The NIH Director On Why Americans Aren't Getting Healthier, Despite Medical Advances (npr.org) 208
An anonymous reader quotes a report from NPR: It's Dr. Francis Collins' last few weeks as director of the National Institutes of Health after 12 years, serving under three presidents. Collins made his name doing the kind of biomedical research NIH is famous for, especially running The Human Genome Project, which fully sequenced the human genetic code. The focus on biomedicine and cures has helped him grow the agency's budget to over $40 billion a year and win allies in both political parties.
Still, in a broad sense, Americans' health hasn't improved much in those 12 years, especially compared with people in peer countries, and some have argued the agency hasn't done enough to try to turn these trends around. One recently retired NIH division director has quipped that one way to increase funding for this line of research would be if "out of every $100, $1 would be put into the 'Hey, how come nobody's healthy?' fund."
In a wide-ranging conversation, Collins answers NPR's questions as to why -- for all the taxpayer dollars going to NIH research -- there haven't been more gains when it comes to Americans' overall health. He also talks about how tribalism in American culture has fueled vaccine hesitancy, and he advises his successor on how to persevere on research of politically charged topics -- like guns and obesity and maternal health -- even if powerful lobbies might want that research not to get done. In regard to Americans not getting healthier over the last 12 years, NPR asked Collins why there haven't been more gains and what role NIH should play in understanding these trends and trying to turn them around. Here's what he said: Well, sure, it does bother me. In many ways, the 28 years I have been at NIH have just been an amazing ride of discoveries upon discoveries. But you're right, we haven't seen that translate necessarily into advances. Let's be clear, there are some things that have happened that are pretty exciting. Cancer deaths are dropping every year by 1 or 2%. When you add that up over 20 years, cancer deaths are down by almost 25% from where they were at the turn of the century. And that's a consequence of all the hard work that's gone into developing therapeutics based on genomics, as well as immunotherapy that's made a big dent in an otherwise terrible disease.
But we've lost ground in other areas, and a lot of them are a function of the fact that we don't have a very healthy lifestyle in our nation. Particularly with obesity and diabetes, those risk factors have been getting worse instead of better. We haven't, apparently, come up with strategies to turn that around. On top of that, the other main reason for seeing a drop in life expectancy -- other than obesity and COVID -- is the opioid crisis. We at NIH are working as fast and as hard as we can to address that by trying to both identify better ways to prevent and treat drug addiction, but also to come up with treatments for chronic pain that are not addictive, because those 25 million people who suffer from chronic pain every day deserve something better than a drug that is going to be harmful.
In all of these instances, as a research enterprise -- because that's our mandate -- it feels like we're making great progress. But the implementation of those findings runs up against a whole lot of obstacles, in terms of the way in which our society operates, in terms of the fact that our health care system is clearly full of disparities, full of racial inequities. We're not -- at NIH -- able to reach out and fix that, but we can sure shine a bright light on it and we can try to come up with pilot interventions to see what would help.
Still, in a broad sense, Americans' health hasn't improved much in those 12 years, especially compared with people in peer countries, and some have argued the agency hasn't done enough to try to turn these trends around. One recently retired NIH division director has quipped that one way to increase funding for this line of research would be if "out of every $100, $1 would be put into the 'Hey, how come nobody's healthy?' fund."
In a wide-ranging conversation, Collins answers NPR's questions as to why -- for all the taxpayer dollars going to NIH research -- there haven't been more gains when it comes to Americans' overall health. He also talks about how tribalism in American culture has fueled vaccine hesitancy, and he advises his successor on how to persevere on research of politically charged topics -- like guns and obesity and maternal health -- even if powerful lobbies might want that research not to get done. In regard to Americans not getting healthier over the last 12 years, NPR asked Collins why there haven't been more gains and what role NIH should play in understanding these trends and trying to turn them around. Here's what he said: Well, sure, it does bother me. In many ways, the 28 years I have been at NIH have just been an amazing ride of discoveries upon discoveries. But you're right, we haven't seen that translate necessarily into advances. Let's be clear, there are some things that have happened that are pretty exciting. Cancer deaths are dropping every year by 1 or 2%. When you add that up over 20 years, cancer deaths are down by almost 25% from where they were at the turn of the century. And that's a consequence of all the hard work that's gone into developing therapeutics based on genomics, as well as immunotherapy that's made a big dent in an otherwise terrible disease.
