I was summoned to the emergency room stat. We tried unsuccessfully for more than 40 minutes to resuscitate the patient. Death by heroin overdose. The young man was 43. I had just started my work for Kaiser Medical Center in Richmond. The year was 1981.
"Forty-three, so young," I remarked to the seasoned ER nurse I was working with. She had vastly more experience than I. Her reply: "It's not the years, it's the mileage."
And so it is with our health. Our circumstances cause us to experience the "slings and arrows of outrageous fortune" as well as the more mundane stresses of everyday life differently. It is the social environment and our relative position within it that most determines the course our life will take, what options are open to us, and how long we will live. We human beings are exquisitely sensitive to social position, even if much of that awareness is unconscious.
ZIP Codes Trump Genetic Codes
It turns out that the average income of one's ZIP code is a more powerful predictor of life expectancy than one's genetic code. For every step up the social ladder, there is a corresponding increase in average life expectancy.
When asked to explain why social position determines health outcome in such a step wise fashion, Sir Michael Marmot, perhaps the world's leading authority in this field, put it this way:
The lower individuals are in the social hierarchy, the less likely it is that their fundamental human needs for autonomy and to be integrated into society will be met. Failure to meet these needs leads to metabolic and endocrine changes that in turn lead to increased risk of disease.
When our fundamental human needs for autonomy and belonging are not met, our physiology rebels. Stress hormones can increase and stay elevated. Eventually, this hypervigilant state can wear us down, and premature illness and death can result.
But there is more. There is our behavior. Heroin is a potent pain killer. For some, day-to-day life is terribly painful, and heroin makes it tolerable. In a lesser way, the same can be said for cigarettes. Nicotine is a powerful drug. Our bodies have receptors for it. Nicotine can pep us up when we are down, lessen our hunger, and relax us when we are tense. No wonder it's easier to give up the habit if we are less stressed out and have greater resources at our disposal.
We know that these harmful behaviors come with a price. In the case of the heroin addict, it cost him his life. It can do the same to cigarette smokers.
We are also learning that dietary choices are influenced by our social position. Coke and Pepsi target minority youth in their advertising campaigns in order to increase sales. Their ads equating soda consumption with happiness, success, popularity, sex appeal and athletic prowess are effective despite the mounting scientific evidence linking sodas and other sugary drinks to an astonishing list of chronic illnesses including Type 2 diabetes, obesity, heart attacks, strokes, high blood pressure, dementia, fatty liver disease, and some cancers.
Soda is not heroin, and soda is not tobacco. There are obvious and important differences. But consider this: Sodas are arguably a greater risk to the health of our children than either tobacco or heroin -- more than one-third of our kids will get Type 2 diabetes, and soda is a major culprit.
Sodas, Like Cigarettes, Can Make Us Old Before Our Time
There is something at each end of our chromosomes called a telomere. It is a DNA-protein cap which protects the DNA, our genetic material, from damage. Each time our cells divide to form new cells, telomeres shorten. Eventually the telomeres become too short for the cells to function normally and these cells die or malfunction. Measuring telomere length is one way scientists study cell aging. They not only shorten as part of normal biologic aging, but also from behavioral stresses like cigarette smoking or caring for a chronically-ill child. In other words, telomere length is a way of looking at, as the ER nurse put it, "the mileage."
It turns out that the more soda you drink, the shorter your telomeres. Over time, drinking a 20-ounce serving of soda a day ages cells about the same amount as tobacco smoking.
Our Chance to Make a Real Difference
Enter the Soda Tax Wars. Full disclosure. I'm a veteran. I ran the Richmond, California Soda Tax Campaign. I flew to Mexico to help lobby for the successful passage of the Mexican Soda Tax. I am working to help pass the Yes on D (Berkeley) and Yes on E (San Francisco) Soda tax efforts.
If you needed another reason to vote for these local soda taxes, remember that: Soda could age us prematurely, just like cigarettes. If we want to promote a healthy community we need to decrease soda consumption just like we have done with cigarettes.
Yes on D in Berkeley
Yes on E in San Francisco
Let's help our kids live long and healthy lives!