OKLAHOMA CITY — Like a missionary, Michael Bailey, a county health worker, spends his days driving his beat-up Nissan around this city’s poorest neighborhood, spreading the word in barber shops and convenience stores about the benefits of healthy diet and exercise. “Look at the kids,” he said. “Overweight, huffing and wheezing. Their lives will be miserable if this doesn’t change.”
Mr. Bailey believes that food is slowly killing his community here, and signing people up for a program to prevent heart disease is his way of saving souls.
Local governments across the country are creating dozens of such experiments with money from the Obama administration’s Affordable Care Act. It is part of a broad national effort set in motion by the law to nudge a health care system geared toward responding to illness to one that tries to stop people from getting sick in the first place. To that end, the law created the $10 billion Prevention and Public Health Fund, the largest-ever federal investment in community prevention.
Supporters say the effort is long overdue in an age where preventable disease is the single largest cause of death. Indeed, unhealthy behaviors, like smoking and poor diet, account for 40 percent of premature deaths in the United States, while poor health care and limited access to the health care system accounted for a tenth of such deaths, according to an analysis of federal data and mortality studies by J. Michael McGinnis, a senior scholar at the Institute of Medicine.
But critics say efforts to influence behavior will have only a modest effect without policy measures like taxes on soda and restrictions on marketing to children to change the food environment.
Oklahoma City, run by a Republican mayor, Mick Cornett, has with little notice won federal prevention money through the new law, a surprising source of financing in this deeply conservative Republican state. The governor, Mary Fallin, turned away $54 million in federal money to help prepare for the new law last year.
Republicans in Congress derided the prevention program as “a slush fund to build sidewalks, jungle gyms and swing sets,” but Mr. Cornett has embraced its approach, turning this city — labeled one of the fattest in America in 2007 by Men’s Fitness magazine — into a laboratory for healthy living. In recent years, he has transformed it with bike lanes, walking paths and an Olympic rowing complex. He started a drive called “This City Is Going on a Diet.” He even accepted an invitation from Michelle Obama, who has made childhood obesity her signature cause, to attend the 2010 State of the Union address.
