health fitness exercise healthhabits

Our Health Care System is Completely Backwards

Earlier this evening, I was reading a business book entitled Breaking the Time Barrier. The book is written for small business people (like me) in service industries who bill their clients on an hourly basis. Written as a pseudo-fable, the author tries to hammer home the lesson that I should be billing my clients based on the value I bring to them…not by selling blocks of time to them at an hourly rate.

The author recommends that I…

  1. determine the goals of a potential personal training client – ie a 20 lb weight loss or a 10 pt. drop in systolic blood pressure,
  2. identify the value of their goals to them. How much do they value their health, fitness, appearance?
  3. Offer solutions designed to achieve their goals
  4. Charge them a percentage of the value of their goals in return for my solution

…as opposed to selling them hour long chunks of my day..with the implied promise that those hours are going to add up to their goals…of a 20 lb weight loss or a 10 pt. drop in systolic blood pressure.

And that got me thinking about other personal trainers…and the fitness industry…and then the entire health care system. And by the end of my pondering, I concluded that our health care system is completely backwards.

Our Current Health Care System

Currently, we have a society where rates of diabetes, cancer, heart disease, dementia, depression et al increase year after year after decade. And instead of the health care system offering solutions to help us achieve our goal of good health, it offers us products & services designed to…

  1. mask the symptoms of disease
  2. extend life after the medical condition has become critical

poppin-pills

We’re not paying for health…we’re paying to manage pain, disability and disease.

[colored_box color=”green”]If I was a cynical man, I might start thinking that our health care system is a bit of a racket. Why focus on keeping their patients healthy when they can sell them lots of stuff when they get sick?[/colored_box]

But what if doctors could make a good living and keep us healthy at the same time?

  • What if our health care system taught us how to eat for health?
  • What if our health care system taught us how to be active for good health?
  • What if our health care system taught us how to shop for and cook healthy meals?
  • What if our health care system made healthy food inexpensive?
  • What if our health care system made health & fitness cool like Hollywood makes really bad movie sequels seem cool?
  • What if our health care system made access to exercise facilities universal?
  • What if our health care system focused most of it’s efforts on keeping us healthy?

And what if you paid for these services in advance…like you do everything else?

For example…

  • If you want shelter from the elements, you buy a house or rent an apartment.
  • If you want to get rid of hunger, you buy food
  • If you want to travel from home to work, you get a bike or a car or a transit pass.
  • If you don’t want to be lonely, you talk to people, go on dates, nod and smile at the stuff they find important…

We all pay a price in some form or another to achieve the goals that are important to us.

So why don’t we do that with our health care system?

Why don’t we pay doctors to keep us healthy? Isn’t that what we want? To be healthy…and fit…and strong…and attractive.

seniors exercise fitness

So why do we pay the health care system to mask our illnesses and keep us alive in hospital beds while our family goes bankrupt trying to keep us alive just a little bit longer?

Can anyone answer that question for me?

How is it possible that Americans are living shorter lives with poorer health than the rest of the “rich” countries???

The United States of America spends more money on healthcare than any other country in the world. And yet, Americans have a lower life expectancy and higher rates of disease and injury than almost all other high-income countries.

  • How is it possible that Americans are living shorter lives with poorer health than the rest of the “rich” countries???
  • And why is it happening?

The Data

When compared with the average for peer countries, the United States fares worse in nine health domains:

1. Adverse birth outcomes

For decades, the United States has experienced the highest infant mortality rate of high-income countries and also ranks poorly on other birth outcomes, such as low birth weight. American children are less likely to live to age 5 than children in other high-income countries.

  • Infant mortality

infant-mortality-rate

How is it possible that almost 3x as many babies die in the US than in Sweden?

2. Injuries and homicides

Deaths from motor vehicle crashes, non-transportation-related injuries, and violence occur at much higher rates in the United States than in other countries and are a leading cause of death in children, adolescents, and young adults. Since the 1950s, U.S. adolescents and young adults have died at higher rates from traffic accidents and homicide than their counterparts in other countries.

  • Deaths from traffic accidents

traffic-mortality

  • Violent deaths

violent-death-usa

Hmmmmm, American boys dying violent deaths…I wonder what could be causing that?

3. Adolescent pregnancy and sexually transmitted infections

Since the 1990s, among high-income countries, U.S. adolescents have had the highest rate of pregnancies and are more likely to acquire sexually transmitted infections.

  • Adolescent birth rate

birth-rate

The boys are dying violent deaths, the girls are getting knocked up and everyone is getting sexually transmitted infections. Well done.

4. HIV and AIDS

The United States has the second highest prevalence of HIV infection among the 17 peer countries and the highest incidence of AIDS.

No surprise considering the high rate of sexually transmitted infections. 

5. Drug-related mortality

Americans lose more years of life to alcohol and other drugs than people in peer countries, even when deaths from drunk driving are excluded.

This might explain all the pregnancies and STIs.

6. Obesity and diabetes

For decades, the United States has had the highest obesity rate among high-income countries. High prevalence rates for obesity are seen in U.S. children and in every age group thereafter. From age 20 onward, U.S. adults have among the highest prevalence rates of diabetes (and high plasma glucose levels) among peer countries.

childhood-obesity-by-countr

Obesity, diabetes, heart disease, Alzheimer’s and a whole bunch more lifestyle related medical conditions are driving America’s medical costs up and up year after year.

7. Heart disease

The U.S. death rate from ischemic heart disease is the second highest among the 17 peer countries. Americans reach age 50 with a less favorable cardiovascular risk profile than their peers in Europe, and adults over age 50 are more likely to develop and die from cardiovascular disease than are older adults in other high-income countries.

Hmmmmmmm, the home of McDonalds and Coca-Cola has the second highest rate of ischemic heart disease amongst their peer countries. Quel surprise.

8. Chronic lung disease

Lung disease is more prevalent and associated with higher mortality in the United States than in the United Kingdom and other European countries.

9. Disability

Older U.S. adults report a higher prevalence of arthritis and activity limitations than their counterparts in the United Kingdom, other European countries, and Japan.

NOTE #1 – Looking at all of these problems which cause Americans to live shorter lives with poorer health than the rest of the world’s “rich” countries, I keep seeing the same root problem. POOR LIFESTYLE CHOICES

  • Poor diet – quantity & quality
  • Inactivity
  • Violent culture + easy access to guns
  • Unprotected sex
  • High rates of drug & alcohol abuse

NOTE #2If you want all the details on this research, head over to the National Acadamies Press and download a free pdf copy of the report 

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The Secret Behind Your Addiction to Junk Food

Pulitzer prize winning journalist Michael Moss spent four years researching the scientific research that goes into each bag, box or bottle of processed / junk food.

And what he found, should freak you out.

Teams of scientists spending millions of dollars researching bliss points and maximum bite force and sensory specific satiety…all with the aim of keeping you eating ‘food’ that is high in calories, sugar, salt & fat and virtually devoid of actual nutrition.

And they are very, very good at it.

And because…

  1. They are very, very good at their jobs.
  2. Their lobbyists are good at influencing politicians
  3. Government heavily subsidizes their industry
  4. They spend billions on marketing to both adults & children
  5. And most of us are equal parts lazy and uneducated about nutrition

…the sales of ‘real food’ continue to drop while the sales of ‘processed food’ continue to rise.

Also rising are….

  1. The rate of childhood and adult obesity
  2. The rate of type 2 diabetes
  3. The rate of heart disease
  4. The rate of obesity-related cancers
  5. The rate of Alzheimers
  6. Healthcare costs associated with these conditions

Something to think about the next time you go to the supermarket.

You really should buy Salt Sugar Fat. Or at least take it out from the library

Reference

Stop Heart Disease with HIIT?

  • HIIT workouts are great for fat loss
  • HIIT workouts save your time
  • HIIT workouts are way more fun than slogging away the miles on a treadmill
  • HIIT workouts make you fitter faster

But…they sometimes scare the crap out of newbies….who wonder if such high intensity workouts are going to cause their de-conditioned hearts to explode inside their chest cavities.

