With health care an increasingly prominent issue across the country, two governors visited Charleston on Thursday to focus attention on a statewide effort to encourage healthy living among blacks.

South Carolina Gov. Mark Sanford and Arkansas Gov. Mike Huckabee visited a downtown community health fair at Emmanuel AME Church held as part of a four-year-old partnership between the Medical University of South Carolina and the church called "Health-e-AME."

The two Republicans have been cheerleaders for health improvement efforts. Sanford has spearheaded the Healthy South Carolina Challenge and holds an annual Family Fitness Challenge. Huckabee started similar efforts in his state and is focusing on health as chairman of the National Governors Association, which recently started a Healthy America initiative.

Huckabee has set an example himself, having lost 110 pounds since being diagnosed with Type II diabetes in 2003. This year he finished the Little Rock Marathon and released his fourth book, "Quit Digging Your Grave With a Knife and Fork," a title he got from his doctor.

Huckabee is no longer a diabetic.

"It's an issue that goes to the heart of every human being," Huckabee said. "Everybody wants to live longer."

The health fair was the first in a series of visits Huckabee is making to various states to learn about efforts that could be copied across the country. Huckabee said he visited South Carolina first because the Healthy South Carolina initiative fits that profile.

Huckabee is widely believed to be a potential 2008 presidential candidate, and South Carolina's early presidential primary is considered key for any Republican hopeful.Health care is a vital issue for many governors, including Huckabee and Sanford, who are struggling with the skyrocketing growth of Medicaid, the state-federal health program for the poor. States are looking at increasingly drastic measures for stopping that growth.

Huckabee said Medicaid in his own state has grown from a $600 million program in 1996 to a $3.5 billion program now. "It's a huge issue," he said. "It's the 800-pound gorilla eating all of us."

Many states are watching South Carolina, Huckabee said. The state is proposing a massive overhaul of its Medicaid program that would give recipients personal health accounts with which they could choose to pay for a number of managed-care plans. Recipients also could choose instead to "self-direct" their care.

Before touring the health fair at Emmanuel AME Church, the governors met with hospital CEOs from across the state, asking them for suggestions on controlling health-care costs, especially among the most expensive patients.

In South Carolina's Medicaid program, for instance, Sanford noted that 6 percent of the costliest recipients eat up half the program's costs. Figures are similar in other states.

Both governors believe that encouraging the population to eat less and exercise more may help control those costs. "There are no magic bullets," Sanford said. "It's just one of those bullets in the chamber. If you keep someone from getting Type II diabetes, you can save tremendous cost on the back end."

Health problems are especially acute in low-income and minority communities because of poor overall health and poor access to doctors and hospitals.

In South Carolina, blacks are more than twice as likely as whites to die because of diabetes and are also more likely to die because of heart disease, cancer and stroke.

MUSC has targeted that population by working with the AME church through Health-e-AME, which encourages healthy eating and physical activities among the church's predominantly black congregation.

The initiative includes a cookbook with traditional recipes modified so they're healthier, and programs, such as "Praise Aerobics," which combines aerobics with praise or contemporary Christian music.

"It's a faith-based culture, and the church is the center of that culture," said Thaje Anderson, owner of Praise Aerobics Inc. "The AME church is the largest in the state. If you want to get a message to the African-American community, you go to the AME church."

Anderson said the governors' visit to the health fair can only help that effort be more effective, noting that among the 300 aerobics programs she's started in churches around the state, the more successful ones include heavy involvement by church leadership.

"If the leadership is involved, the congregation will follow," Anderson said. "If we can get the leadership in the state involved (in healthy living efforts), then the population will follow."