lifestyle medicine


Roxbury Center Targets Health Disparities In Boston’s Poorest Neighborhoods

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

By Marina Renton
CommonHealth Intern

When it comes to health in Boston, it’s hard to deny there’s a great divide across neighborhoods.

Need proof? A 2013 Boston Public Health Commission report found that, from 2000 to 2009, the average life expectancy for Boston residents was 77.9 years. But in the Back Bay, it was higher — 83.7 years — compared to Roxbury, where the average life expectancy was 74.

If you want to get even more local, you can analyze the same data by census tract, where life expectancy varies by as many as 33 years: 91.9 years in the Back Bay area between Massachusetts Avenue and Arlington Street, and 58.9 years in Roxbury, between Mass. Ave. and Dudley Street and Shawmut Avenue and Albany Street. That’s according to a 2012 report from the Center on Human Needs at Virginia Commonwealth University in Richmond.

The Whittier Street Health Center in Roxbury is trying to tackle the disparities in a very concrete way. With the launch of a new fitness club and community garden, the center is trying to make healthy food and exercise opportunities available and affordable to all, despite geography.

“What we’re trying to do is to remove those social determinants and barriers that are causing these [health] disparities,” said Frederica Williams, president and CEO of the health center.

‘If I Sweat, I’m Doing Something Right’

The fitness club and garden initiatives just launched June 27, but the Whittier Health and Wellness Institute is already drawing in community members.

Eight months ago, Wanda Elliott weighed 256 pounds. On a visit to her Whittier Street physician, she learned her blood pressure was high — high enough that she had to start taking medication. That was the wake-up call that motivated her to change her diet and start exercising.

“I was dragging,” she said.

Elliott began exercising at a local Y but joined the Whittier Street fitness club when it opened. In eight months, she has lost 52 pounds, leaving her 4 pounds shy of her 200 pound goal weight.

“I have two knee replacements, so I have to keep active every day,” she said. Trainers at the center helped her learn to use the exercise machines, and now it feels like a routine, she said.

“I feel addicted to working out. I feel like if I sweat, I’m doing something right,” she said. “From 256 to 204, I feel like a model. I can walk the runway; that’s how energized I feel now.”

Elliott is now off her blood pressure medication. She is working on making changes to her diet “slowly but surely,” drinking more water, eating more salad, and cutting back on red meat. Continue reading

Is This Chelmsford Doctor A Model For The Nation?

Dr. Damian Folch runs his first half-marathon.

Dr. Damian Folch runs his first half-marathon.

Do you think Dr. Damian Folch, a primary care doctor in Chelmsford, is a model for the nation? You can vote on that here at The Los Angeles Times.

Oh, wait, you want to know how he might be a model? Well, he definitely has my vote when it comes to practicing “Lifestyle Medicine,” tackling his patients’ unhealthy lifestyles and getting them to exercise more. (Check out that story from earlier this year here.) But now The Los Angeles Times features Dr. Folch in “A shift in how care is paid for.” It’s an excellent explanatory piece about the shift away from “fee for service” medicine — paying doctors for each bit of care — and toward “global payments” that pay doctors for a patient’s overall care — and rewards them for keeping the patient healthier and costs lower. That shift is happening more systematically here in Massachusetts than anywhere else, the piece says.

It begins:

CHELMSFORD, Mass. — It’s hard work being one of Dr. Damian Folch’s diabetic patients.

If a lab test shows high cholesterol, Folch is quick to call or email. No patient can leave the office without scheduling an annual eye exam, a key preventive test. A missed exam or an appointment leads to another call.

“We are a real pain in their necks,” joked Folch, a primary care physician in suburban Boston. “We track them down.”

That kind of attention has always been good medicine. For Folch, 59, it’s now good business. He is among thousands of physicians in Massachusetts whose pay depends on how their patients fare, not just on how many times they see them. If patients stay healthy and avoid costly medical care, he gets more money. Continue reading

Why To Exercise Today: Inactivity As A Disease, And One $17 Treatment

standing desk

My standing desk: Laptop on a cheap little pink table

Sometimes a single well-turned phrase can change you forever. That’s what happened to me a few months ago when I heard the director of the Institute of Lifestyle Medicine, Dr. Eddie Phillips, say, “Sitting is a disease state.”

He was speaking to a lunchtime symposium of Harvard medical students about “Lifestyle Medicine,” a field that aims to get doctors to tackle the bad diet and exercise habits that underlie so many of their patients’ diseases. And he was explaining why the students were invited either to sit on big balls or to walk around the seminar table.

The phrase reverberated in my mind when I got my new desk in the WBUR newsroom, to the point that I bought this $17 table and now spend about half my time with my laptop perched on it, standing and shifting my weight as I type. (Two of my colleagues were already doing the same, improvising with piles of books or boxes beneath their keyboards.)

And I thought of it again when I saw this NPR post: “Should lack of exercise be considered a medical condition?” It frames the disease state a bit more broadly than sitting, as inactivity in general. And it asks whether doctors should literally diagnose “deconditioning” or “inactivity” in their patients who don’t exercise, to help them understand what a reliable precursor of disease it is. Continue reading