And since I am not a cutting-edge cardiologist, I find it best to check with the experts before shooting my mouth off about the awesomeness of HIIT.

Luckily for us, some of the big brains at the Montreal Heart Institute have just published another study extolling the virtues of HIIT workouts for the rehabilitation of their patients with heart failure and reduced ejection fraction.

In this study, they compared the circulatory (hemodynamic) respones to:

  1. a 8 min HIIT workout
  2. 22 minute moderate-intensity continuous exercise (aka cardio) style of workout

Their findings?

  1. The HIIT workout was well tolerated by the test subjects and produced no significant ventricular arrhythmias and (or) abnormal blood pressure responses
  2. Compared with the cardio workout, the HIIT workout produced a similar circulatory response (blood pressure, stroke volume, etc) to the cardio workout
  3. Both workouts also produced similar C(a-v)O2 responses. This is a measurement of how much oxygen is absorbed from the arteries into the rest of the body.

Their Conclusion

HIIT may be an efficient exercise training modality in patients with heart failure and reduced ejection fraction.

What does this mean to you?

If the leading edge cardio researchers are looking at HIIT as an effective treatment for HEART DISEASE patients, then it might just be good for you too.

Reference

America’s Great Big Fat Problem…is getting worse

America has a big, big, big problem.

According to the report F as in Fat: How Obesity Threatens America’s Future 2012, “if obesity rates continue on their current trajectories, by 2030…

  • 13 states could have adult obesity rates above 60 percent,
  • 39 states could have rates above 50 percent,
  • and all 50 states could have rates above 44 percent”.

And if that wasn’t bad enough, this could lead to a 10x increase in the number of “new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis between 2010 and 2020—and double again by 2030”.

Obesity could contribute to more than…

  • 6 million cases of type 2 diabetes,
  • 5 million cases of coronary heart disease and stroke,
  • and more than 400,000 cases of cancer in the next two decades.

But maybe you’re like me and take your health/fitness seriously and you don’t need to worry about these health warnings.

Unfortunately, this rise in obesity rates is going to affect you financially.

By 2030, medical costs associated with treating preventable obesity-related diseases are estimated to increase by $48 billion to $66 billion per year in the United States, and the loss in economic productivity could be between $390 billion and $580 billion annually by 2030.

Although the medical cost of adult obesity in the United States is difficult to calculate, current estimates range from $147 billion to nearly $210 billion per year.

This means….

  • Your health insurance rates will increase
  • Social healthcare costs increase
  • Federal & state tax revenues are reduced due to lost productivity

And we all know what happens when government revenues can’t keep up with government spending…

  • Your taxes are increased, and
  • The quality & quantity of government services are decreased

so…what do YOU think…is it time that we did something real about reducing obesity across the board???

Reference

America’s Free Market Health Care System Sucks

When it comes to the America’s healthcare system… the free market sucks.

Here’s why:

  • Health care is a very complex marketplace.
  • An unfortunate result of that complexity is an economic condition called information asymmetry  in which consumers do not have the information required to determine which product/treatment is best.
  • Because of this imbalance in information, it is ONLY at a systemic level that WE can figure out which healthcare decisions work best and which are not worth the money.

And while that may sound a little Big-Brotherish…it’s true.

Heck…even Novartis chairman Daniel Vasella thinks so:

In America, no one has incentives to make quality and cost-effective outcomes the goal. There are so many stakeholders and they each want to protect themselves. Someone needs to ask, ‘What are the critical elements to increase quality?’ That’s what we’re going to pay for, nothing else.

It pains me to say this as a free-market advocate, but you have to have [the] government act in this case. Health care is very complex. Only at a systemic level can you figure out what works best based on the evidence, and what procedures and treatments are not worth the money

And unfortunately for my American cousins, their free market system of healthcare focuses on selling products & services…not producing the best healthcare outcomes for the American population.

For example:

  • Smoking rates are higher in France than in the United States, so the French population has higher rates of lung disease. Yet the French system is able to treat the disease far more effectively than happens in the United States, with levels of severity and fatality three times lower than those in this country. And yet France spends eight times less on treatments per person than the U.S. system.
  • Or consider Britain, which handles diabetes far more effectively than the United States, while spending less than half of what we spend per person. Studies have shown that the British system is five times more productive in managing diabetes than is the United States.

Successful healthcare occurs when the focus is on results and not on sales figures.

And until that shift in philosophy happens, Americans…and Canadians..and French..and British…and Brazilians… and every other person in the world will be receiving sub-standard healthcare.

[box type=”note”]As a Canadian, I can report that my non-Free Market healthcare system also fails badly when it comes to looking at the big picture. Instead of focusing on results, Canada’s system focuses on treatments and wait times and availability. We spend less than 1% of the healthcare budget on disease prevention even though the costs associated with poor lifestyle choices are going through the roof.[/box]

 Reference

Are Overprotective Parents the Cause of Childhood Obesity?

Back in the olden days (the 1980s), me and my friends would race home from school, dump our schoolbags in our rooms, shove some leftovers down our gullets and run back outside to play road hockey (or baseball, football, etc) until…

  • it became too dark to see
  • or our Moms dragged us back inside for dinner & homework

Fast forward to 2012…

  • 46% of Canadian kids get 3 hours or less of active play per week
  • Only 35% of Canadian kids walk or ride their bikes to school
  • The average Canadian kid gets 7 hours and 48 minutes of screen time every day
  • As a result, Canadian kids spend 63% of their free time being sedentary
  • And they’re even less active on weekends than on school days

And according to Active Healthy Kids Canada, “two of the major barriers to regular, active play in Canadian kids are screen time and parental safety concerns. In combination, these societal realities force children and youth into highly-controlled environments, where they have little opportunity to let loose and just play“.

Play…like we all did back in the good old days…before the world became a scary place and we needed to start bubble-wrapping our kids to keep them safe.

Fifty-eight per cent of Canadian parents say they are very concerned about keeping their children safe and feel they “have to be over-protective of them in this world.” Safety concerns, whether or not they are founded, such as crime, traffic, neighbourhood danger, outdoor darkness and lack of supervision, discourage parents from letting their children and teens play outdoors.

And as a result, our precious little bundles of joy are fat and borderline diabetic.

NoteWhile this data is Canadian, I’m willing to bet that it isn’t unique to Canada.

Reference

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Why is America so Fat

The Free Market Doesn’t Give a Shit About Your Health…

… and why should they?

McDonald’s isn’t your Mommy.

  • They prepare food
  • You buy it
  • Their stock price tripled in the past 8 years
  • As did the ass size of the typical McDonald’s customer.

Unfortunately for fast food restaurants, childhood (and adult) obesity has become a major medical, political & social issue.

fatkidatmcds

 

A big enough issue that at the most recent McDonald’s shareholder meeting, a small group of shareholders came forward to say that “McDonald’s can no longer ignore the spiraling costs of its business practices on our children’s health and on our healthcare system. This issue is not only critical to the health and well-being of generations to come, but also to shareholders who should be better informed about the liabilities associated with the businesses they’re investing in.”

The resolution would compel the Board of Directors to assess how the growing body of evidence linking fast food and its marketing with diet-related conditions will impact McDonald’s finances and operations.

In response to the proposal, McDonald’s board of directors recommended a “no” vote on the proposal, calling it “unnecessary and redundant.”

  • 93.6% of McDonald’s shareholders agreed and voted NO.

Hmmmm…. a cynical person might assume that 93.6% of McDonald’s shareholders and the entire board of directors already know how McDonald’s menu & marketing practices impacts childhood obesity…and they don’t want to see their profits, share prices and performance bonuses get hammered by the truth.

  • And why would they?
  • Their job isn’t keeping our kids healthy.
  • That’s our job.

Just know that McDonald’s (and KFC, DQ, Taco Bell, Burger King, Wendy’s, etc) doesn’t give a shit about your health or the health of your children.

