Addressing childhood obesity also supports US military readiness (The Hill)

THE HILL | Our childhood obesity epidemic here in the U.S. is as concerning as it is well-documented.  It’s no secret that obesity trends have been on the rise for the last 20 years. In fact, in 2016, 18.5 percent of youth ages 2-19 were classified as obese. And it’s only getting worse. 

The implications of these data and the impact of poor nutrition on our overall health and well-being are disheartening and demand action. And while the broad strokes of this challenge may be familiar to you, what is less well known is the way childhood obesity is inextricably linked to our country’s long-term national security.

Nationwide, 11 percent of our 17- to 24-year-olds do not qualify for military service strictly due to excess weight. If you combine this with other eligibility factors such as crime or drug abuse or even academic issues, this shocking ineligibility figure has held steady at 71 percent for years.  

However, the Department of Defense’s most recent figures show that an astonishing 77 percent of Americans of prime recruiting age would be ineligible for military service. This is a massive increase. Over three-quarters of American young people are ineligible due to some combination of factors, chief among them obesity.

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It’s Time To Prioritize Nutrition: Better Diet Quality Leads To Better Health And Wellbeing For Americans (Forbes)

FORBES | September should be a big month for nutrition. For too long, we have struggled and failed to curb food and nutrition insecurity, to mitigate rising rates of obesity, and to reduce the prevalence of diet-related chronic illnesses such as diabetes, hypertension, and coronary artery disease.

This issue is very real to many of us, but it is especially real to me.

For nearly 12 years as a cardiac surgeon, I operated five days a week on people’s hearts, palpating and coming face to face with fatty, calcified, and hardened coronary artery disease caused in large part by bad nutrition. I saw firsthand how, despite growing up hearing that “you are what you eat,” many of us fail to consume nutritious foods fundamental to promoting health and wellness. We know better.

Our nutrition – or lack thereof—has thwarted our nation’s health and wellbeing. And it’s costing many Americans their lives and their savings. It is time we act on what science, clinical medicine, and public health experts have long understood: our country must prioritize better nutrition policy.

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Cultivating A Culture Of Health: How Comprehensive Community-Wide Hypertension Data Are Inspiring Heath Equity (Forbes)

FORBES | It’s no secret that the best data often begets the best policy, especially when it comes to community health and wellness. Having accurate, timely, and well-informed data is often the difference maker that allows communities to dramatically move the needle on health disparities.

When it comes to health disparities, the city of Nashville can – and must – do better. Nashville is known nationally as a health services capital, yet our own community health and well-being statistics rank far worse than the cities we compete with on a daily basis.

For many, this comes as a surprise. Nashville is filled with top-level academic institutions, nationally renowned hospitals, and tremendous economic growth, and it is home to some of the largest health and hospital systems in the country. But when compared to cities like Austin, Charlotte, Denver, and Dallas, we have the worst life expectancy and highest rates of infant mortality, smoking, and number of poor mental health days by far.

How can Nashville, an otherwise thriving city, work to ensure that every single one of our community members has an opportunity for a healthy life?

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Reducing The Health Harms Of Incarceration: Five Big Ideas From The Aspen Health Strategy Group (Forbes)

FORBES | Our nation has the highest incarceration rate in the world with 10 million people incarcerated each year, yet the health of these individuals is truly an afterthought. We must recognize that their experiences and their health outcomes are not contained in a vacuum. These individuals are often struggling with undiagnosed or untreated behavioral health issues and chronic illnesses prior to being jailed or imprisoned, and their health challenges before and after incarceration have a ripple effect that substantially impacts the health and well-being of their families and communities, and ultimately our country.

We know incarcerated Americans are sicker – those who have been jailed or imprisoned are associated with having an elevated risk for nearly all diseases, and they touch a much larger percentage of our population than many realize. In fact, 45% percent of Americans have had an immediate family member who has been incarcerated, and for these Americans, this connection to an incarcerated individual is correlated to a life expectancy that is two years less than for those without a family member who has been incarcerated. The carceral system is taking years off Americans’ lives, even if they haven’t served time.