But we've lost ground in other areas, and a lot of them are a function of the fact that we don't have a very healthy lifestyle in our nation. Particularly with obesity and diabetes, those risk factors have been getting worse instead of better. We haven't, apparently, come up with strategies to turn that around. On top of that, the other main reason for seeing a drop in life expectancy -- other than obesity and COVID -- is the opioid crisis. We at NIH are working as fast and as hard as we can to address that by trying to both identify better ways to prevent and treat drug addiction, but also to come up with treatments for chronic pain that are not addictive, because those 25 million people who suffer from chronic pain every day deserve something better than a drug that is going to be harmful.
In all of these instances, as a research enterprise -- because that's our mandate -- it feels like we're making great progress. But the implementation of those findings runs up against a whole lot of obstacles, in terms of the way in which our society operates, in terms of the fact that our health care system is clearly full of disparities, full of racial inequities. We're not -- at NIH -- able to reach out and fix that, but we can sure shine a bright light on it and we can try to come up with pilot interventions to see what would help.
Oddly tech-related (Score:2)
Re:Oddly tech-related (Score:5, Insightful)
This article "summary" took 6 paragraphs of directly-lifted content to state what could have been stated in three short sentences, like this:
"Dr. Francis Collins is the director of the National Institutes of Health, now about to retire after a 12 year career. He says the reason we aren't seeing an improvement in nationwide health, despite technological advances is: "we don't have a very healthy lifestyle in our nation. Particularly with obesity and diabetes." He also points out "On top of that ... is the opioid crisis."
That's it. It would have saved me time and agitation if the article summary said exactly that, and I could still click through if I want to read all that other fluff.
Re: (Score:3)
Your comment sounds a little paranoid. Rather than looking for alternative explanations, just look at life expectancy. It's rather hard to redefine this. If you look at this page (https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy), you will see the US languishing down around 40th place globally in terms of life expectancy, and improvement (delta) since 2000 less than other countries that had higher life expectancy (one would think higher allowing less scope for improvement). The page al
Isn't it obvious? (Score:5, Informative)
Eat crap, drink tons of liquid sugar, barely move, live in houses made of cancer-causing materials.
Funny story - was in Sweden last week, went into one of those second hand clothing stores. They like "American style" clothes, and there was a pretty large rack of jeans. They use US sizing for jeans. It started at 24 and topped out at 34 (the largest size had precious few items).
Re:Isn't it obvious? (Score:5, Interesting)
" live in houses made of cancer-causing materials."
I don't know what those are, but as a european it rather amazes me that most houses outside the centres of big cities in the USA are made of rather cheap looking wood planks. We call those sorts of buildings "sheds". Houses over here are built of brick, block or similar unless you're really poor and they don't tend to blow down in storms plus keep the heat in much better.
Re:Isn't it obvious? (Score:4, Interesting)
Here in California where we have earthquakes we laugh at your stacks of blocks. There's nowhere on the planet immune from quakes, only places where they happen infrequently.
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Most places in europe never see anything above magnitude 2 which any brick or block structure can survive.
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Kind of ironic that the GP post is regarding Sweden, where houses are often built with low grade wood making up structural insulated panels (SIPs). There are a few things used in the US that are less common in Europe, like TJI joists (essentially a wood I-beam), but construction techniques for similar climates and environmental hazards are remarkably similar. The US does not do much stone or brick work outside of veneers, but some is done.
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You're about as european as a big mac.
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You're about as european as a big mac.
That's Le Big Mac to you :D
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Really? Why would that be then yankee doodle?
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Re:Isn't it obvious? (Score:4, Informative)
Well, that's a sign of bad parenting more than anything else.
My parents would have jerked a knot in my tail for pulling something like that, much less in public.
