INTERVIEW BY Martha Thomas PORTRAIT BY André Chung

Nicolette (Nikki) Highsmith Vernick is executive director of the Horizon Foundation, a philanthropic organization established Foster Johnson-Lewisin 1998 as a result of the merger of Johns Hopkins Medicine with Howard County General Hospital. The foundation funds initiatives to overcome barriers to good health as well as to promote preventive care. A native of Texas, Highsmith Vernick previously worked for the Massachusetts Medicaid Program and, most recently at the Center for Health Care Strategies, an organization focused on improving care for beneficiaries of publicly financed health care programs in the U.S.

Q What drives your work at the Horizon Foundation?

We have a broad view of health. We want people in Howard County to live long, healthy lives, free of disease, full of physical, mental and social well being. That guides everything we do. We’re focused on prevention and primary care, as well as population health – how we can make our overall community healthier. After a strategic planning phase, we’ve focused on two major issues: one, that everyone in the county has access to high quality health care, has health insurance and can get primary preventive care from culturally competent health care providers who speak their language. We’re also focused on preventing disease: heart disease, cancer, stroke, diabetes. Those cause half the deaths in our county, and all are chronic conditions that are preventable. Obesity is a root cause of many of those diseases.

Q Howard County is the healthiest county in the state. Does that mean we don’t have a problem here?

I grew up in Houston, Texas. If you grow up in Texas you have a strong sense of place, ingrained from when you are a child. Howard County is the same way. We have an authentic sense of pride in our community and a progressive county government. But even given our wealth and educational status, we are no better on obesity than other places in Maryland. We have significant issues and need to rally as a community to solve a major crisis. We’re raising a generation of children who won’t have the life expectancy of their parents.

Q How do statistics here line up with the rest of the country?

We mirror the rest of the country when it comes to obesity. One in four children are obese, two in three adults are overweight or obese. We know that sugary drinks is the largest single contributor — we know there are other causes, but that is the biggest. That’s why we launched Howard County Unsweetened, to promote healthy drink options and to reduce consumption of sugary drinks. The initiative has three levels. One is to influence individuals – mostly parents – about healthy beverage options. We’re working at the community level – targeting faith based and educational institutions, where children live, learn and play. The last level is working with elected officials to look at our government policies. The county executive recently announced that we’re only serving healthy beverage options on county property.

Q Are you getting any pushback – like Michele Obama and New York’s Mayor Bloomberg occasionally get from small government types?

Certainly there was concern that the county was limiting people’s access to sugary drinks. But, one, people can still bring their own drinks – the county just isn’t endorsing or providing sugary beverages. Second, the county provides health insurance for all its employees. High rates of obesity drive up health care costs and reduce economic productivity. So the county is not only looking out for its citizens, it’s looking out for its bottom line.

Q There are a lot of healthy amenities built into the original plan for Columbia. Do people make good use of them?

What was put in place is an amazing start. But we need to look forward to what we’re going to provide for the next generation. There are plenty of progressive communities that have gone beyond the walkable paths that Columbia has – they’ve increased bike paths and established access to local and sustainable food sources. There’s so much more we can do. I agree that we have a great foundation. But I think we need to be thinking of the next 30 years and how we build for the next generations to enhance health and wellness.

Q Are people in Howard County well informed about the new health care law?

Unfortunately, here, as in other parts of the country, the people who stand to benefit the most from the new law know the least about it. A lot of our support for Healthy Howard is to provide resources to reach hard populations. We’ll have a mobile unit that will go throughout the county to reach individuals. Part of having health insurance under the Affordable Care Act is that many preventive care services are now available without a co-payment, whether it’s immunizations for children or mammograms and other tests for women. The Affordable Care Act is kicking down the barriers of preventive services.

Q You have two children – what do you teach them about good nutrition?

All the kids in the neighborhood know that when they come to the Vernick house they can ask for milk or water, they can’t ask for juice boxes. We talk with our children a lot about moderation and what’s healthy. We let them try lots of different things. The favorite snack before dinner is cut up cucumbers.

Q Is there a time and a place for sweet treats?

Dr. Robert Lustig, who has a new book (“Fat Chance: Beating the Odds Against Sugar”). talks about how our norms have changed. Sweets used to be a once-a-week kind of thing – after dinner on Sundays. But now you can have two or three a day. We need to get back to it being a special occasional thing. In our house, there are “always” foods and “sometimes” foods. You don’t have to ask to get an apple. You do have to ask for the “sometimes” foods – like cookies.

Q Do girls have different body image issues today than when you were growing up?

One of the things we’re conscious of here is talking about health in a positive way. We don’t want to stigmatize or make it a negative. I was a cheerleader in high school and we got weighed in every week. You had to maintain a certain weight and if you went over, you were kicked off the squad for one game. I had friends who took extreme measures. I remember being terrified every Friday morning when I had to stand on that scale. That kind of thing would be unheard of today – we spent a lot of time fighting the school system because we thought it was inappropriate. I hope that my daughter won’t have that experience.

Q What is your personal exercise program?

I run. I ran a half marathon two years ago. Weight training has become more important. In our family, we try to incorporate exercise into our daily lives, we spend a lot of time outdoors. We love the Howard County Conservancy. We will also go to Patapsco State Park and just walk. *

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