Healthy Louisville 2020 – A Shared
Community Agenda to Improve Health
LaQuandra Nesbitt, MD, MPH
I
n February, Louisville Mayor Greg Fischer
and I unveiled Healthy Louisville 2020. It is
a comprehensive, community-wide plan to
significantly improve the city’s health over the
next six years. The Metro Department of Public
Health and Wellness gathered and analyzed
data on various community health indicators
from federal, state and local sources, including
the Behavioral Risk Surveillance System Survey,
which the department conducts locally.
To improve overall health significantly, Louisville Metro Government is also taking a “Health in All Policies” approach, which will
consider the health ramifications of all government policy, particularly in such areas as community design and land use planning,
housing, transportation, education, and fiscal sectors. We want to
put health at the heart of the public policy process. This means a
city where, for example, new housing subdivisions have sidewalks
that connect neighbors and invite folks to get out and walk. It’s a
city that recognizes and makes use of practices that have proven
successful elsewhere to improve the health of its citizens.
The 59-page report contains data on key health indicators such
as local rates of cancer mortality, chronic disease, tobacco use, low
birth weight babies and obesity. It makes 82 recommendations to
address Louisville’s consistently high rates of smoking, obesity,
diabetes, cancer and other health problems.
Several Healthy Louisville 2020 recommendations address two
issues at the root of many of Louisville’s chronic health problems—
smoking and obesity. Our goal is to decrease the percentage of Louisville adults who are obese from 29.3% to 26.4%, and to decrease
the percentage of children who are obese from 24.2% to 21.8% for
6th graders, and from 17.9% to 16.1% for kindergartners by 2020.
One obesity-reducing recommendation is to encourage primary
care providers to prescribe structured physical activity regimens
that include specific recommendations for the frequency, intensity,
and type of exercise to patients who are at risk for obesity or being
overweight.
A group of local stakeholders, the Mayor’s Healthy Hometown
Movement Community Coalition, prioritized the community’s
health needs with the Department of Public Health and Wellness
and the Mayor’s Healthy Hometown Leadership Team and identified evidence-based strategies for improvement, and will continue
to plan and implement these to make sure that Healthy Louisville
2020 goals are met. The recommendations have three major characteristics. They emphasize prevention; they advocate evidence-based
interventions; and they take a health-in-all-policies approach.
Research has shown that prevention is key for healthy communities and interventions should primarily focus on proactively
promoting health and wellness rather than treating disease and
disability after the fact. Only policies or programs that are evidencebased and/or outcome driven, proven to be successful and to create
meaningful change, have been chosen.
Additionally, Healthy Louisville 2020 recommends adopting the
National Salt Reduction Initiative, a voluntary public-private partnership aiming to reduce salt intake, and implementing the FDA’s
proposed restriction of the use of artificial trans fats in fried food
and prepared baked goods in local eateries. The FDA last year made
a preliminary ruling that partially hydrogenated oils are no longer
“generally recognized as safe,” which, if finalized, would subject the
fats to pre-market approval by the FDA. If the FDA enacts regulations, the Department of Public Health and Wellness would enforce
them as part of its regular restaurant inspection process.
We also recommended a monitoring system through school
physicals for body mass index, expanding the city’s Bike Share
program beyond downtown, and limiting the density of fast-food
restaurants, especially in food deserts where people have limited
access to affor X