In so many ways, food IS medicine....at least preventative. If you eat right, you will be healthier. The goal being, to eat right, exercise and use that somewhat at preventative medicine. It works.
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Look, you see, big sugar is very generous to help us spread the good word.
Coke is a big sponsor and a calorie is a calorie and you can get all your calories from one coke a day. That’s a cheap way to live.
And big donut. Well hydrogenated seed oils are easily counteracted by statins.
We think the food industry like the pharmaceutical industry is best placed to provide us with accurate research data and sweet sweet fees, donations and gratuities.
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A lot of it is driven by poverty. When you are struggling financially, maybe working multiple jobs or odd hours, it becomes harder to fit in stuff like cooking. Assuming you have a proper kitchen at all. Diet tends to get worse.
Re:Isn't it obvious? (Score:4, Interesting)
Not to mention the philosophy of food ingredients:
The European way is mostly "food can contain ingredients that are proved safe", while the American way is "food can not contain ingredients that are proven unsafe".
So, even basic ingredients like packaged chicken might contain things that you won't find in European foods.
As for proper kitchen... _if_ you know how and have the time you can make decent food in surprisingly austere conditions (there was a series on Jamie Oliver cooking during the initial pandemics lockdown - cooking for 5 in a kind of a shed, filmed by budget mobile phone).
Re:Isn't it obvious? (Score:4, Informative)
Well food laws in the EU are heavily politically driven, while US food is heavily commercially driven. Safety is kinda an afterthought for both of our markets.
America has a near monopoly on the Corn Market.
Europe has a lot of controlling interest for the production of Sugar Cane.
For Americans Corn Syrup is cheaper than cane sugar. So we use it a lot.
For Europe they want to be sure they support their interests so they will encourage Cane Sugar and discourage Corn Syrup
Processed Sugar is bad no matter the source. We should be sweetening our foods with fruits (and honey) as the more healthy options. However our foods have been driven by the Political and/or Commercial desires.
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Quite a bit of sugar in Europe is made from sugar beet, which is locally grown (France, Germany). You can find sugar made from sugar cane, but it usually is "less refined" (crystalized but brownish in color) or even "molassey" (crystalized but with a tendency for soft clumping). Refined beet sugar is extremely white.
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What I find surprising is that the US is more and more aware of that. Health should improve.
Gyms are everywhere, less McDonald's and more trendy, vegan, healthy whatever. Subway even managed to beat McDonald's. I don't know about cancer-causing materials in houses but at least, people smoke less.
Maybe it is a delayed effect from decades of bad habits, but if health doesn't improve in the coming years, I think we should look at other causes.
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$$$
Frozen meals/junk food are a few bucks, fruit and veggies will consume a weeks worth of grocery money for one day's worth of food.
ANd unless you work for a big company, you likely don't have medical insurance so going to the doctor is usually out of reach of many folks.
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Corn, rice and potatoes are a whole lot cheaper than frozen meals.
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Re:Isn't it obvious? (Score:5, Insightful)
You're not wrong, although I think "cancer causing houses" are not the real issue. The US is fat. The last time I visited, I was *shocked* at how fat everyone was.
I ran some errands with some extended family, and then went to lunch. The last errand was across the street from the restaurant, so I didn't bother moving the car. The cousin who was with me walked with me across the street. *Pant* *pant* "I haven't walked this far in ages." Probably 5'4" and 250lbs. The weird thing? She used to be super fit, and worked as a swimming and diving instructor. WTF?
Absolutely massive portions served in restaurants, everybody has a fridge full of junk food packed with HFCS. I was there a week and gained 2kg. I see how it happens. What seems to be missing is public awareness of how to eat healthy food in human-sized portions.
Re: Isn't it obvious? (Score:5, Funny)
I was there a week and gained 2kg.
No, you picked up the extra 2kg somewhere outside the US. If you had gained it here it'd been 4.5 pounds.
