An excellent overview of the state of public health today!
Here’s some good news: Seat belts save lives[1] . So do vaccinations. The world’s population is living longer. The childhood obesity rate has declined[2] in parts of the United States.
That’s miraculous, because the policies for food, energy, climate change and health care are, effectively, “let’s help big producers make as much money as they can regardless of the consequences.”
Except for just after the most visible tragedies, public health and welfare are barely part of the daily conversation. When New York is flooded, climate change dominates TV news — for a week. When innocents are slaughtered with weapons designed for combat, gun control is a critical topic — for a week. When33 people die violent, painful deaths from eating cantaloupe, food safety is in the headlines — for a week. When nearly 70,000 people die a year, from mostly preventable diabetes, most media ignore it.
Forget the fiscal cliff: we’ve long since fallen off the public health cliff. We need consistent policies that benefit a majority of our citizens, even if it costs corporations money.
And guns are just the bloodiest public health menace to go virtually unregulated.[3] Preventable, chronic disease — to a large extent brought about by diet — is now the biggest killer on the planet. Soda kills more people than guns — more people than car wrecks — only less dramatically. What we need is the equivalent of a dietary seat belt.
And guns are just the bloodiest public health menace to go virtually unregulated.[3] Preventable, chronic disease — to a large extent brought about by diet — is now the biggest killer on the planet. Soda kills more people than guns — more people than car wrecks — only less dramatically. What we need is the equivalent of a dietary seat belt.
When we hear about extended life expectancy on a global scale[4] , we’re hearing about the triumph of public health policies — from municipal water treatment and delivery to sewer systems and immunizations. We’re also hearing about health care that extends lives despite chronic disease, a triumph of expensive technology over thoughtful, less expensive planning.
And we’re hearing about the failure of policy to address the leading public health challenge of the 21st century: not finding a “cure” for our leading killers — coronary artery and related disease, cancer, diabetes (which jumped from the world’s 15th rated killer to its 9th in 20 years) — but taking easily defined action to prevent them[5] .
The global burden of disease report found an impressive decrease in childhood mortality and deaths from malnutrition but also found a doubling of deaths from diabetes since 1990. Stroke and heart disease – not exclusively the result of obesity, but tied to it – are together responsible for a quarter of all deaths worldwide.
Malnutrition in the form of overeating is now a bigger problem than starvation, and both are preventable by sane policy measures that could make decent and real food available to all. Contrary to the hysterical preaching of techno-agriculturalists, there already is enough real food to feed everyone on the planet; there simply isn’t access[6].
Preventing chronic diseases – for the first time in history responsible for the majority of deaths – would not require massive public works programs like building water delivery or sewer systems but simply regulating the quality of our food and the quantity of the nonfood we allow ourselves to ingest. It is not a matter of technology or of miracles, but of policy[7] . Minor inconveniences and infringements that benefit everyone — like seat belts, gun control and limiting our “right” to smoke or drink — should take precedence over our “right” to kill ourselves and one another.
There is evidence not only in studies but also in the real world that public health policy measures can be successful. Why did the childhood obesity rate decline in such disparate places as New York City, Philadelphia, Mississippi and California? It’s simple: These places aggressively tackled dietary issues in schools and elsewhere.
In 2007, Mississippi’s Healthy Students Act mandated 45 minutes per week of health education (home ec, anyone?) and limited the kinds of food and beverages sold in school vending machines. California banned sugary drinks in schools in 2009 and limited unhealthy snacks in 2007.[8]
Philadelphia hasn’t allowed soda or sugary drinks in vending machines in schools since 2004, and its schools no longer have deep-fryers; the Food Trust (as I wrote in 2011) has pushed healthier food in corner stores. And New York has, among other things, banned trans fats from restaurants, made it easier for low-income people to shop at farmers’ markets and run a highly visible ad campaign that tells subway riders, for example, the number of miles they’d have to walk to account for that sugary drink.
Like Philadelphia, New York has come close to passing a soda tax, which has raised consciousness about the dangers of sugary drinks. The so-called Big Gulp Ban (which will not, sadly, affect actual Big Gulps) will be implemented in March; if it hangs around, New York’s obesity statistics may slide even further below the national average before too long.
These are dietary seat belts, and seat belts save lives. And only a jerk would say: “It’s a slippery slope toward telling me what to do. If I want to ride without a seat belt, it’s my right!”
When we see something, we should do something. The something we can all see is this: Eating badly – consuming unprecedented amounts of nonfood, like soda – causes obesity. Obesity brings about chronic disease. Chronic disease kills, wrecks lives and wreaks havoc on our health care system and our economy. We have the power, collectively, to further reduce disease and improve longevity. Who’s against that?
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