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The state can't make people exercise. Can it make them want to? 

Chronic Problem

More Richmond residents suffer from many chronic diseases than people elsewhere in the state, new findings from health reports and census data show. Poor diet and lack of exercise are blamed for much of the disparity.

While that news is nothing new — areas in the inner city with low incomes consistently have more health problems — the most recent figures have spurred public-health officials to ask: Is there some new way to get people to exercise?

Information from the U.S. census is being used to reexamine and adjust health reports to show what populations are at the greatest risk of deadly diseases. And while the latest analyses have some good news for Virginians — including fewer cases of tuberculosis and HIV infections than previous analyses— the state still ranks higher than average for other conditions like stroke, heart disease, cancer and diabetes, according to a recent report by the state health department.

For Richmond residents, the news is even more disturbing. A 1998 study (the latest available) compiled for the city shows that city residents are in poorer health than the statewide average. Findings show death rates nearly double the state averages for stroke, heart disease and diabetes.

In theory the cure is simple: regular physical activity. But past initiatives to promote vigorous exercise — like offering weight training and exercise classes at area civic centers — have failed to get enough people involved.

Now health officials have a new plan. And they're learning from the few programs that are making a difference — like the one that saved Gilbert Menefield.

Over at Randolph Community Center, the temperature rises quickly on Thursday nights. That's when Menefield takes charge.

Menefield has reason to sweat. Diabetes runs rampant in his family and when he was diagnosed with the disease four years ago, he decided to do something about it. He joined Rock Richmond.

"I'd go all over the city anywhere there was a class," says Menefield, who credits regular exercise for the fact that he no longer requires daily medication. Now he teaches aerobics classes six days a week at Randolph and other locations around Richmond.

On a recent weeknight, 30 women pile into the gleaming white gym and instantly a powdery smell overpowers the stink of sweat and sneakers drifting in the air after a boys' basketball game. In minutes the women sweat, too.

In the four years since the city's public-health department started Rock Richmond, an aerobics program that aims to help residents get in shape, 600 have signed up. Exact figures aren't yet available, but city health officials say most of those who start get hooked. Nearly 80 percent of residents had never exercised regularly, says Michael Welch, Ph.D., chronic disease program manager for the city's Department of Public Health.

"Retention has been phenomenal," says Jody Lynn Stones, cardiovascular health project manager at the state health department that works with the city on some projects. "In this day and age to hit a market is really wonderful."

Despite the success of Rock Richmond, such community-health programs haven't gone as far as public health officials would like. A staggering number of city residents remain at high risk for chronic disease.

As a result, says Welch, state and local public-health officials are changing their approach to public health. The state health department's Stones calls the new approach "cutting edge."

The department is calling for public-health officials like Welch to look at how a community's environment can act as a barrier to exercise. The idea is that if the environment is more attractive, people will be more likely to use the area to get in shape.

The idea is for public-health officials to work with the city's Department of Parks Recreation & Community Facilities and others to promote things like site cleanups, bike paths and walking trails and updated lighting and landscaping. The idea, says Stones, is to make the idea of exercise more attractive to people.

"It's a whole paradigm shift from programming to a focus on policy and the environment," says Welch. "We've tried programming for 30 years and it hasn't worked."

Since the 1970s, Welch notes, health experts have been hounding people to exercise 30 minutes a day five days a week. "But if only 35 percent of the people have listened, it's like the definition of insanity. We're doing the same thing over and over again and expecting different results," says Welch.

So now public health officials are looking more closely at how environment influences a community's collective health. They're doing that by looking at places like South Side's Hickory Hill.

Two years ago the city renovated the Hickory Hill School at 3100 Belt Boulevard. So far, about 40 people pay the required $15 a month to be members. That gets them the use of two rooms brimming with new equipment and weights. Plus there are diet and exercise classes from the site's part-time exercise trainer. Still, the number of people using the facility has not reached expectations.

"We really had a good response when it first started," says Carol Collins, a neighbor who visits the center regularly for meetings and activities but doesn't exercise there. "But I have talked to people and they say it has fallen off."

Collins says the lack of interest is the result of a lack of publicity, and she suggests city officials focus their efforts there.

The new approach may be working. Helene Vango, Hickory Hill's event manager, says turnout has improved since the grounds have been spruced up with Bradford pear trees, holly bushes, benches and a fenced-in playground. The parking lot also has been freshly paved.

The city still has a way to go to get a regular crowd of exercisers to pack the place. Next on the city's wish list is getting funds to fix up the basketball courts and softball field. "A lot of people have asked about a pool," Vango says.

It's just the sort of feedback public-health officials are hoping to get through face-to-face contact with folks from the community.

Next in store, neighbors of Hickory Hill will be asked how they feel about their community's health and how it could be improved, says Stones. "We hope to study it as a microcosm of the city," she says. "This is a new niche for public health."

And if people can be enticed to exercise and get active at the Hickory Hill facility, like they do at Randolph, the model could work elsewhere.

The mothers, daughters, sisters and grandmothers who convene at the gym in Randolph are proof it can work. For some like Liz Burton, it's dramatic.

"I don't like exercise," she confesses. "But this is the most consistent I've ever
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