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Will Humble, director of the Arizona Department of Health Services, makes a point during an interview Wednesday with Cronkite News Service. Sheila Sjolander, assistant director, public health services, is at left. (Photo by Elisa Cordova/Cronkite News)

PHOENIX - Combating a national obesity epidemic 20 years in the making requires more than just passing out brochures, Arizona's top health official said Wednesday.

What's needed, said Will Humble, director of the Arizona Department of Health Services, is policies changing the environment in which people make decisions about diet and exercise. That can range from creating bike-friendly neighborhoods to toughening nutrition requirements for those accepting food stamps, he said.

"If you don't make it the easy choice, it won't be the choice people make," Humble said in an interview with Cronkite News.

As of 2009, 13 percent of adolescents and 25 percent of adults in Arizona were considered overweight, according to the Arizona Department of Health Services.

A recent report by the U.S. Centers for Disease Control and Prevention showed that the obesity rate among low-income Arizona preschoolers leveled from 2008-2011. But Humble said obesity remains a problem for Arizonans of all ages.

For example, he said, Type 2 diabetes, once referred to as adult-onset diabetes, is increasingly common among children.

"Diabetes creates a whole chain of expensive interventions throughout that person's whole life," Humble said.

Beyond harming an individual's health, he said, obesity carries costs for society at large including higher insurance premiums and Medicaid expenditures.

"What you see in this country is an increasingly expensive system to manage chronic diseases that have their roots oftentimes in behaviors like poor nutritional choices, lack of physical activity," Humble said.

"People always are talking about, 'How are you going to bend the cost curve for health care costs?'" he added. "Well, ultimately you drive down costs by keeping people healthier."

Humble said his department's initiatives to combat obesity include working with communities on revising general plans to promote walking and biking. Others encourage kids to walk or bike to school and promote councils through which representatives of schools and communities provide advice on health policies and programs.

Humble said he'd like to see the federal government require that stores participating in the Supplemental Nutrition Assistance Program, or SNAP, offer more fresh fruits and vegetables rather than just potato chips and pop.

"Changing obesity patterns will need to involve public policy changes," he said.

Humble said it's a challenge that will last beyond his career.

"It took 20 years for the country to get as overweight as it is, and it's going to take another 20 years, or maybe longer, for us to turn that around," he said.

Among other topics, Humble said Arizona's decision earlier this year to expand Medicaid coverage will improve the overall health of Arizonans. He noted that health problems are more common among those with lower incomes.

"I think we're going to see over the next year that Medicaid restoration is going to have a significant impact in terms of improving public health outcomes, especially for that childless adult group which has been rolling off the Medicaid rolls for the past couple years," he said.

Humble said prescription drug abuse and misuse has become a major public health issue - and not just for young people. He said the problem probably stems from demand among patients for help managing pain.

"The pendulum, in my opinion, has swung too far," he said.

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