What do you do in your leisure time? If you’re like many adults in Southeastern Ohio, you might answer with some form of sedentary activity.

According to a recent study by the Centers for Disease Control and Prevention, American adults who live in parts of Appalachia and the South are the least likely to be physically active in their free time. And, once those numbers are compared to other CDC data for these areas, a bigger — and bleaker — picture forms. These regions also have the highest rates of diagnosed diabetes and obesity, which is hardly breaking news to the region’s health community.

“We had suspected this several years ago,” said Frank Schwartz, director of the Appalachian Rural Health Institute Diabetes Center operated out of the Ohio University College of Osteopathic Medicine. “The major issue becomes an effort to answer the question, ‘Why is that, and what are we going to do about it?’”

The CDC study, which utilized self-reported data from random-digit-dialed telephone surveys, revealed that just over 25 percent of U.S. adults don’t spend any free time being physically active. This includes activities like walking, gardening, golfing or running. Specifically in Southeast Ohio, an average of 27 percent of the adult population in area counties (Athens, Meigs, Hocking, Morgan, Vinton, Washington and Perry) reported sedentary activities during leisure time.

Unsurprisingly, many of those same adults are considered obese. About 30 percent of area adults are obese. Physical inactivity and obesity are two of several factors linked to type 2 diabetes, according to the CDC. An average of 10 percent of area adults have been diagnosed with the disease.

Addressing all of these issues is complex, Schwartz said. It’s not just a matter of deciding to be healthier, it involves things like economics and culture. Several local organizations, like Live Healthy Appalachia and Community Food Initiatives, have made it their missions to address some of the region’s barriers — something there seems to be no shortage of.

“This winter, I had three patients that one night were living in their cars,” Schwartz said. “How can you worry about long-term preventative care when you’re worried about a place to live? With the increase in homelessness, the budget crisis and all the infrastructural support systems facing cuts, it makes it even worse.”

To help reverse a shortage of diabetes specialists, Schwartz is working with OU to establish a diabetes training certification program for allied health professionals (social workers, physical therapists, molecular biologists) and for nurse practitioners. The goal is to create a curriculum, possibly as soon as next year, that will form a community of experts in diabetes care. With help from a recent record donation to the College of Osteopathic Medicine, nearly $20 million will go toward the construction of a new diabetes center on the Athens campus. The 40,000-square-foot facility, which is expected to be complete by 2016, will provide new faculty, support and research.

The Health Policy Institute of Ohio, a Columbus-based non-partisan think tank that helps legislators make better-informed decisions when it comes to health policy, and the Athens City-County Health Department are working together on a project that tackles one of the biggest challenges in public health — adequate funding.

“It’s hard to make that initial investment in health,” said Ruth Dudding, the health department’s certified health education specialist who has been working directly with the policy institute. ”But whether it’s time, energy or resources, most people find there is return on investment when health is a priority.”

With support from a grant from the CDC and the National Network of Public Health Institutes, the health department and policy institute are developing a program, using evidence-based recommendations, to address physical inactivity in Nelsonville, in one of the regions with the highest risk for chronic illness. Studies have shown that if people at a higher risk of developing type 2 diabetes were to get at least 150 minutes per week of moderate physical activity, like a brisk walk, and lose around 6 percent of their body weight, they could decrease their risk by nearly 60 percent, according to the CDC.

Lisa Frazier, research specialist with the Health Policy Institute of Ohio and leader for this experiment, said the project is addressing existing barriers to healthier lifestyles by partnering with Perform Best Fitness, a private business located on Columbus Road. This is a first-of-its-kind experiment for the institute and the state. The goal is to ultimately create community investment in health programs. This key study could have implications well beyond Athens County. The funding will be used to subsidize the cost of the fitness classes and education programs. Their hope is to take down the financial and distance barriers to becoming physically active and promote it as a lifestyle change.

“Athens County is a unique place where a lot of people care very deeply about the people here and the families here,” Dudding said. “I think we will see changes here. And I think Athens County will become a model for change.”

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