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CHANGE Reports , Editor's Note , Healthcare – April 2, 2019

Editor’s Note: Fight Back Against Genes and Zip Codes

Photo: Elyse Butler

Beverly Creamer’s Report on Health and Wellness covers a lot of important issues. In this column, I focus on one person and one issue: You and your personal health.

Your health depends on a lot of factors, many of which you control and some you don’t. Like with a lot of things, life’s not fair when it comes to health. For instance, the technology is advancing but you still have no control over your genes, which are one more thing you can either thank or blame your parents for.

You have some control over your access to good health care, the career you choose and your environment, such as the quality of air you breathe, the water you drink and the home you live in. All of those affect your health.

The most control you have over your health is your personal behavior: your nutritious diet, physical activity and social interaction (or lack of each), and whether you smoke or drink and how much.

Bev’s report notes that your Zip code is a much bigger determinant of your health than your genes. An analysis from the federal Centers for Disease Control and Prevention found a more than 10-year difference in average life span in Hawaii, based on what Zip code people live in. Generally, the poorer the neighborhood, the poorer the health of its people.

Money helps partly because it gives you more choices: For instance, junk food often costs less than nutritious food and is faster, which is crucial if you are juggling two or three jobs. Affluence buys you more control over your time, so you can create healthier meals or buy them already made. And exercise is more enticing if you can alternate between a one-man canoe, 10-gear mountain bike and 18 holes of golf.

But dollars are not destiny. Farmers markets bring down the price of fruits and vegetables. Frozen produce is cheaper than fresh and almost always just as nutritious. The only barrier to fitness on both dry land and ocean is the cost of running shoes and a swimsuit. Life’s not fair so stop whining and start walking and swimming.

If it sounds like I’m sitting on both sides of the fence, I am. Social factors drive personal health, but like genes, they only rarely fully determine personal health.

Despite doing most everything right, I have not been able to get my good HDL cholesterol any higher than the low 30s, even though the optimal reading is 60 and above. My doctor says that because of my genetic inheritance I will probably do no better. What I did instead was work hard to lower my bad cholesterol and my triglycerides, which I got down to the 60s and 70s respectively, both well within the healthy range. That’s not boasting; I’m merely pointing out you have to play the hand you’re dealt.

We can’t ignore the social determinants of health. What we as a society have to do is help increase the healthy options for the poor and working class – things like teaching working parents how to pull together easy yet nutritious meals for busy days and helping enroll their kids in active programs even when their parents don’t have the time to coach.

Many companies focus that extra attention on their employees’ wellness. That makes sense, morally and economically. More of us need to see health and wellness through that lens: Make it easier for everyone to make healthy choices.

Health in Hawaii: Good News, But Not for Everyon...

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