Indiana faces serious health challenges. Almost two-thirds of the state’s population is either overweight or obese. Nearly 10 percent of the state’s 6.4 million people have diabetes, double the rate 20 years ago.106 More than a quarter get little or no exercise and just one in five eats enough fruits and vegetables.107 And, more than a quarter of the state’s adults smoke, the second highest rate in the country.

Obesity, tobacco, and unhealthy lifestyle choices all contribute to higher rates of chronic illness, including heart disease, hypertension, diabetes and cancer. The result: hundreds of thousands of Hoosiers don’t live as long as they should, experience a lower quality of life, and spend billions extra on health care.

According to a study published earlier this year, obesity alone costs the state more than $3.5 billion a year in health care and lost productivity.

“We are spending an enormous amount on obesity-related disease,” said Marcie Memmer, director of the Indiana State Department of Health’s Division of Nutrition and Physical Activity. The private sector also recognizes that the state’s health holds back economic development.

“When you look at the drawbacks to Indiana, health is at the top of the list,” said Chuck Gillespie, director of the Wellness Council of Indiana, a private group affiliated with the state chamber of commerce, which helps companies set up or improve wellness programs. “I’m concerned that companies may think twice about relocating here.”

Over the past six years, the state’s public and private sectors, led by Governor Mitch Daniels, have worked hard to increase physical activity, improve smoking cessation and decrease tobacco use. In 2005, the state rolled out INShape Indiana, an effort to help residents get healthier; in 2007, with the governor’s support, the state legislature passed a significant tax on cigarettes; and earlier this year, the state released an ambitious ten-year plan to reduce obesity and boost residents’ overall health.

“Adopting a healthy lifestyle is good for you and good for Indiana,” the governor has said. “Too many Hoosiers are losing years because they do not embrace healthy habits. And, health care costs in Indiana are among the highest in the country. Our rising cost of health insurance coverage, combined with lost productivity due to illness, has made Indiana a less desirable place to do business.”

Daniels himself is a fitness buff: almost every day, he runs, swims, works out in the gym, or golfs (he usually walks all 18 holes). His wife Cheri walks 10 miles nearly every day.

Information to Help Hoosiers Help Themselves

The core of INShape Indiana is a website, which serves as a clearinghouse of information for Hoosiers who want to lose weight, quit smoking or otherwise improve their health.

The site includes advice and recommendations on a range of health-related topics. It features information on how to incorporate walking into daily life (walk at work, use a pedometer, wear shoes with proper support), as well as maps of appealing walks all over the state. It also gives advice on how to reach CDC’s recommended 150 minutes of exercise per week (do small amounts of exercise several times a day).

The site is divided into three sections: “Eat Better,” “Move More” and “Avoid Tobacco.” Each section offers information on how to be healthier, as well as practical hints about how to reach your specific goals. For example, the section on diet counsels residents to do most of their shopping in the perimeters of the grocery store, which generally includes fresh and frozen fruits and vegetables, dairy, eggs, meat, chicken and seafood. (The central aisles of most supermarkets tend to have more processed foods, such as potato chips, cookies and sodas.) The section also has a list of more than 100 healthy recipes, including vegetable pasta with tomatoes and green beans with roasted red peppers.

In addition, the site has a link to a list of every farmers’ market in the state, and a downloadable nutrition log to help users keep track of what they eat.

In the tobacco section, residents can find out how to join a cessation program, and how, if they still smoke, to minimize exposure of family and friends to second-hand smoke. In the Community Corner section, the site lists health-related resources —trails, gardens, nutrition education centers, YMCAs, and so on — in each of the state’s 92 counties.

For inspiration and guidance, the site also offers stories from people who have improved their health in one way or another. Among those featured is Allison Fore, of Indianapolis, Indiana. In 2009, after hearing the governor’s wife speak about INShape Indiana at the state fair, Fore, who is 49, began visiting the site regularly and going on some of the walks listed there. Over the past two years, she has lost more than 40 pounds. This spring, she completed a 13-mile race, her longest so far. She visits the site about twice a week for events and tips. “I like reading the stories about other people,” she said. “So many of us share the same problems. It gives you a sense of community.”

Businesses and community groups around the state have also leaned on INShape Indiana for weight loss guidance. The Northwest Indiana Community Action Corporation adapted INShape’s “10 in 10 Challenge” — an approach that encourages people to lose 10 pounds over 10 weeks — for use with senior citizens. Participants learned how to exercise at home and eat smaller portions; some lowered their cholesterol and reduced their consumption of sugar.

Earlier this year, the site went through an extensive redesign to make it easier to use. In addition, INShape Indiana has increased its use of social media, and now regularly posts health information to Twitter and Facebook.

Over the past six years, INShape Indiana has also rolled out several marketing campaigns to spread the word about its web site and the importance of being healthy. A survey last year found that almost 60 percent of state residents were aware of the program. Since 2005, 86,000 state residents have asked to receive INShape Indiana’s regular emails. More than 50,000 are currently signed up.

In 2007, INShape Indiana started the “10 in 10 Challenge,” encouraging people to lose 10 pounds in 10 weeks. The campaign included an extensive media campaign, and more than 40,000 people signed up. That same year, INShape Indiana won an “Innovation in Prevention” award from the U.S. Department of Health and Human Services.

INShape Indiana also works in the non-virtual world. It helps the Indiana Department of Natural Resources promote its improved network of trails. Along with the state Chamber of Commerce and the Wellness Council of Indiana, INShape Indiana puts on an annual conference on private sector wellness programs.

Gillespie, director of the Wellness Council of Indiana, said the state’s program encourages businesses to do more for workers’ health. “When the governor lives it, breathes it and supports it,” he said, “it makes it very hard for corporate leaders to ignore it.”

He said Indiana businesses are starting to understand the importance of encouraging employees to be healthy. His group has 70 members; he expects that to double or triple over the next two years. “CEOs are saying �?What can we do to lower health care costs?’” Gillespie said. “The conversation is starting to move toward prevention.”

The state has also focused on reducing tobacco use. In 2006, Daniels eliminated smoking at the state government complex.121 In 2007, the state raised the tax on a pack of cigarettes by 44.5 cents — a move supported by Daniels. “The biggest impact of a higher price is on dissuading young people or nonsmokers from taking it up in the first place,” the governor has said.

According to the state health department, in the year after the increase went into effect, consumption of tobacco products dropped by almost 20 percent, a decrease of 81 million packs. Earlier this year, a bill to ban workplace smoking was defeated in the state senate. A study by the American Cancer Society found that the ban would have saved the state $84 million in health care costs.

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