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Arkansas plans to reward healthy employees
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     The state of Arkansas is launching cash incentives and lower rates of insurance for state employees who show measurable improvements in various health and medical variables, in an attempt to tackle obesity.

    Arkansas is the third unhealthiest state in the United States, if levels of obesity, inactivity, and smoking are any indication. Only Mississippi and West Virginia rank worse than Arkansas, where 24% of the population is obese, according to the Centers for Disease Control and Prevention.

    Increasing levels of obesity are adding to the burden of disease, according to Fay Boozman, director of the Arkansas Department of Health, who says that the number of diagnoses among children of type II diabetes related to obesity has increased by 800% in Arkansas抯 general paediatric clinics and hospitals.

    Arkansas plans to combat the increase through a state run initiative that will encourage citizens to lose weight, exercise more, and stop smoking. The state抯 governor, Mike Huckabee, and Dr Boozman are drafting a plan that will reward state employees who lower their concentrations of blood sugar and cholesterol and who stop smoking.

    Specific plans have not yet been made public, but Governor Huckabee has said that they will involve cash incentives and lower rates of health insurance for positive behaviour rather than penalising people who are ill. He believes that a major fault with the current healthcare system is that it fails to address prevention and essentially rewards unhealthy behaviour by subsidising the cost of health care for patients with preventable diseases.

    "We want to come up with a way to incentivise prevention," he said. "Essentially we want to reward people who reduce their risk factors."

    Non-smokers, for example, might pay a lower health insurance premium than smokers.

    The incentive plan is due to be released later this month and will be publicised in a series of presentations by Dr Boozman. Governor Huckabee and Dr Boozman are suitable role models for the plan, as they抳e each lost several kilograms in weight while in office.

    Arkansas is in the vanguard of states seriously trying to combat obesity. In a related but controversial drive the state passed a law, Act 1220, in late 2003 that requires public schools to calculate the body mass index of each student yearly and to include the scores on the students?report cards. The law faced opposition from people who believed that it further stigmatises overweight children, but several moves to repeal the act have failed. Meanwhile Texas attempted to combat childhood obesity by limiting schoolchildren抯 access to snack and soft drink machines, but its efforts were opposed by the state抯 soft drink associations and were eventually dropped.(Richmond, Virginia Debora)