09/05/2012 10:37 am ET Updated Nov 05, 2012

The Basic Care and Feeding of a Social Animal

All adults now living in the U.S. are, to some degree, children of the Cold War. So we tend to impart a particular venom to the term "communism," and by extension, "socialism."

These are not used to describe philosophies -- they are epithets, referring to a specific political system that oppressed its own people, and threatened ours. And of course, the surviving manifestations of this once global phenomenon still do.

We all know about the tendency to get carried away with such ardent opposition as well. Most of us are a bit young to have firsthand experience with McCarthyism, but our parents lived through it. How ironic that at its moment of fiercest and most paranoid opposition to the political manifestations of socialism, the U.S. government acted most like what it professed to revile.

Nowadays, there is still cause to protest the abuses of socialism practiced in China, North Korea, and Cuba. But these are not the protests we hear most often. When the term "socialism" is being used derisively in the prevailing dialogue of our culture, it is being directed at our own government -- and the Obama administration specifically.

I suspect those who ever lived under the brutal oppression of truly socialistic regimes must find the denigration of a Democratic administration's efforts to preserve some strands in a social safety net as "socialism" objectionable at best, appalling at worst.

To say that the U.S. government is socialistic is an insult to those who lived behind iron curtains. One need only visit Eastern Europe to get a sense of what living under true socialism -- the political variety -- was like.

I am fortunate to have been born and raised in the U.S.A., so I never suffered any such abuse of my personal liberties. But I have visited Eastern Europe, and seen the poignant memorials and monuments of those who have.

The history that inspires the heart-rending art -- and clearly stalks the nightmares of Poles and Czechs and Hungarians -- is far beyond even the most wildly morbid fantasies about potential excesses of the U.S. government. I was in Poland not long ago, and the widespread homages to the brutal repressions of real socialism brought tears to my eyes more than once. We are shaming ourselves to pretend anything remotely like that is going on in the home of the free.

The only proof we need of this is that we the people of the United States can and do express such wild imaginings, and suffer no reprisals. If we were threatened by genuine political socialism, you would be risking your life to say so.

The formal definition of political socialism completely precludes free enterprise, and capitalism. Since those undeniably exist in the U.S. today, we don't have political socialism, or anything like it. So those inclined to throw "socialism" and anyone associated with it under the bus must have something else in mind -- a more generic definition of "socialism," as in: the state of being social. The enemy, it seems, is the very notion of common good, or collective action. The rallying cry, I suppose is: Every man (and woman and child) for him (and her) self! None for all, and all for none.

But before parting company over the proper ways and means of keeping one another's company, let's pause to reflect on some of what is implied by the prevailing use of "socialism."

It refers, in principle, to a system in which the many band together for common good. It refers to a system in which common good is defined by a central, and higher authority. As it has been practiced, it refers to systems with accountability to a clear hierarchy of officials. It implies a bureaucracy. And it certainly requires tithes of some kind so that the masses work to sustain the structure of governance.

And, in return, the system looks out -- to one degree or another -- for the weak, down-trodden, and disenfranchised. The system engages in some pattern of good works, ministering to the needy.

Maybe this description had the hair on your neck rising as you pictured the hammer and sickle. But I had something else in mind. I was thinking of the Catholic Church. Or any organized religion, for that matter. I was also thinking of the U.S. military. And we might add Medicare -- the popularity of which has both political parties swearing they will protect it, whether or not both actually mean it.

Some of our most honored institutions are emphatically -- socialistic. Which simply suggests that socialistic systems of government are heinous to us, but that is not true of every way of being social.

We are social -- and it's not even a choice. We are innately, biologically social creatures. Not all animals are. Adult male polar bears are loners. So are tigers. But we, like creatures as diverse as dolphins and ants, lions and bees, wolves and chimpanzees -- are, and have always been, social animals.

Why do I care? Because our attitudes about all things social impact my day job directly.

Culture is social; culture shapes behavior; and behavior shapes health. In fact, our behaviors and the social institutions that influence them have a greater impact on health than anything else.

A steady stream of research publications dating back to 1993 have reaffirmed consistently that fully 80 percent of the chronic disease burden in modern society -- heart disease, cancer, stroke, diabetes, etc. -- could be eliminated with better use of fingers (not smoking), forks (better dietary patterns), and feet (more routine physical activity). Feet, forks, and fingers are the master levers of medical destiny -- exerting a vastly more potent influence on years in life and life in years than everything else under the rubric of so-called "health care" combined.

And yet, this knowledge has not proven to be power. We have known for 20 years that we could make heart attacks, strokes, diabetes, and cancer disappear 8 times in 10, but have not done so. What stands in the way?

For one thing, the companies profiting from the status quo. The very opposite of socialism -- pure, unfettered capitalism.

But for another, it's our lack of collective action. It's our resistance to policies and programs that could help make eating well and being active every day the norm in our society.

Often, that resistance takes the form of calls for personal responsibility, a variation on the theme of anti-socialism. Once again, it's an every man, woman, and child for him/herself mentality.

But while it's true that how I use my feet and fork is up to me, is anyone truly naïve enough to think that environmental and social factors are irrelevant? Since we now have widespread obesity and Type 2 diabetes among 7- and 8-year-olds, and never did before, are we to infer that today's 7-year-olds have less personal responsibility than every prior cohort?

There is nothing remotely socialistic about the American government in general. Those several of our institutions that represent the closest approximations are among our most widely revered, and universally supported. I might object to the denigration of all collective action for the common good as "socialism" simply for the inaccurate nonsense it is. But my protest is far more specific.

As a specialist in health promotion and disease prevention for more than two decades, I am entirely convinced that many of the best defenses of the human body reside ineluctably with the body politic. Many of the actions most certain to increase years in life and enhance life in years are collective actions. Ill-informed castigations that call into question our Americanism itself every time such actions are contemplated forestall vital progress. Progress that would redound to the benefit of my patients -- and my family -- and yours.

I am an American -- privileged and proud to be so. I do not feel I am suffering the brutal oppressions of socialism when our government takes my tax money to support the social enterprise of our military, which defends the American freedoms I enjoy. I do not feel my children's recourse to public education makes me a socialist. Nor do I feel so burdened when an ambulance rushes to the aid of a crash victim without first verifying their capacity to pay the bill when it comes due.

There are inalienably social aspects of our society. There are inalienably social aspects of every human society. We are, since long before there were political institutions of any kind, social animals. To renounce that as vehemently as some now seem inclined to do simply ignores aspects of reality as fundamental as the hive to the bees.

To rail faithfully against socialism -- not just as a political institution, but as a condition of life -- stay home from church, don't attend a political rally, don't join a political party, and don't let the U.S. military defend you. Never seek medical care, renounce the classroom, and avoid social media (including The Huffington Post). You really can't repudiate social enterprise as a member of any group, without undermining your own cause. If you are inclined to be a member of any group or to be the beneficiary of any collective action, then maybe you are not as adamantly anti-socialistic as you thought.

But if you are that rare exception, the true, anti-socialistic loner, then when you express that opinion, there should be nobody around to hear it -- with the possible exception of a tiger or bear, but certainly not a lion.


Dr. David L. Katz;