Saving us from ourselves
BY JANET PEARSON Associate Editor
Sunday, June 10, 2012
6/10/12 at 3:20 AM
What's next? That's the question lots of Americans are asking in the wake of New York City Mayor Michael Bloomberg's plan to ban the sale of 32-ounce sodas in some city venues. Rest assured something else will be next. This subject isn't going away any time soon.
And there's a good reason this subject of managing harmful human behavior keeps coming up. Or rather, lots of good reasons. Just look around. With some of the highest obesity and chronic-disease rates in the country, Oklahoma residents are near the top of the list of reasons.
Bloomberg's idea, not surprisingly, was immediately controversial, as it should have been. But whether you agree with his proposal or not, he brings home an undeniable point: It's not really a matter of whether we regulate consumption of certain products. It's just a matter of how much and which ones.
How we got here
Why should politicians be allowed to tell us what we can eat and drink and smoke? A look at how poorly we do on this front helps explain how we got here:
According to the state Health Department, about a third of Oklahoma adults are obese and another third are overweight. About a third of Oklahoma children also are overweight and/or obese.
These statistics regularly land us in the top 10 worst states for such measures as obesity, life expectancy and incidence of chronic diseases. Obesity is one of Oklahoma's (and the nation's) top health problems, contributing to such conditions as heart disease, high blood pressure, high blood cholesterol, Type 2 diabetes, stroke and some cancers.
In children, obesity can negatively impact mental health and school performance, along with increasing the chances of developing diabetes.
And how did we get in such lousy shape? The usual ways. About two-thirds of Oklahoma students don't have physical education courses in their schools. Nearly a third of Oklahoma adults in a recent study reported getting no regular physical exercise. A quarter of Oklahoma adults use tobacco, well above the national average.
And, Oklahoma is ranked 51st - 51st! - nationally in terms of fruit and vegetable consumption. Only about 15 percent of Oklahomans, adults and youths, eat five or more helpings of fruits and vegetables every day, as recommended.
So, just because we can't or won't take care of ourselves, is it proper for politicians to try to save us from ourselves through mandates, restrictions and regulations? Wouldn't it be more American for our leaders to just try to educate and persuade us to adopt better health habits, and to see to it we have access to the right kinds of foods, activities and services to get healthier?
Would that it were that easy. That's what lots of observers are saying in the wake of Bloomberg's plan, and if Americans were the type to take such advice to heart, it would be a great solution. Problem is, health advocates (and journalists and many others) have been harping about healthier habits for decades, with only limited success, if any at all. In fact, as statistics show, the trends in some cases are heading in the wrong direction, even in the face of plentiful information and evidence.
Losing ground
Case in point: diabetes in Oklahoma.
A report prepared nearly a decade ago raised alarming concerns about the growth of diabetes in Oklahoma during the prior decade. The "Oklahoma Diabetes Plan - Reducing the Burden of Diabetes," determined that the prevalence of diabetes among Oklahoma adults had increased by 43 percent during the decade of the 1990s.
Diabetes was one of the top 10 leading causes of death in the state at the time, accounting for about 1,800 deaths a year. In 1999, Oklahoma ranked 15th in diabetes deaths in the nation.
The report estimated that the cost of diabetes to the state then was about $1.8 billion a year.
According to the report, one in five Oklahoma adults back then was obese. And remember what the figure is now? One in three. So since the alarms were sounded about diabetes a decade ago, our obesity problem has grown far worse. And our diabetes problem has grown as well, nearly doubling in the last decade. Oklahoma's death rate from diabetes has risen from 15th highest in 1999 to the nation's fourth highest in 2007.
No easy answer
So is the answer to the diabetes and obesity epidemics to restrict sugary products? If we resort to such a strategy, opponents are justified in asking what's next, given that restrictions seem to breed more restrictions - which suggests maybe there are good reasons for the restrictions. But though new limits may seem onerous at first, people tend to get used to them and even acknowledge their worth after awhile. Remember when it was acceptable to smoke in movie theaters, airplanes and elevators? Lots of us at first thought it was kind of extreme to ban tobacco use in those places, but now those restrictions seem quite mild. In fact, most of us support indoor tobacco-use bans.
OK, so sugar isn't exactly the same as tobacco, as critics of sugar restrictions are quick to point out. Secondhand smoke can harm other people, but gulping a gallon of soda doesn't hurt the person next to you. Except when it comes time to pick up the soda-guzzler's health-care tab.
The health crusade against tobacco can help guide us on the obesity front, even if the issues aren't identical. What worked to help bring tobacco use down was not one single strategy, but a combination of approaches that are still ongoing. Higher tobacco taxes, educational campaigns, tougher restrictions, higher insurance rates, accessible cessation programs and changes in attitudes all have combined to bring usage down.
I personally don't much care for Bloomberg's plan, but he makes a good point: If a soda drinker has to get up to go buy another 16-ounce beverage, he or she may think twice about it - and maybe even about other eating habits that are unhealthy.
And at least Bloomberg is willing to do something bold and dramatic, and take some heat in order to save children from a serious condition that could shorten their lives. We could go the easier route by adopting a less-controversial obesity-fighting strategy that will take decades to have much effect - if it works at all - but to do that, we could be dooming tens of thousands of children to poor health and premature death.
Janet Pearson 918-581-8328
janet.pearson@tulsaworld.com
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