This post is a follow-up to yesterday’s post – and bonus! My cold has mostly cleared up so this one might even be coherent! Yatta!
It is in response to a commenter who praised the woman who took personal responsibility for her health and reminded us all that here in America the battle isn’t limited to Medicine vs health, but also health vs FREEDOM! (You must read that as Mel Gibson’s William Wallace or it doesn’t work.)
I also want to clarify something that I failed on yesterday – namely that weight is not an indicator of overall health and that the woman in the example I used referred to herself as morbidly obese and her surgery as life saving while admitting that it would not have been life saving if she had not turned her life around and chosen a healthier life afterward. The surgery allowed her to START, it was up to her to follow through.
She also talked about the fact that while she was not ashamed of her previous size, there was a lot of pain around the trauma that led to her weight gain – and that is another conversation that I would like to have one day with all of you, the ways that trauma and internal pain manifest externally and the self-harming behavior many of us turn to in response to unresolved trauma. But that is a LONG and complex conversation, so I’m going to bench it for the moment.
It is also another place that American Medicine failed her, because no one asked – no one asked about the weight gain, how or why it started, how she felt about it, if she needed counseling to help her resolve the issues that led to it. There was a medical procedure, it was done and paid for and then she was left to her own devices. She still struggles with some of the self-harming behaviors that led to her surgery. Beyond the surgery, she needed counseling to help her deal with the root causes of those behaviors. This is part of another larger conversation we need to have about how mental health is ignored in this country if there isn’t a pill that will take away the symptoms or a crime committed that can be punished with jail time.
That said – our nation’s obsessive love affair with junk food just might be killing us.
People all over the country FREAKED OUT when NY Mayor Bloomberg tried to levy a soda tax and ban super-sized sodas, because FREEDOM!
Mind you, these are largely the same FREEDOM! fighters who railed against ObamaCare because they didn’t want any of their red cents paying for some slut’s birth control… Um, but you want everyone on your insurance plan to have to pay for your triple by-pass surgery? Interesting.
And here we get into the debate between individual FREEDOM! and collective responsibility – it’s a conversation that is WAY past due in my book.
If we are going to truly change health care in America and shape it into something that actually promotes health, then we have to change not just the medical culture – but the culture of America as a whole.
We have to accept that there is no such thing as absolute FREEDOM! because freedom comes with responsibility, and that responsibility extends beyond ourselves and to our communities.
While I agree that it is rad that the woman I was speaking about yesterday took personal responsibility to turn her health around, I think it is tragic that she had to do so without any true support.
Another commenter yesterday pointed out that it isn’t really more expensive to cook healthy food for yourself than it is to eat junk and she’s tired of hearing that excuse. And I hear her – and that is true especially if you factor in the health costs of eating shit. BUT, I say that as someone who lives near a grocery store that stocks real food, and who owns a car to haul groceries in. I say that as a person who knows how to cook (making that transition without help can be challenging, not impossible, but challenging. Internet helps, but not everyone has internet access at home.) I say that as a person who only has to work one job and thus has time to regularly cook real food from scratch. (Back when I was working two full-time jobs that was next to impossible. Cooking was a day-off activity, and I didn’t have many of those.) I say that as a person who has a partner who helps with both money and time, filling in the gaps. I say that as a person who can afford to spend 20 hours a week shopping, cooking and cleaning up in order to have real food.
I say that as a person who is incredibly privileged and who has multiple supports in place.
I am watching a friend go through this transition right now. And it is BRUTAL. Not impossible, but very, very hard. And it would be great if instead of shaming and blaming people like her for making “bad” choices, we as a culture, as a society, had systems in place to HELP her, and to help people like the commenter who also had to make this transition on her own. Again, it’s not impossible, but if health is a cultural goal – shouldn’t we be working to make it easier?
So how do we change this? How do we shift as a culture so that we truly promote health rather than just shaming illness and blaming people for making poor choices?
It would be great if SNAP benefits were worth double when you used them to buy fruit, veggies, whole grain products, healthy (unprocessed) meat and dairy products so that people trying to stretch those very few dollars didn’t feel compelled to “choose” cheap calories over healthy calories.
It would be great if Welfare benefits and SNAP benefits came with some in-home tutorials on cooking healthy meals and using vegetables, etc. (I would LOVE to go into people’s houses and help them learn how to cook awesome food that their families would eat, but the people who need this service the most can’t afford to pay me for it, and I can’t afford to work for free – yay capitalism?)