Reference

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Exercise Is Medicine

I am a big believer in the power of social media as a tool to share information, affect public opinion and empower the little guy.

I am also a big believer in the power of daily exercise as a tool to keep you healthy, fit and looking super-sexy.

To that end, I would like to suggest that we all begin using the hashtag #ExerciseIsMedicine whenever we’re tweeting or re-tweeting a story about exercise.

Thanks in advance.

Doug 

Childhood Obesity : A Primer for Parents

Having an obese child doesn’t make you a bad parent.

  • Uninformed : MAYBE
  • Bad : NO
  1. Processed food producers spend an ungodly amount of money learning what type of foods encourage overeating…and over-purchasing. Sugars, fats, processing techniques, flavor enhancing chemicals, etc.
  2. In addition to the bio-chemsitry, then spend big bucks on neuro-psychology to determine how your eyes and brain can be manipulated while you shop. Believe it or not, there is a lot of science behind product placement and purchasing decisions.
  3. Moving on to the science of manipulation, our food producers also spend huge amounts of money creating and delivering marketing campaigns aimed directly at your kids….knowing that if they get them while they’re young, they will have them for life. Creepy – YES…but also very effective.
  4. And if that wasn’t enough, they also spend a lot of money employing lobbyists to protect their interests within government, generate massive food subsidies and to block any legislation limiting their influence over our kids.

Put it all together and it’s not too surprising that our kids keep getting fatter and fatter.

Luckily, there are solutions.

  • Informed parents can make better food and activity choices for their kids.
  • Informed parents can tell their government that they don’t like advertising directed at their pre-pubescent children.
  • Informed parents can bring attention (thank you social media) to the political manipulation that makes a mockery of the Free Market.
  • Informed parents can talk to other parents and local government to improve access to healthy foods in their neighborhood.
  • Informed parents can take advantage of existing grants and support organizations to improve the walkability and “playability” of their neighborhoods

And how does a parent get informed?

Here’s a good place to start.

Other Resources

Canada's Health Ranking Falls Like a Fat Guy Through an Wicker Chair

Canadians love to talk about their healthcare system.

  • We love to brag about how much better it is than the American system, yet
  • We also love to complain about the long wait times and the imminent bankruptcy of the system.

Lately, it’s been more complaining than bragging.

  • We blame the nurses’ union for being greedy.
  • We blame the hospital bureaucrats for their big salaries and “obvious” incompetence.
  • We blame illegal immigrants and the poor for clogging up the emergency room instead of going to their GP.

We blame. We blame. We blame.

Problem is….we should be blaming ourselves.

According to the Conference Board of Canada, the real problem with the Canadian healthcare system isn’t the system…it’s the Canadian public and their lazy lifestyle that is ruining the healthcare system.

Canada’s 2012 Health Report Card

The Conference Board of Canada takes an annual look at 17 industrialized nations and compares them using 11 different markers of health.

  • In the 1990s, Canada was ranked 4th.
  • Today, Canada has fallen to 10th.

What gives? 

According to the research, while top-ranking countries like Japan, Switzerland & Norway have invested in programs designed to promote a healthy lifestyle, thereby lowering the economic impact of chronic diseases like diabetes, cancer, depression, dementia, osteoarthritis, and heart disease, Canada has virtually ignored health promotion.

And according to the Conference Board of Canada, “most top-performing countries have achieved better health outcomes through actions on the broader determinants of health such as environmental stewardship and health-promotion programs focusing on changes in lifestyle, including smoking cessation, increased activity, healthier diets, and safer driving habits.

Leading countries also focus on other determinants of health—such as education, early childhood development, income, and social status—to improve health outcomes”.

It’s a novel concept…spend a small amount of money preventing disease instead of spending a large amount of money treating disease.

What now?

The cynic in me believes that nobody is going to pay attention to this report and that the status quo will rule the day.

However, just last week, the federal government announced $4 million in additional federal money for Health Canada’s Healthy Eating Awareness and Education Initiative.  And while $4 million is a drop in the bucket compared to the total spending on healthcare, it’s a start and may represent a shift in government thinking.

Time will tell.

What can we do NOW?

You could write a letter to your MP or MPP or the appropriate federal/provincial Health Minister….and they might send you a nice form letter telling you how they take the health of Canadians seriously…yadda yadda.

Or you could use your Twitter and Facebook accounts to put a little heat under their seats.

  • Canada – Leona Aglukkaq – Federal Minister of Health and Long-Term Care – Facebook – Twitter
  • Alberta – Fred Horne – Minister of Health and Wellness – Facebook – Twitter
  • British Columbia – Michael de Jong – Minister of Health – Facebook – Twitter
  • Manitoba – Jim Rondeau – Minister of Healthy Living, Youth and Seniors – Facebook
  • New Brunswick – Madeline Dubé – Minister of Health – Facebook
  • Newfoundland – Susan Sullivan  – Minister of Health and Community Services – Facebook – Twitter
  • Northwest Territories – Tom Beaulieu – Minister of Health and Social Services  – website
  • Nova Scotia – Maureen MacDonald – Minister of Health and Wellness  – FacebookTwitter
  • Nunavut – Keith Peterson – Minister of Health and Social Services – website
  • Ontario –  Deb Matthews – Minister of Health – Facebook – Twitter
  • Prince Edward Island – Doug Currie – Minister of Health and Wellness – Facebook – Twitter
  • Quebec – Yves Bolduc  – Ministre de la Santé et des Services sociaux – Facebook
  • Saskatchewan – Don McMorris – Minister of Health – Facebook – Twitter
  • Yukon – Minister of Health and Social Services- Facebook – Twitter

NOTE – this problem isn’t unique to Canada. Other countries (like the US of A – #17 of 17) could use with a healthy dose of health promotion.

The reason why big government "healthy lifestyle" programs don't work is…

…because they think education is the answer.

And while I am a big fan of education, I am pretty sure that the majority of us know that:

  • Exercise is healthier than watching tv
  • Vegetables are healthier than pizza
  • Meditation is healthier than obsessing over that idiot who cut you off in traffic
  • Drinking a glass of wine with dinner is healthier than downing a bottle by yourself
  • Socializing with friends is healthier than being a loner
  • Stretching tight muscles is healthier than sitting all night after sitting all day at work

We already know this stuff…..and yet, we eat junk food, watch too much tv and barely get any exercise.

EDUCATION IS NOT ENOUGH

Education by itself didn’t reduce the number of smokers.

It took education + higher taxes + municipal bylaws restricting public smoking + a whole lot of shaming from non-smokers who finally felt empowered enough to tell someone to butt out.

And if we want to reduce the healthcare costs attributable to poor lifestyle choices – obesity, diabetes, heart disease, alzheimers, cancer, etc…. we need to do more than education.

Image: http://www.glasbergen.com

 

A Health Habits Plan to Eliminate Obesity – Part 2

A few days ago, I published Part 1 of my Health Habits Plan to Eliminate Obesity

In that post, I identified the two main causes for obesity:

  1. Medical causes which require medical intervention – ie pharmaceuticals or surgery
  2. Lifestyle causes – ie lack of exercise, overeating, junk food, etc

I also highlighted the three main targets for modifying the lifestyle causes of obesity:

  1. Lack of Knowledge
  2. Lack of Resources
  3. Lack of Motivation

And finally, I hypothesized that when it comes to lifestyle modification, there will never be a magic bullet solution for obesity

What’s required is a comprehensive approach that can satisfy the causes I listed above.

  • Lack of Knowledge
  • Lack of Resources
  • Lack of Motivation

Today, I am going to put my ego on the line and start laying out a plan that I think could:

  • Make use of already available expert knowledge
  • Allow small businesses to flourish
  • Improve the image of the corporate business sector
  • Reduce health care costs across the board – gov’t, business, insurance & end user
  • Improve municipal infrastructure
  • Cost the public sector next to nothing
  • Spark our motivation to live a healthy lifestyle
  • Encourage us all to take ownership of our own health
  • Reduce levels of chronic disease,
  • Improve levels of physical fitness, and
  • Drastically reduce levels of obesity

The Plan

As it stands right now, if you want access to the information, resources and motivation required to lose 50 lbs and get into great shape, it helps to have money…lots of money.

