Optimism abounds. For people like myself, who are passionate about health, particularly preventative health and lifestyle medicine, it was music to my ears to hear that the incoming US president has nominated Robert F. Kennedy Jr. to serve as secretary of the Department of Health and Human Services.
They want to “make America healthy again.”
The fact that health is moving up on the ladder of priorities can only be positive. But I say this with a little bit of apprehension.
Are the powers that be going to take the right approach and really bring health and wellness to what has become an ill society? Will they focus on the most important health issues? 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 US amount to about 18% of GDP, the highest among industrial nations. More than $700 billion are spent yearly just on drugs. Yet, with all of the money being thrown at health, the United States sits at the top of 16 democracies in death from all causes.
If that sounds terrible, how about this: Of OECD nations, America is second to last (number 34 out of 35 nations) in life expectancy and third worst (number 46 out of 48) in health outcomes from all diseases, with only Turkey and Iran worse than it is.
The United States of America may be a world leader in health spending, but it is not a world leader in health care. These numbers are both surprising and disappointing.
When one takes a close look at leading causes of death as listed by the Centers for Disease Control and Prevention (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 its ramifications are short-lived. In 2016, a team led by Dr. Marty Makary, professor of surgery at the Johns Hopkins University School of Medicine found out something the CDC and other agencies just don’t want you to know: The No. 3 cause of death in the United States is actually medical errors.
Makary and his colleagues have calculated that more than 250,000 deaths per year are due to medical mistakes. This study was published 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., but 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 cases of death.
Positive news
We have now identified many of the issues facing healthcare in the United States. But are we finally going to address the root causes of disease and stop just throwing more lip service and money at the issue?
Kennedy wants to revamp the FDA (I’m all in favor) and reviewing the way vaccines are approved (I’m not an anti-vaxxer 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, but what will make the most difference in the health of Americans?
Learn from smoking
The most successful lesson in public health was the American initiative to reduce smoking that began 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 your health – just like cigarettes. It causes illness and it shortens your life. Multiple studies have proven this beyond any doubt. These foods need warning labels and they need to be taxed – just like cigarettes.
We need to consume more foods with fiber (whole grains, fruits, vegetables and legumes), and less animal protein like meat, chicken, eggs and dairy. Once the government makes these points clear, then concrete steps can be put in place.
Practical application
1) Nothing is more important than education. If you don’t know 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, each individual is ultimately in charge of their health, but you need knowledge. 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 even understand that fruits and vegetables are healthier than hamburgers and French fries. Start with this: Know that what you eat matters to your health. Over time, we can educate our children on nutrition, activity and exercise, and proper hygiene, and to avoid dangerous substances. In conjunction, run extensive advertising touting the benefits of a healthy, plant-centered diet devoid of ultra-processed junk food, as well as the benefits of leading an active life.
2) 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 ones, they need to say that. Remember the anti-smoking ads on TV and in magazines in the late 1960’s and 70’s? We need to begin doing the same in regard to the food we eat.
3) We need the medical community to finally get educated about just 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 Medicine 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.
4) 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.
5) Create the incentives necessary for people to be healthy. Just like a non-smoker pays less for insurance, so someone meeting certain criteria in health habits, including how much they weigh and what they eat, should get similar discounts. Money is a very strong motivation for many people – use it!
Mr. Kennedy, we have more drugs, procedures, surgeries and ways to take images than ever in our history – but with that, we are ravaged with increasing disease, illness, sickness and premature death, and 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, discussing a hypothetical new drug that “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,” he said. “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, but we do know that if you practice the healthy precepts of lifestyle medicine, that kind of reduction is exactly what happens. 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 of this. 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, greatly cut health care expenditures, bring happiness and enjoyment to our lives and “add hours to your days, days to your years and years to your lives.”
The writer is a wellness coach and personal trainer with more than 25 years of professional experience, and director of The Wellness Clinic. He is a member of the International Council of the True Health Initiative and a member of the board of Kosher Plant Based.