For these reasons, we at the Aspen Health Strategy Group (AHSG) – which I co-chair with former U.S. Health and Human Services Secretary Kathleen Sebelius – have determined, “Incarceration is a primary source of poor health for individuals, families, communities, and our nation as a whole.” This is the issue AHSG’s 24 multi-sectoral leaders chose to study in 2021 as part of the Health, Medicine & Society program at the Aspen Institute. Tasked with exploring some of our nation’s greatest health challenges and preparing actionable solutions, we lay out five big ideas on “Reducing the Healthy Harms of Incarceration,” which we arrived at after extensive consultation with experts in the field, as well as with those who have personally experienced the health impacts of incarceration.

Our “five big ideas” center around expanding health coverage, providing coordinated care, implementing quality standards, and rethinking certain justice system approaches to prioritize health.

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Your health (and you thought climate change was not about you) (The Hill)

THE HILL | New Year’s resolutions: chances are we’ve made — and broken — a few of them. And, chances are many of those resolutions have been related to our health: exercise more, eat better, stop smoking. But what if, in 2022, we resolved to improve our health by taking action against climate change?

According to recent data from National Oceanic and Atmospheric Administration (NOAA) and NASA, 2021 marked the sixth warmest year on record. Why does this matter? Well, a warming climate directly affects the health of individuals, communities, businesses and economies alike.

Climate change, if nothing else, is a background condition of our lives that shapes our health. As a social determinant of health, it is as much a public health crisis as it is an environmental and economic one. Things like access to clean air, clean and safe drinking water, healthy food supplies and housing are directly impacting our quality of life, as well as physical, mental and emotional health.

We’re seeing the effects of climate change on peoples’ health already — from increased cases of asthma in children to more heat-related illnesses like heat stroke and vector-borne diseases like malaria. If you’re not seeing these repercussions in your community now, chances are you will soon.  

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Need for Affordable Care Cuts Across Party Lines

(The Hill, August 1, 2012)

Need for affordable care cuts across party lines
By Tom Daschle and Bill Frist

On June 28, 2012, the Supreme Court issued a decision that affects the health and well-being of every American, as well as the fiscal future of our nation. By affirming the constitutionality of the Patient Protection and Affordable Care Act (PPACA), the private and public sectors can now turn to implementation, along with natural and needed shaping and modification of the underlying policy along the way.

The court’s decision can and should be a turning point for our national discussion and action on healthcare. Though the upcoming elections might amplify our differences in the short term, it is in the long-term interest of every American to begin now to work together and forge consensus-based solutions for our nation’s most critical healthcare challenges.

The United States currently has an expensive, uncoordinated and inefficient healthcare system. By 2020, healthcare spending will make up one-fifth of our national economy. Excessive and wasteful healthcare spending fuels our nation’s exploding federal debt and imposes unsustainable burdens on our federal and state governments, employers, individuals and their families. This is a grave threat to our nation’s future health, economic viability and ability to compete in an increasingly competitive global marketplace.
As the co-leaders of the Bipartisan Policy Center Health Project, our mission is to bring together federal, state, business and workforce leaders to develop health system solutions that address ongoing budgetary and healthcare reform challenges. We are embarking on a new initiative to confront and curb the country’s out-of-control healthcare cost growth: Our goal is to promote a rational, competitive, accessible and affordable healthcare system. We will be collaborating on this initiative with Alice Rivlin and former Sen. Pete Domenici (R-N.M.), the distinguished co-chairs of the Bipartisan Policy Center Debt Reduction Task Force. The task force is dedicated to reducing the federal deficit and helping America achieve a sustainable fiscal path, which simply cannot be accomplished without significant healthcare reform.

Healthcare cost containment is a profoundly complex and divisive issue, but we are steadfast in our belief that this issue can be addressed in a meaningful way. We as a nation cannot wait any longer. Our broken healthcare system can be fixed; there are solutions to each of the challenges. But we will never devise and apply them until we commit to do so together, reaching across the political aisle to work with one another.

All Americans generally agree on the end goals for health reform — appropriate and effective patient care, lower costs and easier access for all. We might not agree on the individual mandate, but we do agree on the power of embracing personal responsibility for our health and health decisions. We do not always agree on the most effective way to execute state insurance exchanges, but we can agree that these exchanges provide opportunities for states to use the power of market competition to control costs and engage their constituents on the individual level.

