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Lack of exercise is another concern. During a warm and sunny autumn week in Huntington -- the kind of weather that would bring out small armies of joggers in some cities -- it was unusual to see a runner or bicyclist. The exercise that does occur is mostly confined to a local YMCA, at campus recreation facilities at Marshall, or at Ritter Park in a tony neighborhood south of downtown.
Some attribute the problem to crumbling sidewalks in the city and a lack of walkways along busy rural roads. Others blame it on lack of motivation, as well as a cultural attitude that never included exercise for health.
There's a connection between education and lack of exercise, too, said Dr. Thomas Dannals, a Huntington family physician.
"The undereducated don't know the value of it. They don't have the drive for it. There's a reason you're successful, you've got drive. The same is true for exercise," said Dannals.
Dannals has been trying to change cultural attitudes. The local newspaper has called him "an exercise evangelist" for founding the city's triathlon, marathon and other projects designed to make exercise popular and fun. He's also spearheading a riverfront exercise trail project, called the Paul Ambrose Trail for Health (PATH).
Ambrose was a Huntington physician who died in the Sept. 11, 2001, jet that crashed into the Pentagon. Just before he died, he had been working on a U.S. Surgeon General report on obesity, and was on the plane that morning to attend an adolescent obesity conference in Los Angeles.
But the PATH project, first proposed more than a year ago, has yet to win the necessary funding. The lack of support is not surprising: Dannals can't even get a company to sponsor the Huntington marathon.
Local politicians tend to be equally tepid about improving health, said Dr. Harry Tweel, director of the Cabell-Huntington Health Department.
Smoking -- a common sin in West Virginia -- has been hard to control, Tweel said. When the health department tried to restrict smoking in local bars and restaurants, a group of local businesses fought it all the way to the state Supreme Court. (The restrictions were upheld in 2003.) Even hospitals have fought smoking restrictions in the past, Tweel said.
Other communities have taken more ambitious steps to control the amount of fat in local restaurant food. In July, the Los Angeles City Council placed a moratorium on new fast food restaurants in an impoverished area of the city with above-average rates of obesity. In 2006, New York City became the first U.S. city to ban artificial trans fats in restaurant foods. Other cities are considering similar measures.
Forget it, Tweel said. Not in Huntington.
"You're mentioning areas (of the country) that are well beyond this local region in accepting that kind of change," said Tweel.
"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.
Mayor Felinton echoed Tweel. Felinton had stomach surgery last year to help him lose weight and has been walking to work about three days a week. He has shed nearly 80 pounds and became sort of a local poster boy for weight loss. But in the midst of a re-election campaign last month, he said he had no plans to plunge into a fight over fat in restaurants.
"We want as much business as we can have here," said Felinton, who lost his recent re-election bid and leaves office in January. "As many restaurants as you have, it kind of enhances the livability. Maybe not the health."
To be fair, most people in Huntington don't seem to be aware of how poorly their city looks in national health statistics.
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. The Huntington area includes five counties -- two in West Virginia, two in Kentucky and one in Ohio.
Of the 40 Huntington-area residents interviewed for this story, many had heard something about West Virginia being one of the unhealthiest states. But only one -- Tweel -- knew about the latest report showing how bad Huntington compared with other metro areas.
Some doctors, on hearing the statistics, noted the Huntington area is not in such bad shape by West Virginia standards. 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.
Walden is a third-generation physician in the area, but he's also traveled extensively around the world. He says it's always a little jolting coming home and realizing how obese his hometown is compared to the rest of the world.
"I don't know that I've ever been in a place where I've seen so many overweight people," he said.
Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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