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Back in the 1980's and 1990's the Diet industry who advertises for people to loose weight and look like they did in their 20's, often pushed low fat and high sugar food. People bought into the marketing, and it is still ingrained in us today. The low fat, prevented the foods from being filling, so you will be eating twice as much food with 1/3 less calories. Then there is sugar (In different forms, Corn, Cane, Artificial) and overly processed carbs, and cause an insulin reaction which affects your metabol
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That's underestimating the obesity problem. I would agree that people who are 10-20 lbs over their ideal weight range don't have a problem. 50lbs over is a health problem and contributes to diabetes, htn, cancer, etc. You don't have to be almost double your ideal weight before it becomes an issue.
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I would have to disagree a bit here, that extra weight more often than not, adds higher blood pressure to most people.
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They use US sizing for jeans. It started at 24 and topped out at 34 (the largest size had precious few items).
I have almost no body fat whatsoever and I wear a 34. I wore a 28 when I was 12 years old.
Check Google street view. There are plenty of fat people in other countries. Not a uniquely American thing.
Great advances yes... (Score:4, Informative)
Re:Great advances yes... (Score:5, Insightful)
Healthcare isn't something you subscribe to, it's what you eat, what you do, or don't, do. It's behavioural.
Eat better, eat less, exercise more, at a minimum.
And yeah, from an outsiders (I'm an Aussie) point of view, medicine and medical treatment in the USA is insanely expensive!
Perhaps consider this when you next have the opportunity to vote, and actually go out and vote and consider voting for someone who is promising to get rid of the ridiculous setup that you USAnians seem to have. Banning adverts for medicine would immediately help (by reducing expenses to the medical businesses) as well as mandating govt limits on what can be charged for basic procedures.
I mean, the rest of the world seems to be doing fine via "socialism" (in this case, govt funded cheap medical care via taxes), but in the USA that's a banned word?
Seriously? Reap what you sow, USAnians, reap what you sow.
The USA is an outlier in medical health among the 1st world nations - because the USA largely doesn't HAVE medical health despite huge spending upon it.
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Healthcare isn't something you subscribe to, it's what you eat, what you do, or don't, do. It's behavioural.
Part of it is, but then there are the parts that are genetic and the parts that are environmental, and the parts that are developmental. etc. Consider something like diabetes. Some people can exercise every day and eat a perfect diet and still get diabetes, while others can sit on the couch all day long eating sugary, fatty junk food and never get diabetes. Ditto for heart disease, cancer, infectious disease, etc. Good habits and behavior help, but they're not the be all and end all of health, large parts o
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But the health care costs in the US are out of control. The US invests at least as much public funds in health care as other developed countries. What makes us unique is that an equal amounts of private costs are then paid by individual, making us the most expensive health care in the world. If we are to have accessible health, we need to cu
Re: Great advances yes... (Score:5, Informative)
Oh, they did. In January. The problem is that those people stormed the place because they want less health care, not more.
Obvious problem is obvious (Score:5, Interesting)
You're never going to look like the body models on instagram unless you're one of those fucking people who eats anything they want and still has never had to try and lose an ounce in their life, but there's a LONG space between that and being simply grossly fat that's not exactly difficult to inhabit.
Put down the goddamn soda and drink water. Have some pasta and lean fried meat with veggies, and spices rather than fat sauce, for dinner instead of inhaling half of a family size stuffed pizza by yourself. No bullshit about "b but I don't have time," given that the average American apparently spends more time watching TV every two days than all but the most dedicated jocks spend working out in a week. And speaking of that time, turn off the TV, close the laptop, put down the cell phone, and go for a walk outside. Or ride a bike. Chase a ball. Climb something. Don't just sit there all day.
And with that, I have solved half the medical problems in the entire developed world. You're welcome.
Americans are working more hours than the Japanese (Score:5, Interesting)
Finally when you're working long hours you overeat to keep energy up. You drink soda and snack to get through the day.
None of these problems can be discussed because every time you bring them up it starts up a political discussion and both sides end up shouting each other down. Almost as if somebody wanted it that way because their profiting off of the situation as it stands today...
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They're not skipping exercise because they're lazy, they're massively overworked.
That is not supported by evidence.