For personal trainers, nutritionists, uber-healthy food, supplements, lifestyle coaching, etc…

  • What if we could offer those services in every neighborhood around the country for next to nothing?

Wouldn’t that help with our lack of knowledge and lack of resources?

  • And what if every time you turned on your tv set or surfed the net, you were bombarded with healthy lifestyle advertising created by the world’s best marketing companies featuring the world’s biggest celebrities.

We live in a world where we are convinced to buy stuff that we don’t need but are told that we should want. What would happen if those same companies tried to sell us on a healthy lifestyle?

We’re not talking “say No to Drugs” PSAs…we’re talking big multimedia advertising campaigns boring their message directly into our influential little brains.

Wouldn’t that help with our lack of motivation?

What if I told you that there were already programs like this popping up around the country…but they suffer from a lack of scale, a lack of proper management, a lack of influence, a lack of awareness and a lack of money.

But not for much longer.

Everyday there is a bunch of stories in the news about obesity….from which country is the fattest, to an 8 year old boy being taken from his mother because he’s too fat…obesity has become a major topic of discussion around the world.

A Health Habits Plan to Eliminate Obesity

When “obesity experts” get together to discuss the skyrocketing rates of obesity, the same topics get raised over and over and over. Regarding the causes of obesity, the experts focus on:

  1. Medical causes which require medical intervention – ie pharmaceuticals or surgery
  2. Lifestyle causes – ie lack of exercise, overeating, junk food, etc
  1. Lack of Knowledge
  2. Lack of Resources
  3. Lack of Motivation

Lack of Knowledge Some anti-obesity experts believe that a general lack of knowledge regarding nutrition and physical activity is the cause of our obesity problem. Personally, I think that’s a load of B.S. I have yet to meet an adult human being who thinks that pizza is healthier than broccoli…or that watching tv for 8 hours a day is better for them than going for a walk around block. But….I am willing to concede that food companies employ deceptive practices when it comes to the relative healthfulness of their products, and that it’s easy to be taken in by their marketing efforts. Lord knows they spend a lot of money trying to get us to buy more and more and more. Lack of Resources Other experts believe that our increase in obesity rates is due to a lack of resources.

  • Urban areas that are devoid of fresh food & vegetables
  • The elimination of phys ed & home ec classes
  • Unsafe or unavailable play/sport fields and playgrounds
  • Neighborhoods designed for vehicular…not pedestrian traffic
  • Cheap processed food
  • Expensive fresh food
  • Etc….

The list could go on and on. Unfortunately, fixing all of these problems will cost a lot of money. And in 2011, governments around the world aren’t exactly flush with cash. Lack of Motivation We all know people who…

  • know that they should be exercising and eating healthy food
  • know how to exercise
  • know which foods are healthy
  • know how to cook healthy meals, and
  • have all the resources necessary to exercise and buy healthy food

…but they still don’t do it. For whatever reason, their motivation to be healthy and lean can’t overcome the thoughts/emotions/cultural programming that keep them obese and un-healthy.

The Trifecta of Obesity

In my humble opinion, our biggest hurdle to solving our obesity epidemic are the obesity experts themselves. Because there is a lot of money to be made trying to help people lose weight, a massive weight loss industry has grown out of our burgeoning waistlines. And if you’re a business trying to make money in the weight-loss industry, one of the first things you must do is create a niche. You can’t peddle the same diet or exercise advice as the other guys in the market. You have to have a unique selling proposition that will set you apart. This means that you have to focus on a single “miracle” cure. And then market the heck out of it. Unfortunately, because people are usually obese for more than one reason, these miracle cures are doomed to failure. What we need is a comprehensive approach that can satisfy all (or at least most) of the causes I have listed above

  • Lack of Knowledge
  • Lack of Resources
  • Lack of Motivation

In Part 2 of this post, I will outline a plan that will:

  • Make use of already available expert knowledge
  • Allow small businesses to flourish
  • Improve the image of the corporate business sector
  • Reduce health care costs across the board – gov’t, business, insurance & end user
  • Improve municipal infrastructure
  • Cost the public sector next to nothing
  • Spark our motivation to live a healthy lifestyle
  • Encourage us all to take ownership of our own health
  • Reduce levels of chronic disease
  • Reduce levels of obesity, and
  • Make us all look damn sexy in a pair of jeans

That’s it for today…stay tuned for Part 2. .

The Economics of Obesity

Billions of dollars are spent every year on treating obesity and it’s related health conditions. Unfortunately, only a teeny tiny fraction of that money is spent on OBESITY PREVENTION.

Which is weird considering that obesity is largely a result of poor lifestyle choices.

For example….

  • In Canada, it’s estimated that the cost of obesity (2008 numbers) rose to a staggering $7.1 billion.
  • Based on population data, the province of Ontario’s share of that cost is approximately $2.75 billion
  • And yet, it’s department of Health Promotion & Sport has a total annual budget of $470 million
  • Of which, only $4.3 million is spent on nutrition & healthy eating.

Hmmmmm

  • Obesity cost to Ontario:  $2, 754,8000,000
  • Amount spent by Ontario gov’t to encourage healthy eating:  $4,324,400

Does this make sense to you?

Back in the olden days, my Grandma used to tell me that an ounce of prevention is worth a pound of cure. As a six year old, I had no idea what the heck she was talking about.

My guess is that whoever’s paying for these obesity costs still hasn’t figured it out.

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BTW, it’s us paying the cost

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Reference

The Fat Taxes Are Coming

Denmark, one of Europe’s leanest countries, has instituted the world’s first “fat tax”.

Approved by a large parliamentary majority back in March, Danish consumers now have to pay a 16 kroner ($2.72 USD) tax per kilogram of saturated fat in a product.

This means that Danes have to pay $0.15 more for a burger and $0.40 more for a small package of butter.

This is in addition to the higher fees already applied to sugar, chocolates and soft drinks.

Why a Fat Tax?

Officially…these targeted food taxes are part of a larger government plan to increase the life expectancy of Danes by three years over the next 10 years.

“Higher fees on sugar, fat and tobacco is an important step on the way toward a higher average life expectancy in Denmark,” health minister Jakob Axel Nielsen said, because “saturated fats can cause cardiovascular disease and cancer.”

Opponents to the tax say that it is very complex, involving tax rates on the percentage of fat used in making a product rather than the percentage that is in the end-product.

As such, they expect that this new level of bureaucracy will cost Danish businesses about $28 million in the first year.

Do Fat Taxes Work?

Opponents of fat taxes say that there is no proof that fat taxes will:

  1. Reduce consumption of fatty foods, and/or
  2. Improve the health and longevity of the Danish citizens

However, considering that fat taxes are a new invention, the opponents don’t know that they won’t work either.

Proponents of fat taxes look at the success of cigarette taxes to lower consumption levels and hope that Danes will be eating healthier and living longer because of this intervention.

However, food is different from tobacco. Smokers can live without cigarettes. No one lives without food. 

As well, there is no proof that replacing butter with margarine and a weekly burger with a fish sandwich is going to result in greater longevity.

At the end of the day, neither side can prove their argument…and as a result, what we have here is an experiment. An experiment being watched by governments around the world.

  • Governments that are desperate to reduce their healthcare costs.
  • Governments that are also desperate to increase tax revenue in order to generate balanced budgets.

And it’s those budget deficits that are going to play a big part in the adoption of fat taxes around the world.

Governments have become dependant on cigarette and alcohol taxes to help stay afloat.

And a nice big fat infusion of tax dollars coming from a pro-health fat tax seems like a real win-win for progressive legislators.

