By Curtis Thill, M.D.

 

After three decades of seeing multiple generations of families in southern Indiana, I know that boosting health – especially heart health – can be a challenge. I also know that doing what’s needed for heart health isn’t a one-size-fits-all conversation. Heart disease remains our leading killer, but steps can be taken to prevent future heart issues. 

February is a month to focus on cardiovascular wellness, so that gives us an opportunity to talk honestly about the unique challenges we face in rural southern Indiana—and some real solutions that can actually work here.

What am I talking about? Our region deals with a number of heart health risk factors that differ from people living in larger cities. Because of a variety of factors, higher rates of smoking, being overweight, and consuming high-calorie, processed foods often exist in our region. 

This doesn’t demean people in our region, but understanding why these patterns exist is crucial to do something about them.

Here are some examples: many of my patients work physical jobs, yet ironically, they don’t get the kind of physical exercise that actually promotes wellness. Shift work at manufacturing plants and service facilities or long stretches at desk jobs disrupt normal rhythms of sleep and rest. 

Here are some issues many of us face: when someone finishes a ten-hour day, driving to a gym forty minutes away feels impossible. A store offering quality nutritious food to promote health may be twenty-to-thirty miles away, while a convenience store with highly-processed foodstuffs is only a short drive up the road. And yes, smoking remains deeply woven into our southern Indiana culture in ways people living outside our region don’t always understand.

But here’s what I know: rural people are pragmatic. We respond to solutions that fit our lives, not solutions designed for someone else’s reality. Here’s some to consider.

Start with conversation, not judgment. When patients come in, I’m not here to badger them. I’m here to listen. Mrs. Johnson wants to lose some weight, but she mostly eats processed foods. Why? Because she’s working two jobs and needs meals she can prepare for herself and her kids in fifteen minutes. Can we work together on that issue? Absolutely.

Make reasonable exercise and movement realistic. Forget the Iron Man marathon training plan. I encourage my patients to use what’s already available: walking the driveway while talking on your cell phone, taking the stairs, parking farther away. A thirty-minute walk three times a week in your neighborhood costs nothing and requires no driving. Just getting outside for a brief stroll offers numerous benefits.

Rethink the food conversation. When it comes to food and maintaining weight, some think of the discouraging old joke: “If it tastes good, throw it away.” From my perspective, food is here to be enjoyed. So, yes, you can keep your casseroles—but let’s talk about adding more vegetables. Can you try using ground turkey instead of ground beef in your favorite recipes ? Are there frozen vegetables that fit your budget and cooking style? Can you shop at roadside vegetable and fruits stands in the Spring and Summer? Let’s focus on progress, not perfection.

Address smoking thoughtfully. Quitting smoking or using other types of tobacco is tough. It requires time and support, not ultimatums. When a patient tells me they’re thinking about breaking the smoking habit, I discuss options. Each person’s path is different.

Most importantly: regular checkups. Yes, I know that many people — especially men – put off a regular exam. But this is non-negotiable. Why? High blood pressure often has no symptoms. High cholesterol sneaks up silently. A simple visit once a year—more frequently if you have risk factors—can catch problems early when they’re most treatable. We can’t fix what we don’t know about.

My message this February is simple: You belong in this conversation, your challenges are real, and your solutions can be practical. Schedule that checkup. Take that walk. Make one small change this month. Your heart—and your family—will thank you.

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A board-certified family physician, Dr. Curtis Thill has practiced medicine in southern Indiana for more than thirty years.