Unemployed people are the most likely to be obese. [gallup.com]
Re: Americans are working more hours than the Japa (Score:2)
Re:Americans are working more hours than the Japan (Score:4, Insightful)
Lets not make hasty generalizations. You can't cherry pick one specific small section of the populace (>1yr unemployed) and say their behavior applies to everyone.
Long-term unemployment probably means you have a disability or disorder preventing you from working or keeping a job. If you didn't have depression already, you're probably going to get it if you have poor living conditions or feel like a mooch/useless/unfulfilled. Depression very quickly manifests as not taking care of yourself.
So I know this is going to sound crazy (Score:4, Insightful)
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They eat processed food because it's super cheap and it keeps a long time so they can limit the number of trips to the grocery store
It sure is cheaper and quicker than, oh, I don't know... a lifelong supply of insulin and multiple trips to the hospital for example.
Somebody needs to learn (Score:2)
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>go for a walk outside
Even something that mild can have positive effects.
https://en.wikipedia.org/wiki/... [wikipedia.org]
The chemicals secreted by muscles repeatedly contracting have wide ranging effects, not all understood but presumably good.
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Pasta contains large amounts of carbohydrates.
Carbs aren't necessarily bad -- fruits and vegetables are mostly carbs -- but pasta, like white bread, is very low in fiber, very easily/quickly digestible (high glycemic index) and isn't very nutritionally diverse. There are better options for your carbs.
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Fruits are mostly bad. They're genetically modified over thousands of years to be as much like candy as possible. And in today's society, with the food made easily available, carbs are bad unless you really take care how you eat.
Re:Obvious problem is obvious (Score:5, Insightful)
Lol, "pasta" is the worst nutritional advice you've ever heard? Seriously? We must be at peak "carbs are the debbil" levels if that's the case.
Nothing wrong with moderate amounts of pasta, rice, bread as a part of your diet.
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Nothing wrong with moderate amounts of pasta, rice, bread as a part of your diet.
Ultimately there is nothing wrong with moderate amounts of anything. Even moderate amounts of exercise give you most of the benefits.
Problem is that this is a boring suggestion that can't be monetised.
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But there is little profit to be made off complex carbohydrates, one can seldom find hulled barley, and most in the US donâ(TM)t like food that canâ(TM)t just be
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That is literally among the worst nutritional advice I have ever heard. Pasta contains large amounts of carbohydrates.
Asians eat rice with nearly every meal and yet they're not waddling around.
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People do need carbs to survive, though in moderation.
No they don't. There is such a thing as essential fats, there is such a thing as essential amino acids, but there is no such thing as essential carbohydrates. You can eat exactly zero carbs and have no problems whatsoever, your body can synthesize all the carbs it needs through gluconeogenesis pathway. And I'm not talking theory either, there are people who do exactly that, because for some reason that's not very clear, doing zero carb diet tremendously helps with epilepsy.
The only trouble with avoiding c
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Oh, ok, I will sit and be educated, thanks.
"The only trouble with avoiding carbs is that food industry adds tons of sugar to pretty much everything. Why the heck would there be sugar in freaking ham?"
I suspect, and greatly HOPE, that you are referring to the USA market here, as I'm in Australia and ... while there's a lot of sugar about, it's not in everything, and it's certainly not high fructose corn syrup, it's actual sugar (sucrose, from cane sugar) if it's there. And ... it's not (yet) everywhere.
I've
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But I've got two friends with epilepsy, I'll suggest that they do some research into zero carb diets and see if that helps them, thanks for that (well, thanks if it works for them! : )
Here's the link they might want: https://en.wikipedia.org/wiki/... [wikipedia.org]
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I suspect, and greatly HOPE, that you are referring to the USA market here, as I'm in Australia and ... while there's a lot of sugar about, it's not in everything, and it's certainly not high fructose corn syrup, it's actual sugar (sucrose, from cane sugar) if it's there.
