It takes a village.
Too true, we learned in The Washington Post report from Manchester in Clay County. It takes a village to raise a child; it takes a village to enable a culture where obesity can flourish.
Manchester delivers both, reporter Wil Haygood showed in the story published in the Tuesday Herald-Leader.
Yes, it's a small town where people appreciate and recognize the accomplishments of two sisters raised by their father and grandmother.
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It's also a place where people are more likely to be dangerously overweight than in the rest of the country and to suffer the consequences: type 2 diabetes, heart disease, stroke, high blood pressure, asthma and certain types of cancer.
In Clay County, home to Manchester, the obesity rate has been pegged as high as 52 percent, more than twice the national rate of 24 percent. In our unhealthy state, Clay recently won the dubious honor of the least healthy county, with 41 percent of residents classified in poor or fair health.
Indeed, the two girls at the heart of the Post story are overweight, as is their father.
We can start with personal responsibility and never lose sight of it. Calories in/calories out is the bottom line in weight control.
That said, there are many environmental factors that play a role.
As the Post story notes, Manchester is awash in fast-food restaurants but doesn't have a YMCA, a parks department, nice walking or cycling trails or even a private gym.
The story makes only a passing reference to Manchester's economic woes. Some 38.3 percent of the residents live below the federal poverty rate compared with 17.3 percent for all of Kentucky.
It takes no notice at all of the area's history of political corruption. In the past five years, more than a dozen local officials have been convicted of crimes that included extorting kickbacks from a contractor, laundering money for a drug dealer and wholesale vote buying. And there's plenty of indication that prosecutors aren't done yet.
What's all this got to do with obesity?
Obesity is essentially another disease of the poor.
In this country, poverty and obesity are very closely linked. And no surprise, when you think about it. Fast food is cheap; processed, high-calorie snacks and treats, don't spoil and require almost no preparation. Eating fresh fruits and vegetables, while healthful and flavorful, can also be expensive and time consuming.
It's also not much of a leap to figure that public officials bent on lining their own pockets and doing favors for helpful cronies, aren't totally absorbed in creating healthier communities, collecting taxes to support school exercise programs or better school lunches, or taking the initiative to educate citizens about diet, exercise, calorie counts and the health consequences of personal decisions.
People in Manchester are uncomfortable talking about weight. Neither the girls nor their father weigh regularly; the older sister wants to talk to the younger about controlling her weight but is reluctant to bring it up. "I just don't know a lot about obesity," admits Mayor Carmen Lewis.
But this problem that grows out of so many other problems will damage the lives of the people affected, drain the health care system and put more stress on an already-depressed economy.