W. Virginia town is America's obesity capital

HUNTINGTON, W.Va. — As a portly woman plodded ahead of him on the sidewalk, the obese mayor of America's fattest and unhealthiest city explained why health is not a big local issue.

"It doesn't come up," said David Felinton, 5 foot 9 and 233 pounds, as he walked toward City Hall one recent morning. "We've got a lot of economic challenges here in Huntington. That's usually the focus."

Huntington's economy has withered, its poverty rate is worse than the national average, and vagrants haunt a downtown riverfront park. But this city's financial woes are not nearly as bad as its health.

Nearly half the adults in Huntington's five-county metropolitan area are obese — an astounding percentage, far bigger than the national average in a country with a well-known weight problem.

Huntington leads in a half-dozen other illness measures, too, including heart disease and diabetes. It's even tops in the percentage of elderly people who have lost all their teeth (half of them have).

It's a sad situation and a potential harbinger of what will happen to other U.S. communities, said Ken Thorpe, an Emory University health-policy professor who is working with West Virginia officials on health-reform legislation.

"They may be at the very top, but obesity and diabetes trends are very similar" in many other communities, particularly in the South, he said.

The Huntington area's health problems, cited in a U.S. health report, are a terrible distinction for the city, but the locals barely talk about it. Many don't even know how poorly the city ranks.

Culture and history are at least part of the problem, health officials say.

This city on the Ohio River is surrounded by Appalachia's thinly populated hills. It has long been a blue-collar, white-skinned community — overwhelmingly people of English, Irish and German ancestry.

For decades, Huntington thrived with the coal mines to its south, as barges, trucks and trains loaded with the black fuel continually chugged into and past the city. There were plenty of manufacturing jobs, and nearly 90,000 people lived in the city in 1950.

The traditional diet was heavy with fried foods, salt, gravy, sauces and fattier meats — dense with calories burned off through manual labor. Obesity was not a worry then. Workplace injuries were.

But as the coal industry modernized and the economy changed, manufacturing jobs left. The city's population is now fewer than 50,000. Chronic diseases — many connected to obesity — seem more common.

The Huntington area is essentially tied with a few other metro areas for proportion of people who don't exercise (31 percent) or have heart disease (22 percent) or diabetes (13 percent). The smoking rate is pretty high, too, although not the worst.

Missing teeth, too

But the region is a clear-cut leader in dental problems, with nearly half the people age 65 and older saying they have lost all their natural teeth. And no other metro area comes close to Huntington's adult-obesity rate, according to the report by the U.S. Centers for Disease Control and Prevention (CDC), based on 2006 data.

The area's poverty rate at 19 percent, much higher than the national average. In the hilly coal fields to the south, people still live in houses or trailers with drooping, battered roofs and stare hard at any stranger in a new car. In Huntington and its outskirts, many think of exercise and healthy eating as luxuries.

The economy needs to pick up "so people can afford to get healthy," said Ronnie Adkins, 67, a retired policeman, as he sat one recent morning on the smoking porch of the Jolly Pirate Donuts shop.

Doughnuts don't help either, of course. But breakfast-pastry shops aren't the most common outlets for fatty food. Pizza joints are. Hot-dog places also abound, with the city hosting a hot-dog fest every summer.

Lack of exercise is another concern. During a warm and sunny autumn week — the kind of weather that would bring out small armies of joggers in some cities — it was unusual to see a runner or bicyclist.

Local politicians tend to share the prevailing apathy about improving health, said Dr. Harry Tweel, director of the Cabell-Huntington Health Department.

Defiant outlook

"People here have an attitude of 'You're not going to tell me what I can eat.' The cultural attitude is, 'My parents ate that and my grandparents ate that,' " he said.

The latest numbers came from the CDC report, released in August but little-publicized. It was based on survey data from 2006, comparing about 150 metropolitan areas.

A recent state study found that health problems are significantly worse in the more rural coal counties to the south. But those places didn't show up in the CDC report because they were too small.

Still, Huntington is an unusually obese place, said Dr. John Walden, chairman of the family and community-health department at Marshall University's medical school.

"I don't know that I've ever been in a place where I've seen so many overweight people," he said.