 

Outdoor Fitness Equipment : How NOT to Waste Your Tax Dollars

A few years ago, I wrote about the benefits of municipal governments installing public fitness equipment in public parks.

By eliminating the cost and improving the accessibility to exercise equipment, public fitness parks are increasing activity levels in communities around the world.

Which is good, because a physically active community is a healthy community, and a healthy community spends less  on health care, misses fewer days of work, earns more money, pays more taxes, etc…

Outdoor Fitness Equipment - Uneven Bars

It’s a win:win.

Or at least it should be.

The Problem is that city bureaucrats have no idea how to design an effective outdoor fitness park. So, they rely on the salespeople from the equipment suppliers to tell them what they need.

And fitness equipment salespeople are in the business of making money.

And that’s fine for them, but not so good for the city’s coffers.

So, as a public service, I thought I would compare & contrast two different pieces of outdoor fitness equipment. A set of Uneven Bars (very old-school) and a Combo Lat Pulldown / Chest Press Machine.

Feel free to email this article to your local city councilor as a reminder of how you prefer to see your tax dollars spent.

Uneven Bars

Cost: $1200  + shipping/taxes/installation

Exercises:

  • Chin Up
  • Pull Up
  • Chest Press / Push Up
  • Lat Row
  • Tricep Dip
  • 2 Leg Squat
  • 1 Leg Squat
  • Hanging Leg Raises
  • Hanging Windshield Wipers
  • Handstand Push Ups
  • Bicep Curls
  • Plank / Bridge
  • Calf Raises
  • Balance training
  • Wide variety of Flexibility / Stretching Exercises
  • Wide variety of Strength Band Exercises
  • Wide variety of Suspension Trainer Exercises
Pros:
  • Lower Price
  • Less Maintenance
  • Wider variety of exercises
  • Greater range of exercise intensities
  • Reduced chance of breakdown
  • Longer lifecycle
Cons:
  • Less “sexy” than Lat Pull / Chest Press teeter totter machine
  • Would require an instruction board for all the different exercises

outdoor fitness equipment - lat pull chest press

Lat Pull – Chest Press Combo Machine

Cost: $3450 + shipping/taxes/installation

Exercises:

  • Chest Press
  • Lat Pulldown
  • Some strength band exercises (vertical pole attachment only)
Pros:
  • More fun looking than a set of boring old  Chin Up bars
  • Beginners love the simplicity of single purpose exercise machines
  • Less than body-weight resistance good for beginners
  • Exercise instruction chart comes included
Cons:
  • Higher Price
  • Bearing maintenance cost
  • More complex design = greater chance of breakdown = more downtime = crappy fitness park
  • Reduced exercise options
  • Less effective for more advanced trainees
  • Shorter lifecycle = costs even more money to replace
Conclusion
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Fancy-schmancy exercise equipment looks better in a photo-op than a set of uneven bars. And we all know how much politicians love photo-ops.
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But…it’s your tax dollars. Let them know how you want to see them spent.

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Fat Men Can Be Fit Men

Researchers have found that obese men (who have been diagnosed with metabolic syndrome) can keep their arteries healthy and prevent cardiovascular disease, heart attack and stroke by maximizing their cardiovascular fitness.

The Study

Scientists looked at a group of men with varying levels of cardiovascular fitness and metabolic syndrome.

  • Cardio fitness was measured by peak oxygen uptake during a standard treadmill test
  • Risk for heart disease was measured by their level of arterial stiffness.

Not too surprisingly, the researchers found that the men diagnosed with metabolic syndrome had ,on average, higher levels of arterial stiffness.

However, when the men were separated according to their levels of cardiovascular fitness, they found that all of the men in the highest quartile of fitness had significantly lower levels of arterial stiffness than those men in the lowest quartile of fitness.

That included fit guys who had been diagnosed with metabolic syndrome.

In fact, the fit and fat guys had the same levels of arterial stiffness as their skinny yet exercise-adverse brothers.

Conclusion

It is possible for fat guys to be fit guys.

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Unfortunately, it’s unlikely that those fat & fit guys will ever be as fit as their lean & fit workout buddies.

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Big Pharma are Big Cheaters

Trust plays a big part in our healthcare system.

  • You trust that your doctor cares about you.
  • You trust that your doctor is prescribing the correct drug/treatment/procedure
  • You trust that your doctor is constantly learning about the latest breakthroughs & treatments by studying the most up to date research
  • You also trust that the people doing that research are being completely honest about their work.

And that’s why researchers from Montreal’s Jewish General Hospital and McGill University were shocked to find that financial ties between researchers and pharmaceutical manufacturers weren’t being declared in a majority of meta-analysis studies.

“Patients want their doctors to make their drug choices or treatment decisions based on unbiased evidence,” said Michelle Roseman, the lead author of the study published in the Journal of the American Medical Association. “But we found that a lot of these studies that combine results from a number of different drug trials might have findings that are biased due to drug company sponsorship.”

The Study

Researchers reviewed 29 meta-analyses on a range of drug treatments published in major medical jounals – JAMA, Lancet and BMJ. Those 29 meta-analyses included results from 509 individual drug trials.

The researchers found that only 2 of the 29 meta-analyses mentioned the funding sources of the original 509 drug trials.

In fact, when the researchers identified 7 meta-analyses in which every single drug trial was paid for by the maker of the drug – they found that only one of those studies mentioned who funded the trials.

  • And there goes the trust.
  • And if your doctor can’t trust the research being given to him by drug reps, how can you trust your doctor?
  • And if you can’t trust your doctor, the whole healthcare system starts to fall apart….doesn’t it?

Reference

  • National Post
  • JAMA
FAT BRITANNIA

British Government Sells Out to the Fast Food Industry

As part of it’s continuing effort to destroy it’s healthcare system, the British government has invited fast food companies including McDonald’s and Kentucky Fried Chicken to help write government policy on obesity, alcohol and diet-related disease.

In addition to Ronald and the Colonel, representatives from PepsiCo, Kellogg’s, Unilever, Mars and Diageo are also among the businesses that have been asked to contribute to the five ‘responsibility deal’ networks set up by Health Secretary Andrew Lansley.

And while the details aren’t expected to be released until the government presents it’s public health white paper in the next few weeks, it’s believed that:

  • the Food Responsibility Deal Network will be chaired by one of the above mentioned companies, while the
  • the Food sub-group on calories is to be chaired by PepsiCo
  • the Behavior Change Responsibility Deal Network is to be chaired by the National Heart Forum
  • the Physical Activity Responsibility Deal Network is to be chaired by the Fitness Industry Association, and
  • the Alcohol Responsibility Deal Network is chaired by the head of the lobby group Wine and Spirit Trade Association

WTF!!!

In America, they’re banning the sale of Happy Meals.

In the U.K., they’re asking Ronald McDonald to design national policy on food consumption and obesity.

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Is it any wonder why nobody trusts politicians any more?

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Note – If any of my U.K. readers would like to express their displeasure over this decision to the british Secretary of Health, Andrew Lansley, here is his contact info.

Constituency Office
153 St Neots Road
Hardwick
Cambridge
CB23 7QJ
Tel: 01954 212 707
Fax: 01954 211 625

Email: lansleya@parliament.uk

Which Health Care System Is The Best?

Today, we’re going to take a brief macroeconomic look at healthcare systems around the world.

COST

BENEFIT

COST

BENEFIT

So, what can we learn from these colorful charts?

Well, we could learn that the U.S. health care system (pre 2008), was

  1. The most expensive, and
  2. Also one of the worst as it pertains to life expectancy and potential years of life lost.

We could also learn that countries with public health care systems can simultaneously achieve high life expectancy rates with relatively low health costs.

We could learn those things.

However, we could also recognize that these charts don’t tell the complete story…and that there are a bazillion different factors that influence health & life expectancy.

And maybe we should remember that the next time we get into a debate/argument over health care.

The answer isn’t as simple as the political pundits make it out to be.

http://cloudfront.mediamatters.org/static/flash/player.swf

(h/t Media Matters)

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Putting the "Health" Back in Healthcare

Canada’s healthcare system may be on the verge of a massive change.

