Be Healthy: Q&A With Peter Selwyn, MD

Dr. Peter Selwyn became head of the recently formed Office of Community Health at Montefiore Medical Center two years ago.

The Bronx was recently named the unhealthiest county in New York. Is this true?
Yeah. If you look at the other numbers, the Bronx has the highest prevalence of people who are overweight in the city. It’s over 60 percent . . . diabetes rates are also very high. There’s some variation in the borough [in terms of some areas being worse than others], but overall it seems the combination of poverty, probably some of the environmental conditions in which access to fresh produce or more nutritious food and healthy spaces for physical activity are more limited than some other areas, populations of people who are recent immigrants who may not be insured and interacting effectively with the social services, all these things combined [make it the unhealthiest county].

What can a medical facility do to make the Bronx healthier?
When you look at the interventions one can do when dealing with the outcomes related to, say, obesity or diabetes, what a medical facility can do ranges from the one-on-one patient encounter [with a doctor], to things that can happen with groups of patients to things that can happen with a larger population that may be at risk for a condition and things that can happen with a broader community.

You need to find an array of ways in which to both better organize and provide the medical care and better encourage the interventions that will allow people to be living in environments that have more choice and more access to help promoting healthy behaviors. I think the mantra of the public health sector is: make the healthy choice, the easy choice.

What are some simple steps people can take to improve their health?
If you smoke, stop smoking. There are resources to help people do that through the city Health Department.
Increasing the level of physical activity. Some people get fixated on they have to join a gym or work out or get in good shape. But it doesn’t have to be going to the gym. It can be walking. Walking is extremely beneficial. Get off the subway one stop before your regular stop and walking the extra blocks home. Or whenever you can, take the stairs.

Stay away from high-caloric foods with a lot of fat and sugar in them — also foods with a lot of salt aren’t good.

And increasing the amount of fresh fruits and vegetables people eat. Whole grains. Decreasing red meat. One thing that is an extremely good protein source that is cheap and also has a lot of fiber in it is beans. Beans are a terrific staple that also can be used in a variety of different cultures and cuisines of different nationalities. Also, if there’s any way to reduce the amount of soda drunk, especially by adolescents. It causes not only weight gain, but increases the risk of diabetes.

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