This article was originally published as an op-ed in The Jerusalem Post on Nov. 27 2024: https://www.jpost.com/international/article-830856
Optimism abounds! The incoming US President has appointed Robert F. Kennedy Jr. to be the head of Health and Human Services. For people like myself, passionate about health, particularly preventative health and lifestyle medicine, this is great news. They want to “make America healthy again.” The fact that health is moving up on the ladder of priorities can only be positive. However, I say this with a little bit of apprehension. Are the powers that be going to take the right approach? Will they focus on bringing health and wellness to an ill society? Before we address that, let’s see what some of the main issues are that are in need of repair.
What money can’t buy!
Health care expenses in the USA amount to about 18% of their GDP, the highest among industrial nations. More than 700 billion dollars are spent yearly – just on drugs. Yet, with all of the monetary investments, the United States sits at the bottom of 16 democracies in death from all causes. If that sounds terrible, how about this: of OECD nations, the USA ranks 34 out of 35 in life expectancy. America is number 46, of 48 nations, in health outcomes from all diseases (Turkey and Iran are in front of them). The United States of America is not a world leader in health care. These numbers are both surprising and disappointing.
Shocking!
Taking a close look at leading causes of death, listed by the Center for Disease Controls (CDC), we see the usual culprits: Heart disease and cancer, accidents, stroke, respiratory diseases, Alzheimer’s and diabetes. I have left Covid-19 out of this list as it’s ramifications are short-lived. In 2016, Dr. Marty Makary, professor of surgery at the Johns Hopkins University School of Medicine, and his team found out the number 3 cause of death in the USA. The CDC and other agencies just don’t want this information known. The number 3 cause of death in the United States is medical errors. Makary and his colleagues have calculated that more than 250,000 deaths per year are due to medical error. This study is in the British Medical Journal.
The actual causes of death
Going back to 1993, a remarkable paper was published titled “Actual causes of death in the United States” by Dr. McGinnis and Dr. Foege. The paper was extraordinary in that it didn’t focus on the medical reasons, like cardiac arrest, respiratory disease, cancer, etc. Their research found that behaviors, like smoking, poor quality diet, lack of activity, and drug use were the actual causes of death. This study clearly showed that personal behaviors were the main culprit in most causes of death.
Positive news
We have now identified many of the issues facing health care in the United States. But are we finally going to address the root causes of disease? Will we stop throwing more lip service and money to the issue?
Kennedy wants to revamp the FDA (I’m all in favor) and review the way vaccines are approved. (I’m NOT an anti-vaccer, but there is merit to researching this after what we saw in the Covid-19 pandemic.) He is intent on getting the artificial flavors and colors out of the processed foods we eat. These are all potentially positive actions. Still, what will make the most difference in the health of Americans?
Learn from smoking
The most successful lessons in public health was the American initiative to reduce smoking in 1964. It took a long time, but the number of adults smoking went from about 50% of the population to 11%. That saved a lot of lives and hardship. Let’s implement the same principles.
Step number one is to establish as fact that ultra-processed food, in its many forms, is hazardous to health—just like cigarettes. It causes illness and it shortens life. Multiple studies have proven this beyond any doubt. These foods need warning labels and tax—just like cigarettes. Step number two is we need to consume more foods with fiber (whole grains, fruits, vegetables and legumes), and less animal protein. Concrete steps can be enacted once the governments makes these points clear.
Practical application
Education
Nothing is more important than education. Without knowing what’s right and what’s wrong, you can’t possibly make an informed decision. Education is the single most important step to bringing about health. As I’ve written many times before, it is each individual who ultimately is in charge of their health. But knowledge is still required. We must put a health education curriculum in the school systems. I find it incredibly sad and unfortunate when I meet both adults and children who don’t understand that fruits and vegetables are healthier than hamburgers and French fries. Start with this – what you eat matters to your health. Over time, we can educate our children on nutrition, activity and exercise, proper hygiene, and avoiding dangerous substances. In conjunction, run extensive advertising touting the benefits of a healthy, plant-centered diet and an leading an active life.
Dangers
It’s time to actively warn the public of the dangers of certain foods. If deli meats and hot dogs are as carcinogenic as cigarettes, they need that warning. If junk food causes health problems, including mental health problems, they need to say that. Remember the anti-smoking adds on TV and in magazines in the late 1960’s and 1970’s? We need to begin doing the same concerning foods to avoid.
Doctors
Let’s have the medical community better educated in how effective positive lifestyle change is in preventing and reversing disease. Doctors can get great education in this area through the American College of Lifestyle Medline or the Physicians Committee for Responsible Medicine. More importantly, the curriculum in medical schools needs to change to include lifestyle. It already has gotten better in certain schools but it needs to become the norm.
The right changes
Eating organic is a good thing, but it can’t sidetrack us. Changing our lifestyle habits, even without organic, can bring as much as an 80% improvement in health. That being said, ban the herbicide glyphosate (roundup) immediately. It is banned in many countries and it is harmful in multiple ways.
Incentives
Create the incentives necessary for eating healthy and maintaining normal weight. Just as non-smokers pay less for health insurance, people who maintain other healthy habits can receive similar benefits. For example, people meeting certain criteria in what they weigh and what they eat can also get insurance discounts. Money is a very strong motivation for many people – let’s use it!
Take advantage – the right way
Mr. Kennedy, we have more drugs, procedures, surgeries and ways to take images than ever in our history. Disease, illness, sickness, and premature death are still plaguing us. We haven’t put a dent into that. What we are doing is not working and we are not curing chronic illness. At best, we manage the symptoms of disease, but we don’t eradicate it.
The study I quoted earlier on the true cause of disease was an inspiration to Dr. David Katz to go into preventive medicine research instead of office practice. Dr. Katz has a famous quote:
“If there was a new drug and the drug is stunningly effective, and shockingly free of side effects. It is astoundingly safe – safe enough for newborns and octogenarians alike. It is available in bountiful supply, and remarkably inexpensive. In fact, you might be able to get it without spending any extra money at all – maybe even save money by taking it. And, here’s the punch line. If you take this pill – which everyone else in your family can take along with you – once daily for the rest of your life, it would reduce your risk of EVER getting ANY major chronic disease – heart disease, cancer, stroke, diabetes, dementia, etc. – by 80%.”
Mr. Kennedy, we know that no such pill exists. Yet if we practice the healthy precepts of lifestyle medicine, the result is the same! Based on thousands of studies, I state this with great certainty.
I am thrilled that every media outlet is now talking about health. We must take advantage. Meet with Dr. Katz, Dr. T. Colin Campbell (who has extensive experience in the area of policy), Dr. Dean Ornish, Dr. Neal Barnard, and some of the other lifestyle medicine pioneers and practitioners. They will help guide you to the path that will really make the biggest difference. This path will make people healthy; it will greatly cut health care expenditures, bring happiness and enjoyment to our lives and will “add hours to your days, days to your years and years to your lives.”
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