What makes us so much more unhealthy than other Americans? Basically, we're
more disease prone and we have a lot of bad habits. Heart disease, cancer, diabetes, obesity and hypertension are some of the conditions more common among Louisiana residents. Data has shown that conditions like these have led to an unusually high number of premature deaths (death at less than 75 years of age) throughout the state.

When you look at the prevalence of unhealthy behaviors in our population, it's easy to see why rates of disease are so high in our state. We don't eat well, exercise enough, or take advantage of screenings for early detection of disease. Too many of us smoke and too few of us use seatbelts when we drive.

Also, the very environment we live in puts us at risk for poor health. For one, we have an extremely high rate of occupational fatalities. The most dangerous industries - construction, manufacturing and especially off shore work - are the livelihood of many Louisianans. We also have a high rate of violent crime. Statistics for 2002 revealed an alarming rate of 681 violent offenses per 100,000 residents.

Cardiovascular Disease
According to a study by the United Healthcare Foundation, Louisiana ranks 45th out of 50 states for risk of cardiovascular disease. The study looked at risk factors including hypertension (high blood pressure), obesity and sedentary lifestyles. Cardiovascular disease is the nation's and Louisiana's leading cause of death. In 2002 more than 300 out of every 100,000 Louisiana residents died of heart disease. That's almost 40 percent of all deaths in the state, giving Louisiana the fourth highest cardiovascular death rate in the US. To put it another way, cardiovascular disease claimed 15,522 lives in 1999 in Louisiana, approximately 45 people per day.

Obesity
What can we do about our high risk of heart disease? The answer is simple - we need to reduce our risk factors. And our number one risk factor is obesity. More than 23 percent of Louisianans are obese (body mass index of 30 or greater) and an additional 37 percent are overweight (body mass index of 25 to 29.9). We lead the nation in deaths attributed directly to obesity. In addition to increasing the risk of cardiovascular disease, research has linked obesity to several types of cancer. Of course, we all want to blame the richness of Louisiana cuisine, but there's more to it than that. For example, only 16 percent of us eat the recommended five servings of fruits and vegetables each day. Meeting this dietary requirement should be easy. Our climate offers plenty of unique options, from mirlitons to satsumas, to satisfy the most discriminating palate.

Just as important as our diet is our activity level. A whopping 85 percent of Louisianans are considered inactive. A mere 30 minutes of activity five times per week is considered active. And it doesn't necessarily mean you have to pump iron or take a step class. Our area has beautiful parks and natural sanctuaries, unique to our part of the country, that can make exercise both healthy and fun.

Hypertension
Louisianans are also more likely than most Americans to have hypertension. Hypertension is a key risk factor for heart attack because it strains the heart and forces it to work harder than it should. Over time this causes damage, raising the likelihood of heart attack and cardiovascular disease. High blood pressure can also cause kidney and vision problems. According to family practice physician Andrea Jarma, many of her patients have high blood pressure and don't realize it. She says patients may complain of headache, fatigue or poor performance at work. Others have no symptoms and without regular screenings may not know until hypertension causes a heart attack or stroke.

Dr. Jarma advises everyone over the age of 35 to have regular blood pressure screenings along with a yearly physical. If there is a strong family history of hypertension, however, screenings should probably start around age 20.

Hypertension can sometimes be treated with lifestyle changes, including increased exercise and a low-sodium diet. In many cases, especially if hypertension is common in the patient's family, medication may be necessary.

"We'll often try lifestyle changes first," says Dr. Jarma. "Depending on how well it works, or how motivated the person is to make a change, medication may not be necessary."

Diabetes
In addition to being a serious health threat on its own, diabetes is a major risk factor for other conditions, including cardiovascular disease. If not treated properly, diabetes can lead to blindness, kidney failure, and lower extremity amputations.

And once again Louisiana leads the nation, but not in a good way. In our state, 6.2 percent of the population has diagnosed diabetes, far more than the nationwide prevalence of 4.4 percent. More than 200,000 Louisianans have diabetes today, and more than one million are at risk because of obesity or a sedentary lifestyle. We also have the nation's highest rate of diabetes-associated death. Each year, diabetes claims the lives of over 1,500 Louisianans and, in addition, contributes to the deaths of over 1,200.

Diabetes comes with a huge price tag, too. There are direct costs, those associated with medical care, and indirect costs, including lost productivity and premature mortality. According to the American Diabetes Association, in 1997 those costs totaled over $2.5 billion.

"Diabetes is rampant in this area, probably because food is a way of life here," says Rose Wade, RN, of EJGH's Diabetes Management Center. "I wonder how many people have diabetes and don't even know it. The numbers may be a lot worse than we think."

Rose speaks not only as a nurse, but from experience as well. She was diagnosed at the age of nine with type 1 diabetes. She says her personal history with diabetes helps her to connect with her patients. According to Rose, even with the best medical care, diabetes is a chronic condition that can have complications. If blood sugar levels drop, for example, a person with diabetes may exhibit behavior that is far out of character.

"The brain operates on sugar," says Rose. "When there isn't enough sugar in the blood you may see some strange behavior. The person has no idea he is doing strange things."

The fight against diabetes depends on maintaining a healthy weight and staying active. These measures can significantly delay the onset of type 2 diabetes, and may prevent it all together. If you are diagnosed with diabetes, it is important to keep it under control by checking your blood sugar levels often, eating a healthy diet, exercising, and taking your prescribed medications.

"You have to make a lifestyle change," says Rose. "Diabetes can be controlled, but it takes diligence. Education and support are very important."

Cancer
Cancer is the second leading cause of death in Louisiana, claiming nearly 9,500 lives in 2003. In addition, the American Cancer Society predicts nearly 23,000 new cases will be diagnosed in our state this year. While we remain only slightly higher than the national average in newly diagnosed cases, we are above average in cancer death rates for both males and females. There are several explanations for this, and access to preventative health care may be a major factor. Many Louisianans don't take advantage of screening tests that can lead to early diagnosis and more effective treatment. Without screening tests, cancers are diagnosed at later stages, when treatment is more difficult and prognoses aren't as good.