If I recall correctly, sucrose breaks down immediately in the body into a glucose molecule and a fructose molecule. Then the fructose breaks down into a glucose molecule and formaldehyde. Glucose is the sugar that your body actually uses internally, so ideally it seems like the sugar of choice should be straight glucose. Corn syrup is actually mostly glucose to start with, but they chemically convert some of it to fructose to make it sweeter. So, high fructose corn syrup is actually mostly a glucose/fructos
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I don't disagree with you. I wrote: "The big problem seems to be getting too much of it, regardless of whether it's HFCS or cane sugar.". My point was that there isn't really a big difference between consuming food full of sucrose and food full of high fructose corn syrup. Either way it probably has too much sugar.
That said, I don't think there's that much wrong with the occasional sugar-filled food. The problem is when there are excessive levels in just about everything. People want things to taste good. T
The US is a big place, some states are good. (Score:5, Informative)
Looking at a wikipedia page on life expectancy by state, I see it lists comparable countries for each state.
List of U.S. states and territories by life expectancy [wikipedia.org]
Hawaii, California, New York and a few more states have respectable numbers, similar to other developed nations.
While other states, especially in the South, have third-world life expectancy.
Why do West Virginians die five years younger than Virginians? It can't all be Black Lung and bear attacks.
I was surprised to see such large racial differences, with Hispanics and Asians living much longer than whites or blacks.
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Why do West Virginians die five years younger than Virginians?
WV has the 2nd highest obesity rate. Only Mississippi is higher.
WV has the 2nd highest smoking rate. Only Kentucky is higher.
blame the corporate profit motive . (Score:5, Interesting)
Why aren't Americans healthier? Could it be the corporate incentive to sell us poison?
Of the hundred or so breakfast cereals on supermarket shelves, I only know of one which is not loaded with added sugar. And that one is still mostly empty carbohydrates. Just this year I finally found a low carb bread product among all the junk breads on those shelves. Oh, but you say 'whole wheat'! Look again: whole wheat is probably the 3rd listed ingredient after white flour and whatever. Don't even get me started on the sugar loaded beverages (and that includes the juice that you think is healthy).
Look at your junk mail from local supermarkets. Most items offered are addictive junk food from mega corporations.
But even the healthy foods are not what you think. There was a time when corn, wheat, tomatoes, parsley and green beans were grown in rich natural soil. Those products today are grown in depleted soil and carry only a shadow of the nutrients they once had.
What can the medical establishment do about that? Someone needs to speak out about the quality of what we consume, but who dares go against the corporate monster that funds the re-election of every government overseer?
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There is no mass conspiracy by evil Corporations. They simply sell what people buy.
Amorality: having or showing no concern about whether behavior is morally right or wrong. And I get that they're following market demands, but they have been awfully slow to react when it was publicized that the sugar/carbohydrate lobby HAD perpetrated a conspiracy to influence health policy and public opinion.
I'm not saying they are evil, either. But making a sugary cereal for kids is not moral. If Kellogg's doesn't do it some other company will do it instead, but that doesn't absolve Kellogg's. The fact t
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People demand what marketing tells them to demand. It's awfully hard to resist carefully crafted images and sounds.
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Of the hundred or so breakfast cereals on supermarket shelves, I only know of one which is not loaded with added sugar. And that one is still mostly empty carbohydrates.
What I find especially disturbing alongside the added sugar is the large amount of added salt in those cereals.
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> What can the medical establishment do about that?
That's a key healthcare issue. The UK National Health Service (NHS), and hence the Government, has a strong incentive to promote healthy living because it will save money in the long run.
It means they can do things like this -- https://www.gov.uk/government/... [www.gov.uk]
Single motherhood dominates other factors (Score:2)
The health burdens of poverty poor addiction, incresead addiction to alcohol and drugs, teen pregnancy, violent assault, prison time, and the lack of a spouse for adults swamps other factors and shortens human lifespans. It's the worst for black people with 70% single motherhood for their children, but it's the dominant health risk for other groups as well.
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It's the worst for black people with 70% single motherhood for their children, but it's the dominant health risk for other groups as well.
The large number of single-parent families is recent, the last fifty years, and the black-white life expectancy gap is still narrowing (slowly).