Instead of continuing to spend billions of dollars simply treating the symptoms of disease, Canada’s health ministers have agreed that:

the promotion of health and the prevention of disease, disability and injury are a priority and necessary to the sustainability of the health system.

They also agreed that the main causes of death, disease and disability in Canada today are chronic diseases and injuries, and that a large proportion of chronic diseases, disabilities and injuries can be prevented, or at least delayed.

They continued by saying that more emphasis needs to be placed on the promotion of health and on preventing or delaying chronic diseases, disabilities, and injuries.

Doing this will improve the quality of life of Canadians while reducing disparities in health and the impact these conditions have on individuals, families, communities, the health-care system and on society.

OMG … A healthcare system that focuses on health.

Fingers crossed people. Fingers crossed..

Reference

Obesity Costs the U.S. $215 Billion

According to a new study, obesity costs the U.S. economy $215 billion per year.

That’s 18% of the projected 2010 U.S.  federal deficit.

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Isn’t it ironic that during a time of recession, the American public is unable to tighten their belts because they’re too damned fat.

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A Common Sense Solution to Rising Health Care Costs

(Nick Ray / The Times)

Around the world, health care costs are going up and up. And with the massive baby boomer population bulge entering their senior years, some governments / businesses / insurance companies are looking for new & creative ways to reduce health care costs.

One of those creative solutions is the construction of public (free) fitness parks (playgrounds) aimed at adults. In England, a new Senior Playground has recently been built by a coalition of community activists (Knightsbridge association) and two levels of government agencies.

And this isn’t England’s first “senior playground”. They are popping up all over the country.

And England certainly isn’t the first country to take this sort of initiative. Parks such as these can be found throughout China, Hong Kong, Macau, Korea…

Credit: Christopher Wanjek

And yet, in my home country of Canada, all three levels of government ignore initiatives such as this in favor of spending millions on marketing campaigns urging Canadians to exercise more and billions on treating lifestyle diseases like type 2 diabetes and obesity.

Instead of giving Participaction $3,000,000 per year for a website and some online commercials…

…they could build 50 fitness parks per year.

Or, if they were really serious, they could siphon off 1/1000th of the approx. $183 billion (2009) spent nationally on health care and build 3,050 new fitness parks per year.

($183 B ÷1000 ÷$60,000 per park = 3050 new fit parks)

And who knows, maybe the cost of the new fit parks will actually result in a net savings for government as the costs associated with obesity and related lifestyle diseases decrease.

As your Grandma used to say, “an ounce of prevention is worth a pound of cure”.

Can We "Cure" Obesity?

In my earlier post, Can Big Government Cure Obesity?,  I outlined a few ways that we could use the existing powers of government to help “cure” obesity.

Today, I am going to expand on one of those ideas a little bit.

To begin with, I think we can all agree that most of us are strongly motivated by pain and pleasure. We try to avoid pain and we try to get as much pleasure as possible.

One example of how government makes use of this human truth is with taxes.

  • No one wants to pay taxes.
  • But most of us want to avoid getting hauled off to jail even more.
  • Ergo, most of us pay our taxes.

This takes me to Idea #1Sin taxes on junk food.

At first glance, this seems like a no-brainer. We discourage consumption of junk food while simultaneously increasing tax revenues. It’s a real win-win.

  • Except for one little problem…..which foods are we going to tax?

And who is going to make that decision?

  • Politicians?
  • Scientists?

If so, which ones?

  • The low-fat gurus who have been designing our food pyramids for decades
  • The low-carb minority
  • Or those wacky Paleo Dieters

To be honest, I don’t trust this decision to any of our nutrition “experts”.

  • Big egos + big money usually = big problems for the taxpayer.

But, I do trust my mom.

And, I bet you trust your mom as well. In fact, I trust your mom more than I trust those experts. Heck, I even trust you more than I trust those experts. I bet that just about everybody reading this article already knows what kinds of food are good for them and which foods are really bad for them.

I bet that if I asked you  to make a list of 10 types of food that we should tax in an attempt to “cure” obesity, I bet we would see a lot of overlap and we would be able to come up with a consensus pretty quickly.

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Alright, there we go. I knew you could do it – a Junk Food / Fat Tax list as chosen by the people and for the people.

Democracy in action. .Now we just have to pressure our politicians into doing what we tell them to do…and wait for all of that fat tax money to come rolling in. .

But, what are we going to do with that money?

Next up….A Soical Blueprint to Cure Obesity

Related Posts

Warren Buffett & Healthcare Reform

Today, there are a lot of angry healthcare, health insurance and drug company executives.

They’re angry because America’s investment guru, Warren Buffet, the Oracle of Omaha himself, appeared on CNBC yesterday and eviscerated the current American healthcare system.

Without using any of the political rhetoric being thrown around Washington, Buffett noted that:

  • Out of control health care costs are like a tapeworm eating at our economic body
  • The current U.S. health care system eats up 17 percent of U.S. gross domestic product, at a time when many other countries pay only nine or 10 percent of GDP but have more doctors, nurses and hospital beds per capita.
  • While Mr. Buffett said he would support overhaul legislation proposed by the U.S. Senate, he would prefer existing proposals be scrapped in favour of a new one that attacks costs.
  • “If it was a choice today between Plan A, which is what we’ve got, or Plan B, which is the Senate bill, I would vote for the Senate bill,” he said. “But I would much rather see a Plan C that really attacks costs, and I think that’s what the American public wants to see.”
  • Instead of paying for procedures, American healthcare consumers should be paying for results

http://widgets.vodpod.com/w/video_embed/Video.3150433

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So, does that mean that America’s financial guru has gone socialist?

Not exactly.

Like the great investor he is, Buffett sees U.S. healthcare in black & red.

  • Too much red (costs equal to 17% GDP crippling the U.S. economy, inadequate medical coverage resulting in bankruptcies, American businesses at a global disadvantage due to their healthcare burden, etc…)
  • Not enough black (budget surplus, healthy nation, increased business profits, higher wages, etc…)

And in keeping with his investment strategy, Buffett doesn’t claim to have all the answers to solving the healthcare riddle. (unlike the geniuses on Capital Hill)

He would rather assemble all of the biggest healthcare brains in the country and listen to what they have to say.

Big brains like Atul Gawande.

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If you like what you see here, click here for updates

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Related Posts

Fighting Fat With Vinegar

Your Grandma was right. It turns out that the acetic acid found in plain ole’ vinegar is effective in suppressing body fat accumulation.

The Science

Earlier this year, Japanese researchers found that laboratory mice fed a high-fat diet and given acetic acid developed significantly less body fat (up to 10 percent less) than other mice.

Based upon their findings, the scientists believe that acetic acid fights fat by turning on genes for fatty acid oxidation enzymes. The genes churn out proteins involved in breaking down fats, thus suppressing body fat accumulation in the body.

Conclusion

Vinegar is cheap, harmless and versatile in the kitchen.

It may also help you metabolize sugars more efficiently, lower blood pressure and lose weight.

What do you have to lose?

Reference

Fit Kids Need Playgrounds

Fear of dangerous strangers is keeping our kids and teens from using their neighborhood playgrounds and parks.

Instead, they stay inside and play virtual table tennis on their Nintendo Wii. It’s not the same thing.

Researchers in the Faculty of Physical Education and Recreation at the University of Alberta, looked at perceived opportunities and barriers to physical activity in an inner-city neighbourhood in Edmonton.

Study data revealed three themes that influenced youngsters’ opportunities for physical activity, with positive and negative factors for each.

The first theme identified was “neighbourhood characteristics.”

  • Positive neighborhood characteristics include “walkable” neighborhoods with plenty of parks and playgrounds and nearby amenities.
  • Negative neighborhood characteristics include perceived “stranger danger” fears related to drug users, bullies, prostitutes, gang members and fear of abduction deterred children and youth from visiting these places.

