Health & Human Services

Michigan Fights Obesity with a 4x4

The state is encouraging residents to abide by four healthy behaviors and monitor four health measures. Now all it has to do is convince people to follow the plan.
by | September 2012

This past June, New York Mayor Michael Bloomberg gave Jon Stewart a gift when he announced his much-publicized plan to ban supersized soda drinks in the Big Apple. The comedian rode a weeklong riff about the proposal’s silliness, but the problem the mayor is trying to address is far from silly. States and cities nationwide are struggling to improve their constituents’ health, and to reduce both expanding bottoms and the bottom line of medical costs.

While New York City got all the headlines, Michigan also unwrapped a program to fight obesity that Stewart can’t joke about. It’s a well-thought-out, evidence-based, all-hands-on-deck approach to healthy living, one that Michigan hopes will take it off the list of the 10 fattest states in the nation. It would also help cut the more than $3 billion it costs the state annually in obesity-related health care (a cost that is expected to rise to $12.5 billion by 2018).

The program is called the Michigan Health and Wellness 4x4 Plan, and it encourages everyone in the state to follow four healthy behaviors (eat a nutritious diet, get regular exercise, have a yearly physical exam and avoid all tobacco) and monitor four key health measures (body mass index, blood pressure, blood sugar and cholesterol). It’s part of Gov. Rick Snyder’s call to include good health as a cornerstone of Michigan’s economic revival. And it started last year when the Department of Community Health hosted a summit where about 500 stakeholders hammered out the details of what would become the 4x4 plan.

Granted, none of the eight behaviors and measures is new or earthshaking. But in many ways, that’s the point, says Olga Dazzo, director of the department. Those eight markers are the science-based best practices to prevent or delay costly chronic illnesses. Snyder himself came up with the 4x4 term, Dazzo says, “because he thought it would be wonderful to have a concept that is easy to remember and gets people excited.”

The problem, of course, is getting those people to follow the program. It hasn’t worked in the past in most locations, Dazzo says, because of a lack of coordination. “Everyone works on it, but it’s a little here and a little there,” she says. “It’s not comprehensive, and that’s why we are not moving the needle. What is different about this initiative is, we want to engage the entire state so that we all move in the same direction.”

Dazzo says this program focuses both on individual responsibility and creating an environment where individuals can succeed. That means partnering with schools to ensure access to healthy lunch items, enlisting grocery chains to work harder at supplying food deserts with ample produce, pushing the private sector to add healthy snacks to vending machines, and prodding all these places to encourage workers and students to move around more.

Dazzo hopes to establish coalitions with community leaders throughout the state who will help implement the plan. She is also engaging trade and professional organizations, school systems, employers and all departments within state government to join the effort. A media blitz is, of course, also part of the campaign, and an online dashboard has been created to help promote and measure Michigan’s health and wellness.

“Our goal is to have every Michigander adopt health as a core value,” Dazzo says. “We want everybody talking about this by the end of the year. It takes an individual about 18 months to truly change his or her weight, so this is not something we will see happen overnight. The 4x4 plan is a vision and framework, but the hard work to implement it at the local level begins right now.”

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