While it is correlated to poor health, poverty, and other negatives, I'd certainly not assume that it is directly causal.
Gunz! (Score:2)
Gunshot injuries are not a communicable illness.
When up against American consumerism... (Score:3, Interesting)
The NIH is up against American consumerism, where unhealthy food is often cheaper and better marketed than healthy options, often to the point to where it is culturally ingrained. That consumerism also pushed automobiles, which has driven the layout of American infrastructure to where walking is discouraged, leading to a more sedentary lifestyle. It is also up against cultural violence and the harm it inflicts. Another is the mental health crisis, with the destructive self-medicating so many people do to cope with their illnesses. Tribalism, anti-intellectualism, and conspiracy fanatics are on the rise, which IMHO are extensions of the mental health crisis (most everything on the DSM can be placed on a spectrum, and they're often flirting with various personality disorders).
To reverse those trends, you're looking at changing some very core aspects of American culture and law, some of which is ingrained starting at a very young age. I don't believe that American politics will allow that change.
Americans have the health that they deserve, and they're stuck with it.
what bullshit (Score:2)
Re:what bullshit (Score:4, Insightful)
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Also being poor and obese and dying from heart disease due to bad lifestyle is a great way to reduce deaths from cancer.
Sugar (Score:2)
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I don't think bread tastes good without sugar.
Re:Sugar (Score:5, Insightful)
I don't think bread tastes good without sugar.
I suspect part of that is because that's what you're used to and, at least in my own experience, you build up a kind of tolerance to or get desensitized to the sweetness.
Years ago I started eating low-carb, even as low as "keto". Every now and then, I'd eat a "normal" meal and was often shocked by how sweet things tasted. I never thought of bananas and carrots as sweet... I might have called them savory. But after a couple months of low-carb, they tasted very sweet to me. And things like salad dressings and peanut butter were overpoweringly sweet.
Many years before that, my penpal from Austria visited and she commented that all the bread here was like cake back home.
Anyway, that's my experience and maybe not applicable to you.
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Many years before that, my penpal from Austria visited and she commented that all the bread here was like cake back home.
Eating bread from a real bakery is shocking compared to grocery store bread. Like the first time I had a Garibaldi biscuit and it wasn't sickeningly sweet.
It's a mystery (Score:5, Funny)
Why are
*sips corn syrup*
Americans
*drives suv to mailbox*
So
*watches sportsball*
Unhealthy?
*drinks 12 pack*
We just don't know.
Need Single-payer healthcare (Score:2)
One reason that we have such poor healthcare results and that life expectancy has gone down in the U.S. is that too many people cannot afford healthcare. According to the Commonwealth Fund [commonwealthfund.org], more that 80 million people from ages 19-64 are either underinsured or uninsured. We need a single-payer healthcare system, also known as Medicare for All, that covers everybody and eliminates out-of-pocket costs. H.R.1976 - Medicare for All Act of 2021 [congress.gov] would create such a system.
Medicare for All would allow people to ge
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You apparently haven't seen the chunk your employer was paying to private companies. Ask any company what their biggest expense is behind salaries and it will be health insurance. The rest of the world scratches their head when hearing this.
Re: Need Single-payer healthcare (Score:2)
It's easier to live long (Score:2)
when your 70th birthday isn't locked behind a paywall.
Narrow sense (Score:2)
Still, in a broad sense, Americans' health hasn't improved much in those 12 years
Because they are looking at it in a very narrow sense, life expectancy. There is more to medicine than life expectancy.
For example, the knee repair and hip replacement surgeries have improved dramatically in the last 20 years. That doesn't affect longevity much, but it sure improves quality of life.
Re: Narrow sense (Score:2)
The fate (and in this case, fat) of empires... (Score:3)
Glubb was right. The few technologists, farmers and others of genuine accomplishment keep the place running for a while.
Consider the British decline from 1913 to 2013 from a global empire to a small, weak island of secondary importance then remember every empire and nation fall sooner or later.
