The major public health message delivered by all professionals today is that the average American has a great deal of control over their own wellbeing. They offer advice on how to minimize the risk of premature disease and death. The goal is to help people die young – at a very old age. Why are Americans such a hard sell when it comes to good health? Why does healthy advice often backfire? Why isn’t each one of us doing more?
In the mid-1930s, President Franklin D. Roosevelt said, “I see one-third of the nation ill-housed, ill-clad, and ill-nourished.” If he looked at us today he’d see an over-caloried, under-exercised, air-conditioned, computerized, and highly mechanized population. As individuals, we have a great deal of control over the prevention and treatment of high blood pressure; heart disease, cancer, and stroke, the 3 leading causes of death.
As a population we are shell-shocked. Every day there is another environmental or health scare. Don’t eat tomatoes. Fresh berries are loaded with pesticides. Tuna has mercury. Too much sun promotes skin cancer. When you tell people everything is dangerous, they start to believe nothing is. A bumper sticker captures the frustration, “Life causes death – you can’t avoid it.”
Americans love sensation and catastrophe. News outlets frequently blow risks out of proportion for ratings. Individuals overreact eliminating certain foods or stopping certain behaviors. A good example is canned tuna. Though many varieties do contain mercury, others pose a very small risk. The more subtle health message of how to make good choices is lost among the scary headlines. Headlines cause groups, like low-incomes families, who would benefit from eating tuna rich in protein and omega-3 healthy fats, to avoid a healthy, inexpensive food.
Americans have succumbed to the “health halo” when choosing what and how much to eat. Once a food has a health halo – high fiber, low fat, sugar free, antioxidant-rich – we feel we have license to eat as much as we want. After all, it is good for us. But a box of sugar free cookies or a quart of antioxidant-rich juice still packs a lot of calories. People eat larger amounts of food that they perceive as healthy. A study showed that when a candy is labeled low fat, subjects ate 28% more, underestimating the calories they consumed.
Americans want zero risk. Many are suspicious that modern science and technology has created a world riskier than ever before. This simply is not true. Our distant ancestors ran the risk of being eaten. Medieval history shows plague and starvation were major risks. At the turn of the century infection and diarrhea were major health threats in the US. Today’s health risks are real, but no greater or more devastating than in the past.
The argument could be made that today’s health risks are less devastating because many of them are within our control. In the good old days you ran the risk of dying in infancy. If you survived infancy, you would probably live to 45, 35 if you were nonwhite. Today, you still die, but for most of us it will not happen until our late 70’s or early 80’s.
The majority of health risks can be tied to behaviors: too much fat, sugar, alcohol and tobacco; too little whole grains, fruits and vegetables, too little exercise; and too many calories. To stop smoking, drink less, eat better, exercise more, and use common sense in your everyday activities are all free. The consequences of poor health or injury are not. Choose health.