It would be ideal if (okay, everyone panic, I’m about to suggest a FREEDOM! killing FEDERAL government regulation!) every restaurant and cafeteria was REQUIRED to include at least one full serving of a fruit or vegetable with every meal. I pay close attention every time my family eats out and it is remarkable (absolutely fucking appalling) how easy it is to go an entire day without eating a single serving of fruit or veggies in this country. My sister took me to a SUPER-DUPER FANCY restaurant a while back. The dinner entrées were upwards of $50 and they did not include a single side, that was just the slab of protein. We had to order a $12 plate of asparagus separately and when it came out it only contained 6 sprigs of asparagus – so this is not just a fast-food/low-income problem.
(For the record, my husband and I are researching opening our own restaurant and this is one of our foundational principles, that every entrée will come with your choice of at least one serving of fruit or vegetables.)
Honestly, every time I eat out in this country, no matter the “class” of the restaurant I go to, I spend 80% of the time thinking about Neil Gaiman and Terry Pratchett’s book Good Omens and the character of Famine who has taken over the American restaurant scene and has split it in half. He runs the cheap restaurants by providing huge servings of nutritionally empty food, helping poor people die of obesity and malnutrition simultaneously. In the high-class restaurants he serves single sprigs of asparagus artfully placed on huge platters and skulks about watching the elite starve themselves. It hits pretty close to home.
If we want health, we might need to accept some limitations on FREEDOM! We might need to accept things like soda taxes, removing junk food options from schools, restricting junk food advertising, requiring businesses that call themselves restaurants to serve fruits and vegetables, requiring businesses that call themselves grocery stores to carry fruits and vegetables.
We might need to require more detailed labeling of foods, using terms people understand. What exactly is 8 grams of sugar? What does that look like? What about 150mg of sodium? Those are numbers pulled from reputedly “healthy” cereals and snacks in my pantry. Is the sugar naturally occurring as in fruits and milk, or is it added sugar? What exactly is a serving, and why do so many junk foods come in packages that are clearly meant for a single person to consume and yet simultaneously contain multiple servings?
Honestly, wouldn’t it be great if we expected businesses to be as responsible for the choices they made and the harm they caused as we expect individuals to be about the results of their choices?Is the consumer really the only one we should be holding accountable here?
In addition to regulations and limitations (the stick), we might need to take some pro-active steps to produce more opportunities for people to access healthy food and participate in healthy behaviors (the carrot).
We might need to incentivize businesses (ahem, job creators…) to include gym memberships in their benefits packages and replace their snack food machines with fruit baskets. We might need to help convenience stores and corner stores offer healthier foods to their customers. We might need to increase funding for nutritional programs like WIC and SNAP and school lunches, as well as increasing funding for education to help people learn not just what to eat, but how to shop for it, store it, prepare it and serve it.
We might realize that we need to stop subsidizing corn and soy and start finding ways to incentivize farmers to produce more fruits and veggies.
We might need to go so far as to raise the minimum wage to an actual living wage so that people don’t have to work two jobs to support their families, thereby giving them more time to do things like shop for and cook real food, play at the park and get outside.
And, if we decide we’re willing to go that far, we might just decide we want to go even further and ensure not only that every neighborhood has a store with real food in it, but that every neighborhood also has an actual park where people can get outside and play together, that they have lighted streets that are safe to walk or ride a bike on.
If we decided we wanted to create an actual culture of health, we might go so far as to actually provide all of our citizens with real options and choices and FREEDOM! rather than just giving the processed food industry free-reign to flood the market place and the advertising space. We might realize that parks and community centers and street lights are cheaper than police raids and jail cells and hospital bills. We might realize that developers need to include things like open space and grocery stores and sidewalks and bike paths in their neighborhood designs. We might realize that collective responsibility trumps businesses’ “right” to profit at the expense of the people.
Whole generations of Americans have become separated from their food. It has stopped being something we grow and nurture and prepare and nourish ourselves with to something we blindly and casually consume. Food has become a commodity, rather than a source of health and nourishment. We’ve become separated from the outdoors, trapped in houses and cars and offices and shadowed streets that weave between skyscrapers.
Here in America, as one commenter pointed out, we’ve become separated from the idea that health is something we have to choose and work for, not something we can buy down the street at the discount store.
Health is not a commodity, it isn’t for sale. But in this capitalist society, we only value that which we can stick a price tag on – so, before we all scream, “but who will pay for it?” realize, we’re already paying – in hospital bills and higher insurance premiums and lost days of work and poor educational outcomes (which are highly tied to health and nutrition) We don’t have a choice in whether we pay, but we do have a choice in what we pay for.
Think about it, what is the price of poor health, for yourself, your community, our country? Wouldn’t you rather invest that money in creating better options, better choices, better access to health – for everyone?