This blog has never been wonderfully defined. It is “Health as a Human Right” because I knew when I started writing that human rights, especially the right to health is a passion of mine. I wasn’t sure exactly where I wanted it to go and started by talking about current events or issues in healthcare and policy. It has over the years come to include more of my personal experiences fighting physical and mental health illnesses. And now I’m expanding the scope once again, to include all rights.
I want to repost this post from the new Nebular Health Tech group founded today in Austin, TX. As you can tell from this blog, Health IT is incredibly important to me as a human rights advocate, an ePatient, a lawyer, and an activist.
Here is the story about forming Nebular Health Tech in Austin:
While other posts may be more innovation news oriented (guest posts welcome!), I wanted to start with a post about the formation of Nebular Health Tech – what this group is about, who we are, what we’ll do, how we can make a difference in health and healthcare.
We are all one step away from homelessness. The security we have in our jobs, homes, and family can disappear in the blink of an eye. Homelessness does not just happen to those who made “bad” choices in their lives, people on drugs or convicts. Homelessness can happen to those who lose their jobs or affected by natural disasters. Homelessness affects those with mental illness who cannot find the services they need. Homelessness affects those leaving abusive situations. Homelessness affects our children who are neglected or rejected because of their sexual orientation. Homelessness affects those who served our country and fought for our freedoms.
The homeless are our neighbors, our peers, our friends forgotten. The homeless are us.
A friend sent me this picture:
And then commented “that’s just sad – fight type 1 [diabetes] by getting type 2 [diabetes]”
Yet again I realize how uneducated so many are about diabetes, both Type 1 and Type 2. (note: I am not discussing gestational diabetes in this post) Not only uneducated, but misinformed. Unfortunately, this comes with a huge stigma for those who have either type. Many people think diabetes is all about obesity, and eating sugar, and a laxidasical lifestyle. So when you say “I have diabetes,”almost immediately people start to judge – assuming the person is unhealthy, that the reason they got the disease was their own fault.
Hopefully, today’s post will help a few people understand what diabetes is and dispel some myths.
I find it intriguing what we forget. Only two months ago the news was reporting on the famine in the Horn of Africa. Yet today the news is silent while the crisis continues, and expands. Yemen and North Korea are experiencing food crises as well. How can we forget famine?
I understand that forgetting can be protective. Constantly hearing about disasters can create compassion fatigue. Yet, forgetting doesn’t mean the problems are resolved. While it is difficult to hear of disasters, we must try to remember how much more difficult it is for those suffering and push beyond our boundaries of comfort to help them. Forgetting is easy, remembering, recognizing, and taking action takes courage and compassion.
A crisis has arisen in the Horn of Africa – famine. In the midst of conflict and fighting in a country with no real leadership, Somalia is experiencing a devastating drought and watching food prices rise. Famine is the cruel outcome.
I already warned you yesterday not to eat armadillos, but today I’ll delve a little bit more into the links between food and health.
…medical care and health-related behaviours are indeed important influences on health, but must be considered within the broader context of the social conditions that are more fundamental influence on health. – Paula Braveman, Social Conditions, Health Equity, and Human Rights
Lack of or inability to get nutritious food is one such social condition that threatens health worldwide. The problem food poses arises from a range of factors including personal responsibility, education, availability, and social norms and policies. While we all need to take responsibility for what we are putting in our bodies, we must also consider what we know about the food we eat; what we teach our children about food; the food we make available, especially to the poor; the kind of food we allow in our stores as we create a demand for it, allowing unhealthy food to be the norm; and the policies we can implement to ensure all have access to healthy foods.
