Dear Editor:

I am writing to disagree with Mr. Fahr’s recent "Debbie Downer" editorial on the "Community Health Summit" he attended at Conway Regional Medical Center. Some data collection was done by the Stratasan consulting group and are available on the Internet. There is information collected from residents of Van Buren County included. There is also information from a larger national data collection, America’s Health Rankings, 2011 by United Health Foundation.

I have an interest in health care, as most of us do. I’m a provider and a recipient. If you are like me you have noticed an increase in the amount of information regarding health care. We need information to help us understand almost everything, but I’ve noticed lately that it is hard to sort it all out sometimes. So, I pick up the paper and read articles like Mr. Fahr’s and think, "Well, now here it all is…women deliver too soon, people smoke, they’re too fat, they don’t exercise, they lie about how much they drink and Arkansans are underachievers because we have less diabetes than 17 other states (my understanding of the statistics)". Mr. Fahr’s really goes off his rocker when he is "PowerPointed" with a multi-colored-pie-chart-in-the-face showing lifestyle choice as accounting for 50% of individual overall health. He suddenly has the answer: Discipline! He has a self-righteous lecture for all: No more fried chicken, no gravy, eat salad with low-fat dressing, just get out there and walk, addicts just need to quit and you binge drinkers need to confess! Mr. Fahr even doubts the validity of the binge drinking statistic. Is it possible that he actually does not understand that professionals design their data collections measurement systems to control for problems like "self-reporting" in order to insure reliability … they are professionals. The United Health Foundation America’s Health Ranking overall State ranking of Arkansas came up to 47 from 48 because important public health concerns have been addressed: Infant mortality rates have declined; numbers of children living in poverty have decreased. Mr. Fahr has no ideas, nor never explains what he feels should be done for the low-birth-weight problem ranking Arkansas 44 in the nation. Of course, when 15-19 year old teens are having babies they will tend to be small. This statistic has ranked Arkansas 47th.

The citizens of Arkansas have many health challenges: High prevalence of smoking, high incidence of infectious disease, high rates of cancer deaths and cardiovascular deaths and high rates of preventable hospitalizations (United Health Foundation, 2011). Yes, we need to work on our behavior, but we need our community/environment, Public and Health Policy and clinical care in support to succeed. For instance, Arkansas ranks 41st in number of primary care physicians; 42nd in lack of health care insurance; 40th in eating diets high in fruits and vegetables! I find this hard to believe when so many people I know grow their own food, but then I was OK with Mr. Fahr’s commenting about people skipping the fresh food case in favor of the frozen food aisle when I realized it was because he has never been to that wasteland in Clinton Walmart! Dr. Oz recently recommended eating Endive for its health benefits. How I long for a local shopping experience where I might purchase something so exotic as Endive! To push my cart into the produce aisles that might look like Kroger’s: an endless cornucopia of farmland bounty. Instead, if I’m lucky it’s a week-old bag of organic spinach on that aisle — right across the room from the fried chicken! I don’t know about you, but as soon as I smell that chicken I want some! Forget the Endive! It takes every ounce of my strength to not go get that chicken!

I think Mr. Fahr tried to bring it together with his "advice" to ‘Think about yourself ten years from now’ in order to help people start thinking about better health choices. I just wish he could be a little kinder, a little gentler. Making change is hard. You have to think right now and I think lots of people think about making change. I’ve been working with people trying to make change for 17 years. Perhaps as a publisher he could explore his own possible contributions to the community to make change, improve health, health care and people’s lives, instead of just lecturing people about discipline.

Linda Smith, RNBC, LADAC

Tobacco Treatment Specialist