Southern Indiana Living JanFeb 2014

From a doctor’s perspective:
Pediatrician and general
practitioner Dr. David McCay
weighs in on health trends
Story // Abby Laub
Dr. David McCay, a general practitioner at Floyd
Memorial Medical Group in New Albany said the
most alarming health trend in his daily practice is
the rate of obese and overweight patients.
“I think southern Indiana, unfortunately, is in the bottom
half of the 50 states in terms of obesity rates and being
overweight,” said McCay, a board certifed pediatrician and
general practitioner. “I think 15 to 20 years ago probably the
biggest single health risk was probably people who smoked.
We’re seeing people dying of early from smoking and we’re
seeing people quitting smoking. In another 15 to 20 years
we’ll see the longer efects of obesity.”
But on the positive side, if caught early enough, the health
efects can be reversed.
“The earlier you can reverse the metabolic derangement
that occurs with obesity the better,” McCay noted, adding
that complications of obesity can range from Type 2 diabetes,
heart disease, kidney damage, blindness, and arthritis. “And
there are the things people don’t think about — it causes a
lot more joint breakdown, and sleep apnea also is a big one.”
Another alarming trend, he noted, is the increasing use of
chronic narcotics to manage pain in people at increasingly
young ages.
“Probably 15 years ago we wouldn’t have started those
folks on narcotics at such a young age,” he said, adding that
there have been changes in the practice of medicine that have
led to the point of over treating pain with prescriptions, creating
a lifetime of dependence on medication. “That culture
has caught up to us now. Even if it is for legitimate reasons
initially, there are increasing incidences of substance abuse.”
A positive? McCay said smoking is fnally on the decline.
He said you’d be hard pressed to fnd someone who doesn’t
realize smoking is bad for them. “Most people do legitimately
want to quit and make eforts to do so,” he portend
out. “That’s a positive trend.”
He added that obesity awareness also is on the rise. “The
hardest thing about obesity related changes is it’s very easy
not to do them,” he said. “It’s very easy to eat poorly.”
McCay said people, especially those in their 20’s and 30’s,
need to aggressively go after lifestyle faws and work to correct
them before it’s too late. “When I see a 25 or 30 year
old that is overweight and they’ve probably got some family
history of problems that speak to the train coming down
the tracks — that’s the time that they really need to address
the problem and really aggressively treat it,” he said. “Otherwise
10 years later you may already have some secondary
disease consequences.”
No matter the age, he noted, treat yellow fags before they
become a red fags.
Part of that is making periodic doctor visits. “Things can
change very rapidly,” McCay said. “There are a lot of silent
problems that don’t cause any symptoms, like high choles-
// Story jumps to page 49
part of Head Start.
Low income areas are not the only problem, though. In Floyd
County there are more liquor stores per capita and fewer grocery
stores per capita than the national average. The county’s
income levels are higher than surrounding counties and there
are more fast food options. Carroll speculated that there are
a lot of busy families with the means to spend money out on
meals rather than cooking a balanced meal in the home.
“We get from a lot of people, ‘I just don’t have time. I can’t
keep myself healthy, keep my kids active and get everyone
where they need to be in one day. I’m just doing the next
thing’,” Carroll said, adding that there are a lot of one car per
person families, meaning people don’t walk, ride their bikes
or use community transportation. Instead they sit in their cars
and often eat in their cars with the prevalence of fast food.
Kick smoking in the butt
In addition to unhealthy diet and exercise habits, 30 percent
of the county’s population uses tobacco, so smoking cessation
is the third big initiative for the Healthier Community Initiative.
Incidences of and deaths as a result of lung cancer are
higher than the national averages.
“It requires a lot more thought and strategy to move the ticker
and public perception in that area because of the strength
of the nicotine addiction,” Carroll said. “And one new thing
we’re battling now is the e-cigarettes. They’re not regulated the
same way regular cigarettes are. They don’t contain tobacco,
but they do for sure contain nicotine, and who knows what
else is in them because they’re not really regulated.”
She added that smoking — no matter the type of cigarette
— is especially troublesome for young people. Recently the
coalition sponsored an online health and wellness magazine
geared for college students, called Student Health 101 (www.
studenthealth101.com), and it includes tobacco related topics.
“It is a population we really wanted to target for our tobacco
initiatives,” Carroll said. “They are at an impressionable age,
and it is still early enough for them to quit.”
The smoking cessation coalition also is working on increasing
the awareness of cessation programs and the increased
health insurance premiums for tobacco users.
“We feel an obligation to have resources available for employers
and individuals to aid in their cessation eforts,” Carroll
said. “We want to have about 15 to 20 sites in the community
ofering a class at any given time.”
She also hopes to see nursing home campuses become completely
tobacco free, pursue expanded public smoking bans,
and work creatively with schools on tobacco prevention programs
beginning at young ages, since the average smoker has
his or her frst cigarette between the ages of 12 and 15. And
fnally, they are working with Floyd Memorial Hospital to promote
and expand lung cancer screenings as an evidence based
tool to quit smoking.
Te bigger picture
Carroll acknowledged that no amount of public health initiatives,
free community events and continued education will
make people healthier. It is a choice and it takes time to turn
the tides of a culture with unhealthy habits.
She noted that southern Indiana and Floyd County don’t
have a lot of bike lanes, community transit or sidewalks.
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