The obesity epidemic worldwide and in America has been on the rise for years, and the state of South Carolina is no exception. According to the CDC website, 32.3% of South Carolinians were obese in 2016, while 35.1% were classified as overweight (DNPAO Data). In Charleston County specifically, the top two causes of death are heart disease and cancer (South Carolina County Health Profile, 2019). Obesity is often a comorbidity with both heart disease and cancer as well as other health conditions such as hypertension and diabetes – both of which are prevalent in Charleston. Between 2015-2017, Charleston’s rate of hypertension was 33.7%; of diabetes was 11.7%; of adult obesity was 28.1% (South Carolina County Health Profile, 2019).
Risk factors for obesity include physical inactivity, poor nutrition, genetics, behavior and lifestyle, medical issues, and lack of sleep (Mayo Clinic, 2015). Unfortunately, in 2016 only 25% of South Carolinians reported having parks, playground areas, community centers, sidewalks, or walking paths available in their neighborhood (DNPAO Data). In addition to physical inactivity, poor nutrition plays a huge role in an unhealthy lifestyle and risk for obesity and related diseases.
High rates of consumption of processed foods increases the likelihood of becoming obese (Mayo Clinic, 2015). Having access to healthy foods and being able to afford them is critical for leading a healthy life. When people cannot afford or access healthy food, they simply will not eat it. The food environment index measures the level of a healthy food environment, with 0 being the worst and 10 being the best. Charleston’s food environment index of 7.5 indicates room for improvement.
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The increasing rate of obesity is a pressing issue in the United States as well as in Charleston county. Promotion of healthy eating and active living are necessary. Cities nationwide are creating policies to fight against the obesity epidemic and to promote a healthier lifestyle that includes good nutrition and physical activity. An example of policy in this realm can be seen in Palm Springs, California.
The resolution was brought forth to encourage safe and healthy cities that are designed strategically to promote healthful behaviors of its citizens. This includes adopting city designs that support more walking and biking rather than motorized transportation. It also includes the encouragement of local food production, partnering with the local Healthy Eating and Active Living Network, and advocating all policies and projects in place. The city of Palm Springs has a staff that is responsible for constructing parks, neighborhoods, streets, and business areas that supports the use of non-motorized transportation and promotes physical activity.
The staff is also responsible for establishing new grocery stores, community gardens, and farmer’s markets in order to increase the access of healthy foods. There is a need for strategic city planning to see an increase in physical activity; there is a need for better access to healthy foods to see an increase in healthy eating. Adopting policies to support these foci will help to combat the obesity epidemic in Charleston.
The CDC website explains three different strategies for building a healthy food environment. The first is to provide full nutrition information in restaurants; the second is to have nutritional standards in child care facilities, schools, and hospitals. The third, which could be extremely impactful in Charleston, is to “provide incentives for supermarkets or farmers’ markets to establish their businesses in underserved areas” (Healthy Food Environments, 2018). Food deserts exist in rural areas and cities when grocery stores and fresh food markets don’t reach certain neighborhoods.
Instead of low-income areas being reliant on gas station snacks and fast food restaurants, Charleston must provide a built environment with improved food access. To get supermarkets into underserved areas, the city of Charleston should offer financial incentives, like grants or tax breaks. Charleston could mimic Baltimore City’s proposal which “cut the taxes grocery stores pay on personal property like cash registers, freezers and other equipment by 80 percent” which helped to incentivize stores (The Baltimore Sun, 2016).
A report in World Medical & Health Policy explained how non-governmental organizations like a mobile farmers’ market program could have a huge impact in improving food security and access (Best, 2016). Charleston’s resolution could involve several organizations similar to Hearts for the Homeless, which is a mobile soup kitchen in Charleston. Together, several organizations could help create a better built environment with food accessibility across the county. Partnering with both NGOs and supermarkets would be important for Charleston when implementing this resolution because they are key stakeholders in food accessibility.
A report from International Journal Of Environmental Research And Public Health on the environmental barriers to physical activity in rural Montana reflects many of the barriers existing in Charleston. These impediments include a lack of indoor recreational facilities, lack of age-appropriate physical activity opportunities, a lack of promotion of physical activity, and a lack of funding. They also include a lack of continuous and even sidewalks, street intersection safety, biking lanes, poor walkability, and outdoor lighting (Lo, 2017).
Rural areas of Charleston especially experience these barriers. Charleston could mimic the Palm Springs resolution and adopt a policy to enhance the county landscape and design, promoting more walking and biking and less driving. The county could also work to build more recreational facilities and age-appropriate physical activity opportunities. To start, Charleston could reach out to the Department of Transportation and begin to negotiate and make plans for bike lanes and safe roadways/intersections. Partnering with them would be important for implementing new physical activity opportunities and reducing the use of motor vehicles.
Charleston’s resolution and initiative could be funded several different ways. While increasing taxes on certain items is a common solution for funding, there are different ways to find money. Other opportunities could include federal allowances or grant programs from foundations such as Robert Wood Johnson Foundation. Many foundations give thousands to millions of dollars to cities in need of funding for a specific health intervention.
Overall, Charleston County has lots of improvement to work on when it comes to healthy eating and physical activity. The health of the public depends on it; especially with the significant increase in obesity and linked diseases over the years. The Palm Springs resolution highlights some great starting points for Charleston County. Better population nutrition could be targeted by increasing the access to healthy foods. To do this, Charleston must create a policy and work with grocery stores and NGOs. Improved population physical activity could be achieved by working with state departments, such as the Department of Transportation, to increase the use of non-motor transportation. Charleston County has much potential and can improve the health of the population by implementing such policies.
