My wife shared an article with me that discussed the role health care disparities in the severity of COVID-19. There are indeed some serious disparities that need to be addressed. I am not sure, however, that a laser focus needs to be turned to universal health insurance (commonly referred to as universal health care). The article discussed diabetes’ role in COVID-19 as if obesity and hypertension were secondary. The reality is that obesity is the central factor in diabetes, heart disease, hypertension, and even many immune system disorders.
While obesity (nearly two-thirds of Americans are overfat or obese) has some roots in genetics, it is primarily an issue of physical inactivity, diet, and environment—problems that that are not going to be resolved by treating the symptoms. Like it or not obesity, and the secondary health issues that follow, is a community problem.
The United Kingdom just revealed measured to counter obesity. Personally, I don’t think we can legislate health. I do believe we have personal responsibility for our health and should bear the cost of our poor health choices, but this can only work when “poor health choices” are our only choices. Nevertheless, we must “make America lean again”. The question is “how?”
Making health care accessible and affordable is important; however, this doesn’t mean the population will be healthier. It just means their symptoms are treated. It also disincentivizes healthy habits.
More important to community health is the infrastructure that promotes healthy lifestyles. We can begin with substantial physical education in K-12. We can choose to invest in “healthy” buildings—in light of COVID-19, that would include proper air circulation, as well as structures that promote movement and other healthy practices. We can begin to rethink urban development and public safety to support physical activity and exercise. We can address “food deserts” in our inner cities and rural communities. There is no reason that the wealthiest and most fertile nation on earth can’t feed its own healthy foods. (I read once where farm workers in California didn’t even have access to the very foods they were harvesting!) We need to address the whys of obesity and its consequences while we address how to treat the subsequent disease.
Whatever happened to President John F. Kennedy’s Council on Physical Fitness (now the President’s Council on Sports, Fitness, and Nutrition)? Wikipedia additions are sparse after 2012—other than to add the names of celebrity “co-chairs” and that the Physical Fitness Test will “no longer be available after the 2012-2013 school year” and that the “Champions awards (for raising one’s amount of physical activity) ended on 30 June 2018”. It is no surprise that the testing ended as society became increasingly “fragile”. A Vox article1 labeled the test as “sadistic” and cited an NPR quote of teacher” “We knew who was going to be last, and we were embarrassing them.” While this statement was accurate (I personally, never passed the Physical Fitness Test) and the test may have some military intentions, there we no efforts to modify the test—moreover, efforts to assist children in passing the test declined over the years (the one test the education couldn’t seem to find the will to teach to). Today, physical education and sports are likely to be the first activities cut in the school budget.
We should not “fat shame” or punish people for unhealthy body composition, but we consider obesity a community problem—a matter of national security, for that matter. We must invest in a healthier population or pay the greater cost of treating an unhealthy population.
Time to get creative and supportive. The best way to reduce the cost of health care is to reduce the demand. Preventative self-care is always less costly than emergency medical care. Universal health is less costly than universal health care.
Be your best today; be better tomorrow.
Carpe momento!
1https://www.vox.com/2015/4/24/8489501/presidential-fitness-test