The second theme was “family involvement.”

  • Researchers found that while children and youth were rarely allowed out alone, involvement by a family member, for example, accompanying them to a park to play, increased their engagement in physical activity.

The third theme was the “availability of adult-supervised programs.”

  • On the positive side, we have neighborhoods with a large variety of programs offered by dedicated, hard-working staff and volunteers.
  • Conversely, neighborhoods with minimal resources; poor staff and volunteer recruitment and retention, and little public knowledge of program availability suffered badly. Even when kids did sign up for available programs, there was a high dropout rate.

Conclusion

If we want our kids to grow up fit and strong and healthy, we need to:

  1. Take back our neighborhood parks & playgrounds (easier said than done)
  2. Get involved with our kids’ lives…not just drop them off at the rec center
  3. Push our governments for more public fitness programs

Related Posts

Reference

Just in case America isn’t fat enough…

taco bell fourth meal

As the debate over President Obama’s healthcare proposal rages on, Taco Bell continues to give Americans exactly what they crave….melty, crunchy, spicy and heart attack inducing.

I especially love the tagline at the end…

taco bell it's not just food fourth meal

Of course, I would change it just a little bit.

taco bell not real food

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If you like what you see here, click here for updates

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Related Posts

Did You Play Today?

childhood obesity psa where the wild things are

The U.S. Dept of Health and Human Services and the Ad Council today launched a new series of PSAs designed to address childhood obesity. Featuring characters from the upcoming film Where the Wild Things Are, the PSAs are an extension of HHS’ Childhood Overweight and Obesity Prevention campaign with the Ad Council, which encourages children and families to lead healthy lifestyles.

These PSAs cost millions of dollars.

But do they work?

Will this PSA get your kid to put down the Wii controller and go outside and play?

did you play today

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If you like what you see here, click here for updates

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Related Posts

America's Celebrity Doctors Weigh In On Healthcare Reform

Apparently, a good portion of America has gone completely insane over healthcare reform.

  • We’ve heard from the politicians – Democrat & Republican.
  • We’ve heard from the pro gov’t healthcare crowd…[unitelligible screaming]
  • We’ve heard from the anti gov’t healthcare crowd…[unitelligible screaming]
  • And we’ve heard way too much from the teleprompter readers on tv – left & right & even more right

So, today, let’s take a look at what America’s favorite celebrity doctors have to say about healthcare reform in America.

First up, Oprah’s personal health guru:

Dr. Oz

dr ozPart of the challenge we face is that all eyes are focused on healthcare finance arguments in Washington, but the real action is taking place in our homes across this great land. We cannot have a wealthy country without being a healthy country, but healthcare finance solutions by themselves do not help us care for our health. An insurance card is correlated with, but does not guarantee a clean bill of health.

To control costs without rationing care, we need to improve the quality of the services we buy for our money. Economists and the few remaining car salesmen would agree that this translates to better value.

We have two principal options.

First, we need to eliminate the 20 percent of services offered that are wasteful or harmful.

Doctors need to act like professionals and police our own for doing unnecessary tests and procedures but we also need smart patients to insist on second opinions that will change their diagnosis or therapy in a third of all cases.  Many of you are bashful about pushing to see another doctor, but when you get doctors to speak with each other about your case, they teach each other and every subsequent patient that sees your doctor will benefit because you were brave enough to drive quality into the system.

The second major improvement requires revisiting the business model of medicine.

Professor Christensen of Harvard Business School taught me on a show recently that two primary models exist for any business (excluding networking businesses). “Solution shops” offer intuitive insights into unpredictable ailments, something doctors (and lawyers) are superb at addressing.

On the other hand, value-adding processes like building cars in an assembly line or managing correctly diagnosed diabetes with a specific plan for chronic management are far less expensive than solution shops and usually are more effective in offering reproducible results.

In America, we lump these fundamentally different approaches together so we get highly trained doctors using sophisticated approaches to manage tasks that could often be better accomplished by other well-trained health professionals who actually like double-checking that you took your medications and watched your diet.

We speak of prevention a lot these days, but what does prevention mean?

I moderated the last White House Town Hall on Health and came away from the experience understanding that America believes “prevention” is really about making the right thing easy to do.

This includes everything from making healthy locally grown vegetables easy to find, bike racks available in our work places and a healthcare system that provides a crutch to remind us that we forgot our colonoscopy.

We cannot look to Washington for these changes without engaging the battle ourselves.

original article

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Next up is America’s integrative health guru:

Dr. Andrew Weil

dr weilNot to be outdone by Dr. Oz, Dr. Weil has 2 articles in this weeks Huffington Post.

The first is a general discussion of healthcare reform…..

As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.

And, what’s true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the “public option” for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can’t afford coverage will finally get their fair share.

But what’s missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what’s even worse than its stratospheric cost is the fact that American health care doesn’t fulfill its prime directive — it does not help people become or stay healthy. It’s not a health care system at all; it’s a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.

It’s impossible to make our drug-intensive, technology-centric, and corrupt system affordable.I’m not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism’s innate capacity for self-regulation and healing. It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can’t, both our personal health and our economy are doomed.

Politicians aren’t going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.

Dr. Weil’s second article deals with a patient of his who:

  • was relatively healthy,
  • in his mid-30s,
  • and had been diagnosed by his GP as having gastroesophageal reflux disease — also known as GERD (aka heartburn)

His GP never took a dietary history, asked about his lifestyle or even explained the nature of GERD nor the long term effects of proton pump inhibitors.

Dr. Weil reviewed his diet and lifestyle and explained the nature of GERD and the factors that contribute to it (stress & certain foods).

Based upon the patient’s history, Dr. Weil identified coffee, strenuous exercise, long hours spent at work in front of the computer and an inability to handle daily stress as the likely causes of his GERD.

Diagnosis:

  • Ditch the coffee
  • Supplement his diet with de-glycyrrhizinated licorice
  • Practice stress busting breathing techniques

A few weeks later, Dr. Weil weaned his patient off the drugs.

Problem solved.

And as Dr. Weil says, this is not brilliant doctoring. Any motivated medical student can learn how to interview a patient to get to the true root of a problem. He or she can also learn simple, safe, inexpensive treatment protocols like these.

This kind of medicine should be the new foundation of American health care. It is the key to cutting the out-of-control costs that are sinking the system.

How’s that for Healthcare Reform!

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America’s Celebrity Doctors Weigh In On Healthcare Reform

Apparently, a good portion of America has gone completely insane over healthcare reform.

  • We’ve heard from the politicians – Democrat & Republican.
  • We’ve heard from the pro gov’t healthcare crowd…[unitelligible screaming]
  • We’ve heard from the anti gov’t healthcare crowd…[unitelligible screaming]
  • And we’ve heard way too much from the teleprompter readers on tv – left & right & even more right

So, today, let’s take a look at what America’s favorite celebrity doctors have to say about healthcare reform in America.

First up, Oprah’s personal health guru:

Dr. Oz

dr ozPart of the challenge we face is that all eyes are focused on healthcare finance arguments in Washington, but the real action is taking place in our homes across this great land. We cannot have a wealthy country without being a healthy country, but healthcare finance solutions by themselves do not help us care for our health. An insurance card is correlated with, but does not guarantee a clean bill of health.

To control costs without rationing care, we need to improve the quality of the services we buy for our money. Economists and the few remaining car salesmen would agree that this translates to better value.

We have two principal options.

First, we need to eliminate the 20 percent of services offered that are wasteful or harmful.

Doctors need to act like professionals and police our own for doing unnecessary tests and procedures but we also need smart patients to insist on second opinions that will change their diagnosis or therapy in a third of all cases.  Many of you are bashful about pushing to see another doctor, but when you get doctors to speak with each other about your case, they teach each other and every subsequent patient that sees your doctor will benefit because you were brave enough to drive quality into the system.

The second major improvement requires revisiting the business model of medicine.