We all know that greater transparency in pricing and outcomes will help eliminate duplication, waste and inefficiency. We want to see our system provide frictionless and coordinated care that brings satisfaction to caregivers and peace of mind to patients. We want our health records and data systems to be brought into the 21st century through health information technology, providing vital health information when and where it is needed instantly and securely. The only question is how we get there.

Healthcare is in a period of explosive growth and transformation. Every day, the sector performs technological miracles, creates jobs and saves lives. We must harness this power, but at the same time, strive to do more. The American healthcare system has the power to be more efficient and more accurate, without sacrificing our nation’s capacity for private-sector innovation, productive public-private collaboration and incredible technological advancement.

Allowing healthcare costs to soar at unsustainable levels and allowing America to fall behind on key indicators of care quality and access is not a political victory for either side of the aisle. Assigning blame along partisan lines gets us nowhere.

A healthy population, a happy and productive workforce, and affordable healthcare are vital to the future of our nation. Unless we are willing to work together to transform our healthcare system for the better, these essential goals will remain out of our reach.

Former Senate Majority Leaders Daschle (D-S.D.), now a senior policy adviser at DLA Piper, and Frist (R-Tenn.) lead the Bipartisan Policy Center’s Health Project.

This article was originally featured in The Hill

Why both parties should embrace ObamaCare’s state exchanges

(The Week, July 18, 2012)

By Bill Frist, M.D.

Largely lost in the fight over ObamaCare is a worthy provision that lets states develop insurance systems that are right for them — but they must act soon.

When the new health care reform law was being debated in 2009 and 2010, everyone talked about “death panels.” When challenged in court, everyone debated the individual mandate. After last month’s Supreme Court decision, the conversation has now switched to Medicaid. During all of this, however, we have largely ignored what is perhaps the most innovative, market-driven, and ultimately constructive part of the law: State exchanges.

Originally a Republican idea, the state insurance exchanges mandated under the Affordable Care Act (ACA) will offer a menu of private insurance plans to pick and choose from, all with a required set of minimum benefits, to those without employer-sponsored health insurance. These exchanges are expected to bring health insurance to an additional 16 million Americans. Unlike the Medicaid expansion, these Americans will gain private insurance, and can choose the plan that’s right for them.

The exchanges should facilitate competition among private insurers as they design new benefit packages and cut prices to stay ahead of the game. While I’m slow to favor a mandate, these exchanges will offer those who can benefit from insurance a broad array of tailored options and varying prices that should help them find it. Helping more Americans find and compare the private insurance they need and can afford should be an easy principle both political parties agree on.

As a doctor, I strongly believe that people without health insurance die sooner. Sure, they can eventually go to an emergency room. But it is often too late. They wait longer to get a breast lump checked out. They wait until their nagging cough turns into a fulminant pneumonia. They skip preventive care and then show up to the ER with severe, costly, late-stage symptoms that are harder and more expensive to treat.

State exchanges are the solution. They represent the federalist ideal of states as “laboratories for democracy.” We are seeing 50 states each designing a model that is right for them, empowered to take into account their individual cultures, politics, economies, and demographics. While much planning has yet to be done, we are already seeing a huge range in state models. I love the diversity and the innovation.

Helping more Americans find and compare the private insurance they need and can afford should be an easy principle both political parties agree on.

Want a more conservative, small-business focused exchange that bans abortion coverage in all its plans? Try Utah and its state exchange, originally founded under Gov. Jon Huntsman. Think that President Obama missed a huge opportunity to steer the nation towards a single payer system? Try Vermont, which plans to ultimately transform its state exchange into a single payer system, Green Mountain Care, that will offer coverage to all state residents. With soaring health care costs one of, if not the most, dangerous threats to America’s greatness, a new round of national health care experimentation is exactly what we need.

But the clock is ticking. While the exchanges must be fully operational by January 1, 2014, they are also required to submit a blueprint for approval by mid-November of this year, which will indicate if they plan to run their own exchange or will participate in a federal-state partnership. While almost all of the states have at least planned for an exchange, roughly half took a wait-and-see approach as they awaited the Supreme Court ruling. This means that in the coming weeks we will see a frenzy of state activity and legislation as governors rush to meet this deadline. Enacting some sort of exchange establishment legislation is expected to be crucial to receiving federal approval for a state-run exchange. And though some GOP governors refuse to set up an exchange of their own, I see little advantage for states to default to the federally designed, one-size-fits-all exchange when they can design and run their own.