The utter absence of an intellectual class in a savagely religionist nation (originally conquered by religious fanatics) with zero conditions enabling rebirth ensures a very brittle society of willfully ignorant, vicious fools.
Of course they won't take care of their bodies. Their minds won't permit it.
Is the answer "everything"? (Score:5, Informative)
It seems like Americans have a lot stacked against them.
We have a healthcare system where billing is confusing at best, and insurance companies are arbitrators of healthcare. Many people avoid preventative care because of the cost.
We have a culture that's not really healthy either. The nearest place to groceries for me in a walkable distance sells mostly chips and soda. Other than some bananas on the counter, there's nothing for fresh fruits or vegetables. Food deserts are the norm for many Americans.
Speaking of norms, driving is the norm as well. Which is likely due to how we build our cities and the lower population density in exurbs and rural areas. That limits the amount of walking we get, which reduces our daily exercise.
We work longer hours than many other nations, which means we're eating more convenience food and fast food.
And we have income disparity, and stress isn't healthy.
Maybe the question should be why do Americans live as long as they do? The deck is stacked against us. Yes, we can be healthy, but that takes determined effort, day after day after day.
Re: Is the answer "everything"? (Score:2)
Re: (Score:2)
That's exactly it. This extensive analysis says "It's not your fault. It's very probably a simple contaminant:
https://slimemoldtimemold.com/ [slimemoldtimemold.com]
Unhealthy food mostly. (Score:2)
That's obvious (Score:2)
Universal healthcare would make a huge impact (Score:2)
If you don't need to fear a surprise $4,000 bill for sitting in an empty room you'll be more likely to go to a doctor to get things checked, and thus more likely to catch things before they get too bad, and thus live a longer, better life.
Poverty, no universal health care, poor education (Score:3)
All the rest stem from those.
Health gradient (Score:4, Insightful)
the elephant in the room (Score:2)
Environmental. Quit the bullying. (Score:2)
Americans are exercising more than ever and eating less sugar:
https://slimemoldtimemold.com/... [slimemoldtimemold.com]
ughm.. bull shit (Score:3)
It's the system if misaligned incentives in the healthcare industry.
There is a reason why Theranos was able to pull off the fraud it was able to pull off. Insurance companies are not liable for treating any condition which tests do not discover. And doctors cannot be sued for a test which showed that there is nothing to treat. Doctors can, however, be sued for not treating or mistreating after a test shows a problem.
So everyone, who has any decision to make, is incentivized not to discover that someone is sick. If the incentives were reversed (and doctors were only paid if they treated something like dentists are), they would be much more eager to make sure that there is no false negatives when it comes to discovering illnesses. If the insurance companies could be sued for recommending Theranos (which provided cheaper tests but statistically insurance companies had to see that it had a higher rate of false negatives), they would also have incentives to to recommend tests which discover nothing over tests which are more likely to discover something.
One of many reasons (Score:2)
Inequity (Score:3)
These wonderful advances are only available to people who can afford them. The most significant thing that would both improve the health of Americans and reduce per-capita medical care costs would be a single-payer universal healthcare system similar to the one in Canada.
You can compare this to modern cars (Score:2)
Ask the 10 corporations that own everything. (Score:2)
Re: (Score:2)
Well if we stop being reactionary against towards the word racism. And stop to see how racism is a factor (not the entirety) to many of the problems we have. We can get a bigger picture of the problems and see what we can do to help fix them.
For the United States Race relations had been an issue. There have been a lot of laws built around isolating other races from each other, while many of these laws have been rescinded over time, their impact is still around. Such as low bridges, or highways that cut
Re: (Score:2)
People are doing stuff about that. What gave you the impression that they weren't?
Re: (Score:2)
Well the fact that McDonalds apologised shows that racism is becoming less acceptable in China now. Generally speaking the Chinese people I've met in China have been friendly and accepting of me. One taxi driver tried to rip us off by my wife was having none of it. That happens everywhere though, taking advantage of people who don't know the area.
It's an on-going battle. State TV channels seem to be making some effort to portray black people in a positive light. It also depends very much where you go, somew