First, there is no doubt that despite any policy put in place or recommendation from health officials, changing our unhealthy practices has to be self-driven. No one can stop the world from eating poorly, we have to take the responsibility on ourselves. We need to be aware of what we put in our bodies. There are tons of resources online to learn about healthy and nutritious foods. You can also talk to your doctor or a dietetic educator. Learning to read labels is a great start – understanding the ingredients and the fat, sugar, and salt content. I know it seems like a hassle, if the food tastes good and isn’t too expensive, it’s easy to take it off the shelf and put it in our baskets without looking. Worse, running through the drive through on the way home you don’t even get the option of reading the label (and in that case, ignorance is bliss until you develop heart disease). Until I was diagnosed with Celiac Disease in college, I too ate like this. To adhere to a strict diet with no gluten, I had to teach myself about the contents of my food. And then actually seeing what was in my food became a bit scary considering all the extras and fillers they mix in there to make it addictive. (The FDA has a list of Everything added to food in the US)It shouldn’t have taken the onset of this disease to take more responsibility for my own eating habits. Ultimately, it’s your choice not to consume nutritious food, but you place the burden on all of us when your health care costs skyrocket.
Education is a key component of eating healthy. Most adults don’t know how to read nutrition labels, and sadly many of our children can’t name standard fruits and vegetables because they never eat them. We buy prepackaged foods without even reading the labels and then feed them to our kids because it’s easy. Kids aren’t exposed to healthy foods, and they aren’t being taught to think about their food. On top of that, we serve them junk food in schools, we promote junk food on tv, and we don’t think about how our eating habits affect our kids. While at a certain age personal responsibility kicks in, our kids cannot be held responsible for eating healthy when we as a society are responsible for educating them and we are the ones feeding them. As a result of our actions and inaction, around 40 million children under 5 years old are overweight or obese worldwide according to the WHO. That’s far too many and it’s not their fault, it’s ours.
Our responsibility to ensure children have adequate access to proper nutrition is stated quite clearly in The Convention on the Rights of the Child, Article 24 (c) and (e):
2. States Parties shall … take appropriate measures:
(c) To combat disease and malnutrition, including within the framework of primary health care, through, inter alia, the application of readily available technology and through the provision of adequate nutritious foods and clean drinking-water, taking into consideration the dangers and risks of environmental pollution;
(e) To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation and the prevention of accidents;
Yet we don’t ensure our children have nutritious foods and we don’t educate about nutrition. It seems that children are more likely to get their food education from marketing campaigns then from teachers or parents. In 2006, 44 major food and beverage marketers spent $1.6 billion to promote their products to children up to age 17. Though we’ve made progress since then, with some companies drastically cutting their marketing efforts, we still have a long way to go. The Federal Trade Commission proposes that all companies that market food or beverage products to children under 12 adopt meaningful, nutrition-based standards for marketing their products and improve the nutritional profiles of products marketed to children and adolescents, whether in or outside of schools.
The unhealthy foods available on the market are disturbing.
In many cases, highly processed foods are the cheapest and most convenient way to fill an empty stomach. They are also the most unhealthy way. – Dr. Margaret Chan, Director-General of the WHO
Studies show that nutritious foods are more expensive, which creates a barrier to eating healthy. Instead, our cheaper foods are filled with additives like corn syrup, fat, sodium, artificial flavours, and processed flours. Foods aren’t what they seem. Sugar free doesn’t really mean sugar free. And for the life of me, I still can’t completely understand why the first ingredient in soy sauce is wheat. Somehow with all these additives and extras, this food is still cheaper. So when income is limited, or when relying on food stamps, cheaper may be the only option. Next time you’re at Whole Foods take a moment to consider how expensive your organic produce costs. Then remember that the poorest of society may never have access to the luxury of high quality, natural and nutritious foods (granted there are ways to eat healthier foods for cheap, but when you’re on food stamps your options are limited as they can’t always be used farmer’s markets or other places).
