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Preventable death

This post summarizes a Harvard study on the top-12 preventable causes of death. (Click on the link for a picture that will drive the point home.) The causes, in order of badness, are:

Smoking: 467,000 deaths.
High blood pressure: 395,000 deaths.
Overweight-obesity: 216,000 deaths.
Inadequate physical activity and inactivity: 191,000 deaths.
High blood sugar: 190,000 deaths.
High LDL cholesterol: 113,000 deaths.
High dietary salt: 102,000 deaths.
Low dietary omega-3 fatty acids (seafood): 84,000 deaths.
High dietary trans fatty acids: 82,000 deaths.
Alcohol use: 64,000 deaths.
Low intake of fruits and vegetables: 58,000 deaths.
Low dietary poly-unsaturated fatty acids: 15,000 deaths.

What’s notable is that 11 of the twelve are diet and exercise-related. Allow me to repeat: 11 out of the 12 leading causes of premature death are related to factors entirely having to do with shit you eat or drink, and getting exercise. And the comical thing is that even this 11/12 figure under-represents the truth of the matter, which you will find for yourself by going to the mall – any mall – and taking a gander at the people around you, who may not be close to death, exactly, but who are in wretched shape and already living lives made wretched by the consequences of their idiotic choices.

In all this debate about health care, wanna know the real dirty little secret? Wanna know how to cut health care spending by eighty percent? Have people eat right and exercise. Period. So the question becomes: is this even possible? If the government were to try this approach, in the face of the corn lobby, the wheat lobby, the milk lobby, big pharma, the whole nutritional edifice based on religion more than actual peer-reviewed research -

if, in short, Obama were to declare a one-man war on the actual causes of preventable human health problems, how far could he get? Or is this something we are just doomed to live with? This isn’t a rhetorical question — I really want to know. Because I realize, truly, how large is the gap between knowing the right thing to do and doing it. My own behaviors are far from optimal, which is ridiculous in light of how the consequences are higher for me (because of chronic pain issues) than for the average person.

But if you believe — as I do — that what a government is _for_ is to provide things for its populace that an entity _smaller_ than a government cannot provide, things that require massive coordination, massive infrastructure, and a time horizon longer than what profit-driven private enterprise can manage -

if you believe that, then you believe that health, in all its guises, is _exactly_ the kind of thing the government should be involved in (vs. things that are the exact opposite of what the government should be involved in, like deciding who should be fucking who; or deciding that schoolchildren need to learn to accept Christ into their hearts instead of learning about actual science.) But that still doesn’t answer the question of how much a government could actually do to ameliorate a very bad situation if it were actually thinking in those terms.

Certainly the health care bills floating around now don’t even begin to address the issue from this angle. I wonder if it will ever be different.

This was written by shanusmagnus. Posted on Sunday, November 1, 2009, at 9:55 am. Filed under health, politics. Bookmark the permalink. Follow comments here with the RSS feed. Post a comment or leave a trackback.
  • LL Dave B
    For those of you still riding the feel good nature of this thread, watch the movie Food Inc. I watched it last night and it made me feel quite sad.
  • LL Dave B
  • Byron's Friend
    I am all for school "clean-up". There definitely are some no-brainer issues. Taco Bell, Pizza Hut, McD, and others easily available within a school cafeteria. Phy ed classes and sports dropped from schools. I completely agree, things need to change. There have been various pilot programs that have ripped out most of the junk food and implemented healthy (some organic) menu items and guess what...less trouble in school, better grades, etc. I am definitely not against change.

    I am not for no-government. I just feel it is wise to be careful with how much control a few dozen men/woman and their lobbyist are allowed to dictate the direction of our life experience. Are government official any more responsible/health minded than the average general public mofo. Who will they get their advice from? Hopefully not Coke.

    I see the two approaches as bottom-up (individuals making better choices) and top-down (government making choices for you or influencing your choices). In the end both will probably be required on some level to get where we want to go as a general population.

    From personal experience, I know where my family's health has gone due to taking personal responsibility and expanding our own awareness versus waiting for the government. The prior has made 100% impact, the later 0%. Seriously. That doesn't mean the government couldn't easily decide to leave special interests behind and have a truly positive impact on health.

    I just don't accept the idea on a personal level to wait for the government to tell me what to do (or create the change) so I don't become one of those statistics above. You can make the personal/family decision today to do the best of your ability to not be on that list...and then when the government rolls out additional programs to support that all the better. You as an individual must be engaged in the process and the sooner the better.

    In the end, people will live the way they want to live. Choose your own adventure. Remember those books.

    I love you man. :)



  • Maybe this is a better way to think about it:

    For the last umpteen years there's been a rash of vending machines and ice cream fountains in high schools and junior highs. The data says that schools that have this plethora of junk food have fatter kids. Now, while nobody would argue that those kids could simply choose to not eat that stuff, the point is that they _do_ eat that stuff. And we could soberly discuss how important it is for them to make good decisions, live mindfully, etc. etc. when the reality, when you zoom out, is very simple: take away the vending machines, the kids get thinner again. This is not a panacea, or a recipe for some newer, superior human being. It is a simple choice, with a consequence clear as clockwork: vending machines in, obesity up.

    This is the crux of the point. We are talking statistical mechanics, not Newtonian mechanics. Large actions have effects on groups of people. We don't even need to talk about the individual in this analysis. It doesn't matter. The model of the individual at the center of the universe, the whole bundle of unique hopes and dreams and drives and whatever, it doesn't matter. What matters on the large scale is the law of large numbers. How do groups respond to stimuli. It might not be a comfortable way to think, but it's the rational way.

