I’m a family doctor in Lawrence. Like my colleagues around this country, I spend much of my effort caring for people with obesity-related chronic illnesses: Type 2 diabetes, hypertension, coronary heart disease. Partnering with patients to control these disorders is important and rewarding work, and I feel fortunate to be able to help. Yet I can’t shake the frustration of knowing all the pain, the disability, and the costs to individuals and to our economy related to these illnesses are almost entirely preventable.
Why don’t my patients lose the weight? Why don’t they get the hour of physical activity they need every day? After all, there is great evidence that exercise combats and prevents diseases ranging from diabetes and heart disease to dementia and many cancers. Is there something wrong with my patients? Is there something wrong with all of us? The truth is that it’s extremely difficult in our modern world to achieve a level of physical activity that is a basic prerequisite for health. I get tired of urging children to bike to school when traffic travels at dangerous speeds and there are literally zero bicycle lanes. It feels bad to urge a family to walk to the park or the supermarket when dangerously wide intersections, congested parking lots, and busy highways stand between them and these basic daily activities.
So what would a Massachusetts look like where it was easy to be active and healthy? Fancy gyms and programs cannot and should not be the answer for everybody. Most of us are too busy working, raising children, and simply living to go to the gym every day. In a healthy community, physical activity would not be something we do, but how we live our lives. Perhaps the biggest key to this shift is a profound change in our transportation system. It’s no coincidence that the average American spends 46 minutes commuting to work and falls 40 minutes short of reaching that vital hour of physical activity.