Forget the health care crisis.
This country is in the midst of a health crisis -- we are simply in worse health now than we were a decade ago. The trend lines are pointing in the wrong direction. And it all starts with obesity.
When you think about it, the U.S. has done a terrific job catering to our worst impulses. Calories are cheap, and so we eat too many burgers and sodas (200 calories of good food are considerably more expensive than 200 calories of processed, fattening foods, as these pictures demonstrate). Entertainment is free and ubiquitous, so we plop down in front of our television sets for hours a day (in fact, researchers have found that the more hours people watch TV, the fatter they tend to be).
The result is that in many areas of the U.S., life expectancy is actually heading downward, for the first time in the modern era. A 2008 study in PLoS Medicine shows that in many pockets of the country, people are simply dying earlier than they used to. "Beginning in the early 1980s and continuing through 1999," the study says, "those who were already disadvantaged did not benefit from the gains in life expectancy experienced by the advantaged, and some became even worse off." A primary culprit: Obesity and the resulting conditions such as diabetes, heart disease and stroke.
This "reversal of fortune," as the study's authors put it, is likely to have accelerated since the year 2000, when the study's data ended -- meaning that the downturn in life expectancy may be even more widespread today.
This health crisis, of course, does in fact dovetail with the larger issue of health care reform. Almost $100 billion is spent annually on medical issues related specifically to weight and obesity, according to the Centers for Disease Control and Prevention, and half of that cost is paid by the government via Medicare.
This is a vast and growing crisis -- and there's starting to be some organization to combat it. Some people, including Michelle Obama with her Let's Move campaign against childhood obesity, are trying to draw attention to it.
And earlier this week, Gov. Arnold Schwarzenegger and former President Bill Clinton took part in an obesity summit in Los Angeles to discuss possible solutions. Alas, many of these solutions look to government bans and regulation rather than improving people's understanding of their health -- and their responsibility in protecting their own health.
The fact is that, for too many of us, our health is something that provokes anxiety, something that we don't want to take care of -- and something we often don't feel very much in control of. We need to change that. We need to find ways that work for us, individually, to engage in our health and make better decisions about what we eat, how much we eat, and how often we eat.
Yes, food companies are doing a very good job of exploiting our brain chemistry. And yes, for some people genetics play a significant role in predisposing them to obesity. But the food companies sold Fritos and Coke 20 years ago. And our DNA hasn't suddenly changed enough to account for the rapid change in our national waist-size. The fact is that we are agents in our own lives, and our actions have consequences. And right now, we are making choices that have made us a more overweight country.
We need to make this a national priority to help people know why their choices matter, and how they can make better choices for better health. The key is to give people a place to start -- let them know their actions have consequences. The calorie counts posted outside fast food restaurants are a good start, and may help change people's decision making (though there's much debate over this). And educating parents about things, like, how to cook healthy meals - an increasingly forgotten skill in this country -- would go miles.
We should increase funding for after-school sports programs and gym classes, so that more kids have a chance to develop healthy exercise habits. It's important that this be about more than team sports -- an "athletic identity" has been closely associated with better health -- and an athletic identity is for everyone!
We don't have to go down this road. We don't have to stand by and watch the country become less healthy. We can act. It all starts with us.
Thomas Goetz is author of the new book The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine.