家庭事务:打破西弗吉尼亚州心脏病的代际循环

RAINELLE, 西维吉尼亚州 — Like many people in rural 西维吉尼亚州, 塞布丽娜福特 grew up on beans cooked with lard and cornbread loaded with sugar, often with a side of fried potatoes cooked in bacon grease.

这是她母亲长大的食物, 当福特成为母亲时, she prepared this meal and other fried foods for her children.

但是多年的高脂肪饮食, 油炸食品和含糖食品还会导致另一个家族遗传:心脏病和其他慢性疾病. 她母亲有15个兄弟姐妹, 14 have had open-heart surgery or stents placed to open clogged arteries. 福特的妹妹在51岁时心脏病发作.

Ford, 52, has Type 2 diabetes, a major risk factor for heart disease and stroke. 今年1月，她曾轻微中风, 发现她的几条动脉堵塞，现在正在服用降胆固醇药物. 她28岁的女儿, Sarah Ward, has prediabetes and battles to keep her blood pressure under control. Ford also has a 30-year-old daughter who struggles with irregular heart rhythms.

As the director of nursing at Rainelle Medical Center, 镇上唯一一家为大约1,170居民, Ford is well-versed in the risk factors contributing to heart disease, 糖尿病和其他疾病. 她担心，如果她不改变这种不健康的状况，她的孙子们将是下一个.

“我不希望他们这样，”她说，她也不想错过看着他们长大的机会. “我想在这里呆很长沙巴足球体育平台. 我想看到他们高中毕业."

福特有理由担心.

美国农村地区——尤其是阿巴拉契亚地区的农村地区——面临着全国最高的心脏病和慢性病发病率. 西弗吉尼亚州的离婚率处于或接近最高水平 心血管病 and diabetes以及高血压、吸烟和肥胖等心血管风险因素.

(VIDEO: Rural 西维吉尼亚州's health crisis gets homegrown help)

多种因素导致这些健康问题.

传统饮食, 文化差异和人们无法控制的社会因素使得人们很难做出更健康的选择. 西维吉尼亚州 has high poverty and low educational levels, limited access to nutritious foods and opportunities for physical exercise, and lack of transportation to get to the region's limited health care facilities.

The end result is that people there don't live as long as everyone else, 农村居民总体上也是如此 更容易死亡 远离心脏病和中风.

On average, the life expectancy of rural Americans overall is about 2.5 years less than people living in urban areas, according to research 在COVID-19大流行之前进行的. In 西维吉尼亚州, they lose additional time, with a life expectancy of 72.到2020年为止的8年，最近的一年 国家级数据 is available from the Centers for Disease Control and Prevention. 相比之下，同一年美国的数字为77.

福特和女儿, Ward, 医疗中心的糖尿病专家, 正在努力打破慢性病对他们小镇和西弗吉尼亚州大部分地区的束缚, a center-run program that includes a series of exercise, 饮食和其他鼓励创造和保持更沙巴足球体育平台方式的举措.

他们相信他们能为家庭和社区做的最好的事情就是以身作则.

"Over the last year, I've been making some lifestyle changes myself," Ford said. “我正在节食，注意我吃的东西. 我瘦了60磅. I want to pass it down to my grandchildren that we practice good healthy habits."

Ford and Ward don't just ask their patients to get up and move. 每周三，他们都会在Rainelle的街道和当地的一个公园里和他们一起散步.

沃德和她的同事, 阿什利·贝瑞, 举办Facebook直播烹饪示范, 他们在自己的厨房里准备健康的饭菜，然后喂给自己的家人. Ford grows fresh fruits and vegetables in her backyard garden, 教她的孙女们品尝新鲜采摘的草莓和生菜的味道.

他们利用了一系列联邦, state and nonprofit grants and resources to make the most of what they've got.

Rainelle医疗中心获得联邦资金，为服务不足的地区提供初级保健服务. 它的服务人数超过14人,000 people in three counties through 11 community health centers, 两个牙科中心, 20个咨询点, 肾脏病中心, 两个药房和七个校本保健中心.

该医疗中心是参与美国心脏协会和美国医学协会目标:BP计划的100多家农村联邦合格医疗中心之一, 哪家公司为员工提供培训, 教育和帮助人们追踪和治疗高血压所需的工具.

也被称为高血压, 高血压是心血管疾病和其他慢性疾病的主要危险因素. 如果人们不能去健康中心, workers go to their homes to measure blood pressure levels and manage medications.

他们的努力开始产生影响.

Across the region they serve, Ward said they've lowered hypertension an average 8.4% and cholesterol by an average 11% since launching Target: BP in 2017.

参加另一项糖尿病项目的患者也看到了重大改善，该项目包括健康教育和监测. 血糖水平急剧下降, 平均下跌32%, 而糖化血红蛋白平均下降了42%，糖化血红蛋白是衡量一个人长期血糖维持情况的指标, 从13%到7%.5%. 糖化血红蛋白低于5.7%是正常的.

在一个只有一家健身房和一家杂货店为高贫困率人口提供有限的健康食品选择的小镇，这可不是一件小事.

Berry, a 36-year-old nurse who had gestational diabetes during both of her pregnancies, knows just how hard it can be to make lifestyle changes. Just three years ago, she was 80 pounds heavier, eating poorly and not exercising.

“我当时的状态是我一生中最糟糕的，”她说. When she was tasked with helping to run the Wellness Works program, “这激发了我的动力."

“我开始非常注意我吃的东西,贝里说。, who grew up drinking a lot of sweet tea and snacking on cookies and chips. 她不再为家人购买加糖饮料，而是专注于减少饱和脂肪和增加纤维. Getting started was difficult, she said, until she got into a routine.

"I started looking at the food as a whole and what benefits it has. I don't really count carbs or calories or anything anymore," she said. “这更像是一种生活方式的改变. 如果我想要意大利面和肉丸，我有，但也可能是火鸡肉丸或意大利面南瓜. 我没有吃面包，而是吃沙拉. 我每顿饭都做蔬菜."

Berry is responsible for maintaining the medical center's Facebook page, 她偶尔会发一些个人帖子，让人们看到她在实践她所宣扬的东西. "I want people to have this personal connection with me. 比如，‘如果她能做到，也许我也能.'"

Ward hopes telling their stories will motivate others.

"We use our influence as health care professionals to display how being active, 烹饪健康膳食, 在杂货店购买更好的选择，自己种植食物是可能的, 即使我们都面临着障碍," she said.

沃德和贝瑞结束了烹饪示范, 向人们展示如何制作豆子, 牛油果和红卷心菜沙拉卷, 沃德的小女儿, McKenna, 在门外不耐烦地等着样品.

这是鼓舞人心的, said Ward, who hopes the next generation will grow up seeing these types of food as normal. “因为这种沙拉很冒险. 对于我们的文化来说，确实如此."

美国心脏协会沙巴足球体育平台(美国心脏协会 News)派出记者到五个州报道农村地区面临的健康挑战, and how people in rural America are working to overcome them.