Sickest city yawns at distinction

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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 feet 9 inches tall 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 higher 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 of their teeth (about 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, Mr. Thorpe 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 in the chemical industry and in glassworks, steel and locomotive parts. 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 burnt 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, and chronic diseases - many of them connected to obesity - seem much more common.

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

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