    So, given that, which decisions do you want made? Because they will be made by somebody. This is what the 'small government' people can't seem to grasp and it annoys the shit out of me. If the government was eliminated entirely we wouldn't all join hands in a market-driven orgy of free consumer choice and clear thinking -- if the government was eliminated the same thing would happen every time the government is eliminated, which is that other entities would rise up and fill the power vaccuum. Big business; organized crime; corrupt officials; neighborhood tough guys; protection rackets.

    We do not face the choice between government or not. We face the choice of what kind of government it is, and who it's accountable to, and what we call it. Whether it's "The Government" or "Biblical Scholar" or "IBM" is an issue of semantic pattycake that nobody with any sense will entertain. And it is in this light that the decisions of these remote, far-off bodies matter; though how precisely they matter, how exactly the consequences might manifest if nutritional health (in the scientific sense of the term, not sense advocated by the corn/wheat/junk food lobbies) were made a governmental priority the way that, for example, reducing tobacco consumption was a governmental priority (hint: it was an enormous, resounding success when measured any way you care to measure it) is the open question.
  • Byron's Friend
    http://www.marksdailyapple.com/coca-cola-partners-american-academy-family-physicians/

    Another reason why taking personal responsibility for your health is a pretty good hedge. As will all things in life, there are no guarantees. Sometimes you can do everything you believe is right and sh!t happens. Such is the life experience.
  • Byron's Friend
    Mindfulness is far from a trick. It is truly being alive. Without mindfulness being a part of someone's life, we are likely to change nothing.

    I guess my personal concern is big government (very inefficient, corrupt on some levels) and the micro-managing of my life. Will the government really ever know what is best for me/you? This seems like a scary proposition in many ways.

    Should the government stop manipulating and supporting manipulation of the "system" - yes. Should the government be pro-sh!t. Definitely not.

    In my opinion there are very few factors larger than oneself that affects a person's individual choice. The buck (figuratively and literally) stops/starts with you. Who isn't surrounded by fast food these days? Yet, there are people that don't eat it or very little of it. Why is that?

    You have two choices. Take personal responsibility for your life or give someone else that power. Most people have given it away and don't even realize it. Some don't want the responsibility. That doesn't mean you can't take it back, if you so choose.

    If enough people stop buying "it", they will stop creating "it"...eventually. The market will change.

    Obviously some kind of change is coming through the government pipe and I am hopeful that it will be a step in the right direction. Is everyone going to be forced to eat fruits and vegetables, exercise, meditate/relax daily, manage stress levels, sleep eight hours a day, limit sugar intake, limit process food consumption, stop smoking, blah, blah blah. Of course not. And would we want that kind of mandate within our country?

    The current health care system's primary involvement is sick-care. Obviously the current paradigm isn't working, yet we hold so strongly to it. This paradigm isn't sustainable so it will be forced to change. Somewhat uncertain is whether this change is occurring because the well (money) is running dry or that the current fairly restrictive system isn't very good at actual "health"-care or "sick"-care in many areas. (or both) The belief on this issue will be very important in guiding the immediate future of our healthcare system.

    Why wait for tomorrow, when you can change your life today. Btw, tomorrow never comes.
  • Hey Dave, those are good points. And of course I don't mean to say that any agency, including the government, can fix everything for you. Obviously that's ludicrous. On the other hand, it's very clear that policy in the large influences decisions in the small; it's very clear that if you live somewhere surrounded by fast food outlets, and far away from a grocery store, you're more likely to eat bad stuff. This is where people get hung up, I think - you can look at somebody who habitually makes crappy decisions and say: nobody forced that Big Mac into his mouth three times a week. And of course that's literally true; but in the larger sense, it's not a very useful statement.

    In other words: yes, people make choices. But the choices they make are heavily skewed by factors larger than themselves. You can do a few tricks to get around this - being mindful of actions, for instances - but the law of large numbers wins out in the end. People are like elementary particles in that way, which is why the group that exerts influence over the environment in the large can have a lot to say about life in the small, lived by people.
  • Byron's Friend
    Oops. I meant to say - Don't expect the government to save us.
  • Byron's Friend
    I have all kinds of thoughts swirling around in my head on this but I will share a thought.

    You can't control (or at least not very well) how others live their lives but we can control our own. We can directly influence the direction of health in this country by how we live our own lives and where we spend our own money. What is the majority of your money supporting? Health or disease?

    For those that have some understanding of what health means to them at this point in time - live it. Lip service only goes so far. Stop complaining about someone else to save you. Take some responsibility. Keep things simple, it really isn't all that complicated. No formulas or degrees are required. Sometimes we don't want to hear that. We like complexity...or the opportunity to feel helpless.

    If you don't know what health is, start educating yourself. Find the most vibrant and healthy person you know and learn what they are doing. That is a great start. A hint: the person on a handful of pharmaceutical drugs is probably not the person to talk to.

    Then ACT.

    Listen. Observe. Grow (not around your waist).

    Do this at a rate that is sustainable for you.

    Health is extremely dynamic and involves much more than exercise and the food we eat. Think of your entire being. One part of self is not separated from the other.

    I am also not even talking about being a "health saint" but putting what you do 'most of the time' in the direction of health. You can change your life.

    But how many people really want to change their life? Be healthy? Or even be in control of it?

    Trying to live a healthy lifestyle in this country is not easy or convenient...but can be done and is worth it.

    Do expect the government to save us. It starts from within. Be it.
  • LL Dave B
    I believe that government isn't going to change. They'll talk a good talk like they always do, but the lobbyists will continue to whisper sweet nothings and provide the cash to gain the support for whatever they want. Just look at corn for example. The corn that is grown isn't even edible until it is processed. Check out the documentary "King Corn" and you'll get more than you ever wanted to know. Follow the money and take a look at the government food pyramid. Eat those grains that we were never designed to eat in the first place.
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