Killing ourselves with unhealthy choices

Inactivity and unhealthy eating are literally killing us. None of this should be news to us. It has been more than a year since The Lancet dedicated an entire edition to the consequences of inactivity, proclaiming it a “pandemic, with far-reaching health, economic, environmental and social consequences” and a “major contributor to death and disability from non-communicable diseases worldwide.”

Indeed, we know that chronic conditions such as diabetes, obesity, coronary artery disease and depression account for 75% of the nearly $3 trillion we spend on healthcare every year in the United States alone.

Worldwide, these conditions are projected to cost our global economy a staggering $47 trillion per year.

We also know that these conditions can be prevented, mitigated and even cured through healthy eating, active living, abstaining from tobacco use and avoiding excessive alcohol consumption.

Certainly, personal responsibility plays a significant role in creating a lifestyle that allows for adequate physical activity and healthy choices. But to label health conditions generated and exacerbated by individual behaviour “non-communicable diseases” misses a huge part of the problem.

In the United States, chronic conditions disproportionately affect racial, cultural and ethnic minorities and those living below the poverty line. Take a close look at these communities and you will often find common fundamental realities: a lack of easily obtainable nutritious food choices, a dearth of safe, convenient environments in which to exercise, and norms that support rather than discourage tobacco and alcohol consumption.

Very few of the world’s poorest communities have a market stocking fresh fruits and vegetables. Most lack safe, well-lit, crime-free pedestrian walkways and places to play.

When high-fat, high-sodium, high-sugar, low-nutrition, cheap, packaged snacks from a tiny corner store are convenient; when watching television behind locked doors is the safest, easiest choice; when cheap tobacco and alcohol are readily available to “ease” the stress of a toxic environment, that becomes an infectious lifestyle that breeds chronic health conditions.

Therefore, diseases that are widely blamed on personal behaviour are arguably quite literally communicable. But they are also preventable and treatable if we act collectively and deliberately as individuals and as a society.

In my home state of California – famed for healthy living and producer of more than half of the nation’s fresh fruit, vegetable and nut supply – inactivity and poor nutrition have combined to create an obesity epidemic that costs $41 billion a year in healthcare spending and lost work productivity.

To combat this tragic reality, the California Center for Public Health Advocacy and the League of California Cities are working together to encourage and enable physical activity and healthy food availability in a partnership called Healthy Eating, Active Living (HEAL) Cities Campaign.

City governments have powerful planning, economic development and public relations tools for attracting and supporting healthy food retailers – and their planning, zoning and infrastructure investment capacities can have a positive effect on health by creating walkable environments.

Hundreds of Californian cities have taken the HEAL pledge and formally resolved to make active living and healthy eating an easy choice for their residents. Communities across the country and around the world would do well to make similar commitments to remove barriers that lead to poor food choices and inactivity as default behaviours.

Personal responsibility is certainly central to improving individual health. But collective resolve can be the catalyst that sparks a global revolution to place healthy living at the heart of every individual, family and community – and in so doing, combat these “non-communicable” diseases that are needlessly destroying millions of lives. Not only are these diseases quite communicable, but so is the solution: to make the healthy choice the easy choice.

Author: Raymond J. Baxter is president of Kaiser Permanente International and senior vice-president for Community Benefit, Research and Health Policy

Image: Hot food in the nutrition break mid-morning consisting of either a mini sausage roll or Vegetarian Italian bagel is pictured at Belmont High School in Los Angeles, California May 18, 2009. REUTERS/Fred Prouser