The silver lining is that with much planning left to do, there is still time to get involved and design the exchange in your state. I urge everyone — citizens, small businesses, health industry stakeholders, churches, large employers — to actively participate in shaping your exchange so that it reflects your state’s values, economy, and common sense. Then, starting in 2014, we can see a variety of big ideas and small tweaks all working together to show our nation what works and what doesn’t.

Simply put, state exchanges represent a distinctly American opportunity to improve our local communities and at the same time help our nation avert a major crisis. Let’s take the plunge.

Dr. William H. Frist is a nationally acclaimed heart transplant surgeon, former U.S. Senate Majority Leader, the chairman of Hope Through Healing Hands and Tennessee SCORE, professor of surgery, and author of six books. Learn more about his work at

This article was originally featured in The Hill

The world needs more health-care workers — millions more

(The Week, Posted on June 19, 2012)

By Bill Frist, M.D.

The most impressive part of any hospital or health clinic is the caring, skilled employees who prevent and treat illness. But the workforce we have is not enough.


As I visit health programs in far off corners of the world and right here at home, the most impressive part of any hospital or clinic is the health workers themselves — the hands behind the health care that is provided to mothers and newborns, to children and the elderly, to teens and adults to prevent and treat illness.

Health workers heal. It’s as simple as that. And in this country, and around the world, there are not enough of them. Doctors are included in that shortage, but it doesn’t stop there. Recent estimates suggest the world is short some 4 million to 5 million community health workers, midwives, pharmacists, lab technicians, nurses, and doctors. Fifty-seven countries have severe health workforce shortages — meaning there are less than 23 clinicians per 10,000 people.

And health workers, particularly in developing countries, are scarcest in the poorest communities and neighborhoods — both rural and urban — where poverty, poor sanitation, and disease conspire to take the lives of children and adults through preventable killers like pneumonia, diarrhea, pregnancy complications, and tuberculosis.

Fifty-seven countries have severe health workforce shortages.

Later this week I am heading back to Haiti with the Clinton Bush Haiti Fund to review past investments in sustainable human health capital. Haiti is in dire need of indigenous health workers who are from and remain committed to their local communities. Long-term health and economic results can only be achieved by partnering with Haitians to build health training and service programs that they own and that they populate.

In targeted areas around the world, training armies of much-needed health workers has become a smart, key goal of U.S. foreign assistance. We are helping train new midwives, community health workers, lab technicians, and nurses through partnering programs supported by the U.S. Agency for International Development, the National Institutes of Health, and the Centers for Disease Control and Prevention. These new health workers are serving in communities hardest hit by infectious diseases and the complications from pregnancy and childbirth.

And it works! Countries that have made a concerted effort to increase the numbers and skills of their health workforces have shown tremendous progress: Malawi has trained more than 10,000 health surveillance assistants in the past 20 years, and in the same period child mortality dropped almost 60 percent. In India, turning normal community members into lay health workers to support healthier newborn care practices reduced newborn deaths by over 50 percent.

Training community-level health workers does not have to be expensive — people who can provide the most basic levels of treatment for sick children and promote healthy practices can be trained for as little as $300. More-skilled community health workers and midwives cost roughly 10 times that amount to train. These workers provide the lifesaving interventions needed to address most of the leading causes of death of newborns and children — all with no need for huge medical school bills. It’s basic health care, but it is lifesaving.

Highlighting the humble service of health workers around the world is the subject of a campaign launched by Save the Children, with whom I have traveled to countries like Bangladesh and Mozambique to witness these health workers going about their daily tasks. The care is effective and affordable. In fact, I think we in the U.S. have a lot to learn from these community health workers delivering local care. Take a look at some of the powerful stories at, where you glimpse the simple and affordable care provided by people who go the extra mile on behalf of others.

No matter what diseases and conditions are threatening, and what new technologies for treatment might come along, we can say for sure that progress will depend on an expanded army of health workers, properly trained and placed, with the right skills and supplies, intent on delivering the best quality health care possible.

As we look at America’s international assistance around the world, surely one of the best examples of success can be seen in the faces of these committed community servants.


This article was originally featured in The Week