Dr. David Carmouche, Chief Medical Officer and Senior Vice President of Blue Cross and Blue Shield of Louisiana.
Dr. David Carmouche, Chief Medical Officer and Senior Vice President of Blue Cross and Blue Shield of Louisiana.

A signature goal of the Challenge for a Healthier Louisianagrant program is to tackle skyrocketing rates of childhood obesity. The problem is quickly becoming a national crisis, with 36% of Louisiana’s children considered overweight or obese.

“That puts us among the top five worst states in the U.S. for childhood obesity,” said Dr. David Carmouche, Chief Medical Officer and Senior Vice President of the Blue Cross and Blue Shield of Louisiana.  “And we aren’t moving in the right direction. We have been wallowing at the bottom for several years.”

And no one understands more than Dr. Carmouche how the poor eating habits of childhood can translate into the chronic illnesses of adulthood. For 15 years, Carmouche directed the Center for Cadriovascular Disease Prevention and the Vascular Laboratory at the Baton Rouge clinic. And so often, the patients battling heart disease and high blood pressure also reported being “heavy” as children. Below, we talked to Carmouche about the weight problem facing our state’s youngest residents, and what Challenge Grant dollars are doing to make a difference.

Q: Why is childhood obesity such a problem for our state?

A: Well, in Louisiana, we tend to celebrate everything with food – the traditional holidays, then we have our own unique holidays, and there’s a festival every weekend, and then throw in some tailgating… We celebrate life and the culture through food. So, that’s the challenge. We want to preserve what’s great about Louisiana, but we can’t go down the path of ‘let’s just blow it out at every meal,’ even if that means we are going to be on the face of this earth for 20 fewer years. I don’t think we want that as a culture.

Q: So, put simply, we feed our kids too many calories.

A: Yes, it is mostly a food issue. Somewhat an activity issue, as we see P.E. in our schools reduced from every day to every other day – or cut out entirely. But in Louisiana, yes, the problem is driven by a significant increase in the calories consumed. We need to get across the message that if you do only one thing for your kids’ health, reform the way they are eating.

Q: But that means parents also have to reform the way they are eating, right?

A: Of course, because when you have an overweight child, you almost always also have an overweight parent. Parents have to understand they have a big influence over the health habits of the child they are raising. Think about it — in today’s world, we wouldn’t think of sitting down at a kitchen table and smoking in front of the kids. Why aren’t we thinking that way about how we eat? It’s a double standard. We need to think of food and diet in the same way we consider cigarettes.

Q:  Let’s talk about what being overweight as a kid means for that child’s overall health. Serious health problems are developing even in adolescent years, right?

A: In Louisiana, the incidence of high blood pressure and diabetes in young adolescents are increasing. It’s alarming. Now they need to be treated as young adults, so that means they may be spending 80 years of their lives on medications treating these conditions.

Q: A lot of parents may just think a chubby kid will “grow out of it,” so to speak…

A: And that’s not correct. It’s often a life long burden. If you are overweight as a kid, likely you will be as an adult. And overweight kids tend to have shorter life expectancy. And then there’s an an emotional toll to it, how that kid is treated by peers and their own self-esteem is an issue. Society can be cruel and there’s emotional damage. The risk of developing depression is higher. It’s a long-term physical cost.

Q: How can the Challenge Grant initiatives make a difference, when the problem seems so big, so daunting?

A: Because the Foundation is really putting its money at the heart of the problem. Not two tiers removed, but in the heart of the communities most affected with this problem.

Q: Explain what you mean by that.

A: A lot of larger funding sources will push a chunk of money into a community and hope for the best. But this is not a one-size-fits-all approach. This acknowledges there are significant cultural differences in Shreveport, La compared to New Orleans, La. So, the solutions will be different. By allowing different interest groups to design what they know will make a difference, then hold them accountable through Pennington (Biomedical Center)’s monitoring, we’re much more likely to see initiatives that bare fruit. That’s the innovative part.

Q: Some of the ideas seem so simple in concept – a new paved walking path, a new community garden, some gym equipment for a school… Can these things really make the kind of difference we need for our children?

A: Absolutely, because they are direct responses to the challenges we face. Because if you see something day in and day out, like people out walking a new paved pathway, you are much more likely to do that yourself. And it can translate out into the entire community.

Q: Name a few project programs that you really see having an impact.

A:  One of the great things about the grant programs is that many are targeting food deserts to bring healthy foods to disadvantaged areas. New community gardens and farmers markets combined with nutritional education programs in the schools, those are important changes. And taking an inner city park and revitalizing it to build opportunities for physical education, again, to promote healthier living in a community, it’s so important.

Q: But as you mentioned earlier, it’s not just building these things for a community. It’s also about measurable outcomes — ensuring folks are really accessing programs and making use of new facilities, and seeing if that is translating into better health.

A: Yes, a year from  now, we don’t want to just stand around feeling good about what we’ve done and pat ourselves on the back. Let’s show what the money did in objective terms. Then we can get the word out to health partners in other communities, sharing what works, and trying to improve what didn’t. It’s an incredible journey. And it’s fine by me if a main focus continues to be on childhood obesity. If we can affect change in our kids, it’s a much more effective way of dealing with the chronic illnesses of adults. Because by the time they’re adults, well, the horse is already out of barn.