For the longest time, I felt a sense of wonder. Here I am, pursuing a PhD in Public Health in the US. In 2005, no such degree was available to me in my native Canada. I have learned that this is because, in Canada, a system of public health is the norm. Public health is health; we didn’t need another term or degree title to ensure the care of our public.

My partner Matthew is 30 years old. For all intents and purposes, he is a specimen of health. Athletic, able-bodied and thin, he has made great strides in realizing a healthy lifestyle. Even staying away from his beloved chicken wings, he also does not drink alcohol or smoke cigarettes. He holds full-time employment and is fortunate to have health insurance. Matthew’s greatest monthly expenses relate to his healthcare (including his gym membership – which I include in this tally since physical activity is clinically proven to prevent illness and improve overall health and well being). Routine and common check-ups, procedures, and medications comprise the bulk of his discretionary income. At 50, I shutter to think where in life he may be (and in debt) if his lifestyle was one of physical inactivity and chicken wings at 30. After all, we know that almost all of the chronic diseases that we have all but accepted as destiny could be prevented through lifestyle. It is only a matter of time until insurance providers in the US consider lifestyle to be a “pre-existing condition” leading to conditions like heart disease and cancer.

The Canadian government takes great care in promoting health and preventing disease; it is in its best interest. For example, Statistics Canada reported the prevalence of obesity to be 23% in 2005, compared to 30% of US adults. This means that 7 fewer people out of 100 may avoid the development of a chronic disease. That’s huge!

The US Department of Health and Human Services released a report in 2003 titled “Prevention Makes Common Cents”. Clever title, but in whose pockets are these ‘cents’?

The food industry spends about $ 11 billion annually on advertising and another $ 22 billion or so on trade shows, supermarket "slotting fees," incentives, and other consumer promotions. Almost a decade ago, the US Department of Agriculture reported promotion costs for popular candy bars at $ 10 million to $ 50 million, for soft drinks up to $ 115.5 million, and for the McDonald's restaurant chain just over a billion dollars. Compared to the National Cancer Institute's $ 1 million annual investment in the educational component of its 5-A-Day campaign to increase consumption of fruit and vegetables, such healthful missions are bound to fail. 

The social changes causing the worldwide increase in body weight include mass production of heavily marketed, energy dense foods, globalization of trade and tastes. Improvements in agricultural productivity over the past decades have facilitated a massive increase in caloric intake.  Figures from the Food and Agriculture Organization show that global per capita, dietary energy supplies are rising, and forecasted to continue growing. A decreasing global population growth rate in combination with a strong growth in agricultural productivity has provided access to better food at lower costs but this is hardly evident in most of the US. If recommendations to consume fewer calories have so little effect, it may be in part because such advice runs counter to the economic imperatives of our food system. Promotions, pricing, packaging, and availability all encourage Americans to eat more food, not less.

We are a culture that celebrates the individual, promotes excess and indulgence. Our insatiable appetite for instant gratification in opposition to alternative means of fulfillment conspires to keep us unhealthy and overweight. Our government will behave no differently until we do. Sure, prevention makes common ‘cents’, but until a system of public health is in place where these ‘cents’ find pockets apart from companies, we will keep gaining and ultimately, losing!

If your only investment in your own health for the day is to do this - tell Congress to pass H.R. 676 toward universal healthcare! Click here to speak up.

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