The financial barriers to nutritious foods are complicated. Fewer additives does not translate to cheaper food. In fact, because of subsidies for things like corn and wheat, making corn syrup and processed wheat flour becomes cheap. These are then used as cheap substitutes which turn out to be quite tasty, but also quite unhealthy. When food is cheap, demand for it remains high and so it will continue to be placed on the shelves in the grocery store. Subsidies are just one example of how our financial priorities run amok on our health and will continue to by keeping the price of unhealthy foods down. Because our financial policies and willingness to accept cheap, unhealthy foods instead of demanding high quality, nutritious food.
The World Health Organization in addressing the rise of noncommunicable diseases such as heart disease, type 2 diabetes*, stroke, lung cancer, and chronic respiratory disease are focusing on the impact unhealthy food on society. Chronic illnesses cause 63% of deaths worldwide (70% in the US, and 90% in Russia) – that’s 36 million deaths. The epidemic of type 2 diabetes, which is closely associated with obesity and urbanization, has skyrocketed in rich and poor countries alike. Worldwide obesity rates have almost doubled since 1980. Interestingly, data suggests that fat intake has risen rapidly in lower-middle-income countries since the 1980s too, with consumption of fats linked to heart disease. Most eat too much salt which can contribute to high blood pressure and cardiovascular risk
By increasing fruit and vegetable consumption to up to 600 g daily would reduce the worldwide burden of ischaemic heart disease by 31%, ischaemic stroke by 19%, stomach cancer by 19%, and esophageal cancer by 20%. By improving diets along with physical activity, the World Cancer Research Fund estimates that 27-39% of main cancers could be prevented. We can take it upon ourselves to reduce our consumption of sugars, fats and salt (read the labels of what you eat to see how much fat and salt it contains).
We can also pursue larger policy efforts. This doesn’t just mean new laws that mandate changes to or tax our food composition. But government intervention may be necessary to make real change and improve the health of our society (as well as other societies that are impacted by our food trade and those who mimic our intake as a sign of wealth).
Civil society organizations have a major role to play, as do food and beverage corporations. As just one example, the industrialization of food production and the globalization of its marketing and distribution have brought processed foods, rich in fat, sugar, and salt, but low in essential nutrients, into every corner of the world. – Dr. Margaret Chan, Director-General of the WHO
Here are a few ideas:
- Pressure food companies or enact laws to
- Reduce salt content of food
- Replace trans-fat in food with polyunsaturated fat
- Restrict on marketing of foods and beverages high in salt, fats and sugar, especially to children
- Impose taxes on unhealthy foods (though just like the problems with taxing cigarettes, this may not be incredibly effective)
- Restructure our current subsidies
- Promote healthy nutrition in schools – through education and restricting unhealthy foods in the cafeteria
- Increase physical activities in schools, workplaces, and communities
- Promote public awareness about diet and physical activity, including through mass media.
These aren’t panaceas to change our health outcomes, there are several other factors to consider including physical activity (though closely associated with diet, I don’t address it here), clean water, sanitation measures, personal responsibility to change unhealthy habits, promoting culture shifts as to what is acceptable, making sure everyone has access to medical care and medications, and ensuring our laws and policies are consistent with our goals to promote and ensure health. This endeavor must be supported by all areas of society including non-health sectors, like trade, agriculture, customs, industry affairs, urban design, and education.
We’ve got to make changes now – individually and as a community. The consequences of our current consumption are obvious and serious. We’ve got to eat healthier, provide healthier food, educate ourselves, and make eating healthy, instead of fast foods, the norm. Start by eating a rainbow of fruits and veggies (not skittles) every day!
- The USDA Dietary Guidelines for Americans and other tools
- Michelle Obama’s Let’s Move campaign
- CDC’s Nutrition Efforts and Fruit’s and Veggies Matter site
- The WHOs Program on Noncommunicable Diseases and Mental Health
- Nutrient Rich Food Coalition
- International Food Information Council Foundation
- American Dietetic Association
* please remember that type 2 diabetes is (a) not just a result of unhealthy eating, though obesity is a risk factor, and (b) completely different from type 1 diabetes (which I mention a lot in my Costs to Live series).