is known: healthy diets and daily exercise. The question is how to deliver the cure.
We propose a public transportation system built around walking and biking as the key measure to lowering the obesity rate in Vermont, including for youth.
The Vermont health system must provide access to health for all Vermonters, which means removing barriers to health. For obesity, this includes removing barriers to physical activity. The primary barrier to physical activity is our built environment.
Currently, our transportation systems and neighborhoods are designed around cars, not people.
The Centers for Disease Control estimate that in 2006 the national medical cost of obesity was about $150 billion per year. When a portion of the indirect costs of obesity are included (e.g., absenteeism), the figure for that same time period was over $700 million just for Vermont, according to the Vermont Legislative Research Service, and rising.
Public health, or preventive care, is critical to keeping people healthy and out of the doctor’s office, and reducing overall system costs, but historically it has been under-funded and under-valued in the United States. Without a significant enough investment in meaningful infrastructure and policy changes, individual communities — making incremental change by providing some safe bikepaths and sidewalks, and some public transit routes — cannot provide enough resources to transform an entire transportation system and make access to healthy transportation available to all, to allow all Vermonters the freedom to travel in a safe and healthy manner.
The Vermont Greenprint initiative takes a page from the Oregon playbook, and would likewise negotiate with Medicaid for large-scale upfront investment. In Oregon, $1.9 billion will go to cover care for Medicaid recipients. In Vermont’s case the vast majority of the investment would go to physical infrastructure.
In Vermont, investment on this scale in real prevention through infrastructure offers a bold, innovative, and transformative way to break through the historical impasse with a system that will actually address the biggest killer of young people in Vermont — motor vehicle accidents — and a major contributor to obesity —inactivity. The model would integrate the statewide medical system, slated to enter a “single payer” model, with a transportation system that finally addresses the biggest challenge our medical system faces: obesity.
- Obesity is the #1 health threat facing Vermonters. Obesity rates are on the rise, and it’s already the #2 “real killer” after tobacco.
- Motor vehicle accidents are the #1 killer of Vermonters ages 5-35.
- Since 1950, Vermont’s population has increased by about 70% while auto vehicle registrations have increased by almost 500%.
- Motor vehicles are the #1 contributor to Vermont’s climate pollution.
Our full input to Healthy Vermonters 2020 can be found here: Our Comments on Healthy Vermonters 2020 (pdf).
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