Professor Christensen of Harvard Business School taught me on a show recently that two primary models exist for any business (excluding networking businesses). “Solution shops” offer intuitive insights into unpredictable ailments, something doctors (and lawyers) are superb at addressing.

On the other hand, value-adding processes like building cars in an assembly line or managing correctly diagnosed diabetes with a specific plan for chronic management are far less expensive than solution shops and usually are more effective in offering reproducible results.

In America, we lump these fundamentally different approaches together so we get highly trained doctors using sophisticated approaches to manage tasks that could often be better accomplished by other well-trained health professionals who actually like double-checking that you took your medications and watched your diet.

We speak of prevention a lot these days, but what does prevention mean?

I moderated the last White House Town Hall on Health and came away from the experience understanding that America believes “prevention” is really about making the right thing easy to do.

This includes everything from making healthy locally grown vegetables easy to find, bike racks available in our work places and a healthcare system that provides a crutch to remind us that we forgot our colonoscopy.

We cannot look to Washington for these changes without engaging the battle ourselves.

original article

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Next up is America’s integrative health guru:

Dr. Andrew Weil

dr weilNot to be outdone by Dr. Oz, Dr. Weil has 2 articles in this weeks Huffington Post.

The first is a general discussion of healthcare reform…..

As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.

And, what’s true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the “public option” for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can’t afford coverage will finally get their fair share.

But what’s missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what’s even worse than its stratospheric cost is the fact that American health care doesn’t fulfill its prime directive — it does not help people become or stay healthy. It’s not a health care system at all; it’s a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.

It’s impossible to make our drug-intensive, technology-centric, and corrupt system affordable.I’m not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism’s innate capacity for self-regulation and healing. It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can’t, both our personal health and our economy are doomed.

Politicians aren’t going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.

Dr. Weil’s second article deals with a patient of his who:

  • was relatively healthy,
  • in his mid-30s,
  • and had been diagnosed by his GP as having gastroesophageal reflux disease — also known as GERD (aka heartburn)

His GP never took a dietary history, asked about his lifestyle or even explained the nature of GERD nor the long term effects of proton pump inhibitors.

Dr. Weil reviewed his diet and lifestyle and explained the nature of GERD and the factors that contribute to it (stress & certain foods).

Based upon the patient’s history, Dr. Weil identified coffee, strenuous exercise, long hours spent at work in front of the computer and an inability to handle daily stress as the likely causes of his GERD.

Diagnosis:

  • Ditch the coffee
  • Supplement his diet with de-glycyrrhizinated licorice
  • Practice stress busting breathing techniques

A few weeks later, Dr. Weil weaned his patient off the drugs.

Problem solved.

And as Dr. Weil says, this is not brilliant doctoring. Any motivated medical student can learn how to interview a patient to get to the true root of a problem. He or she can also learn simple, safe, inexpensive treatment protocols like these.

This kind of medicine should be the new foundation of American health care. It is the key to cutting the out-of-control costs that are sinking the system.

How’s that for Healthcare Reform!

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Healthcare: Canada v.s the U.S.A.

According to the  USA Today, President Obama has begun his health care push.

child medicineAnd you know what that means.

Like it or not, President Obama wants to give you a great big taste of Canadian style healthcare.

So, I thought that I would take a few minutes to let you know a little bit about my experience with the Canadian health care system.

  1. It is a massive (government) bureaucracy that eats up a lot of money and can frustrate the people who rely upon it.
  2. It’s full of hardworking doctors/nurses/technicians/etc who work long hours trying to keep sick people from dying
  3. It’s seems to work fairly effectively – according to the CIA, Canadian life expectancy is 81.23 yrs. (#8 in the world)

So, let’s compare that to the current American health care system.

  1. It is a massive (medical insurance) bureaucracy that eats up a lot of money and can frustrate the people who rely upon it.
  2. It’s full of hardworking doctors/nurses/technicians/etc who work long hours trying to keep sick people from dying
  3. It’s seems to work fairly effectively – according to the CIA, American life expectancy is 78.11 yrs. (#50 in the world)

Hmmm, seems pretty similar to me.

Except of course, the Canadian system is a public health care system. And everyone knows that a public system is essentially socialist, which is another word for communist, and dammit, no way is America going to have a communist health care system.

wow

I got a little excited there…sorry about that.

But seriously, other than this political/ideological argument, what are the differences between our two systems of health care?

1. Quantity of Life (longevity): We all want to live a long life. And without nitpicking, it looks like both countries are doing pretty good at increasing longevity.

Let’s call quantity of life a tie.

2.   Quality of Life: This one is a little trickier. Is there a difference between the general health & vitality of Canadians and Americans? According to all of the latest studies, both nations are growing more fat and less fit year after year. And as far as I can see, both of our health care systems are based on treating illness instead of  preventing illness.

fat couple exercise

So, once again, let’s call this a tie…both countries stink.

3.   Cost: In 2006, per-capita spending for health care in the U.S. was US$6,714; in Canada, US$3,678. (dollar amounts adjusted for purchasing power parity)

healthcare costs

Winner: Canada

And now for a personal story.

My wife blew out her back a few months ago…by sneezing.

I’m not kidding. Excrutiating pain, incapacitation, inability to work, sleep, sit, etc….

So, how did we deal with it?

Because of our personal experience with acute injuries such as my wife’s bad back, we knew that treatment needed to begin as soon as possible.We did not want this acute injury to become a chronic injury.

And that is the biggest problem with Canada’s public health care system. SPEED of SERVICE. Acute injuries become chronic injuries.

So, instead of going through the normal channels (go see the family doc, get an x-ray, wait for a consult, start public-pay physio, etc…), we began a series of physical therapy treatment – chiro, massage, acupuncture, laser and finally osteopathic. All on our dime. Yes, this is possible in socialist Canada.

We also made an appointment (the next day) with our publicly funded sports medicine doctor. Great guy, lots of experience working with professional athletes. And while my wife isn’t exactly an athlete, we like the fact that they focus on optimum health not just pain management.

At the sports medicine doc, my wife was assessed and given an x-ray at the first appointment.(public pay)

The x-ray showed nothing wrong…Yippee!!!

The next step was a requisition for an MRI. Here’s where it get’s interesting.

If we had followed the “normal” procedure, my wife would be getting her MRI in late November.

However, because my wife is in a lot of pain and is a pro-active kind of gal, she made a few phone calls, day after day and less than 2 weeks later, she had her MRI. (public pay)

Supposedly, this is impossible in the Canadian health care system. When I tell people that we got an MRI in 2 weeks, they don’t believe it. They have bought into the mind virus that Canadians are supposed to wait in line like a good little socialist patients and wait their turn.  Like sheep.

So, what’s the moral of the story?

The Canadian health care system isn’t perfect. But neither is the American system.

  • Wait times in Canada can be longer than in the U.S.
  • Medical expenses are the #1 cause of bankruptcies in the U.S. (Pre-Recession stats) That doesn’t happen in Canada.
  • Both systems ignore disease prevention
  • Both systems spend huge amounts of money trying to save very old, very sick patients
  • In a large part, the Canadian system is run by our government
  • In comparison, the American system is run by insurance companies

Pick your poison…I mean medicine.

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Health Care and the Obama Economic Stimulus Bill

presidentialcomics.com
Image: presidentialcomics.com

Americans elected Barack Obama as their president because of their hope that he can bring about real change in Washington.

And according to his blueprint for change, re-building the American health care system is going to be a large part of that change.

obama-healthcare

His plan for re-building the healthcare system has three main planks.

  • To make health insurance affordable and accessible to all:The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan.
  • To lower your health care costs:The Obama plan will lower health care costs by $2,500 for a typical family by investing in health information technology, prevention and care coordination.
  • To promote public health:Obama and Biden will require coverage of preventive services, including cancer screenings, and will increase state and local preparedness for terrorist attacks and natural disasters.

And, unlike previous administrations, it seems like some of these promises may actually be kept.

In the economic stimulus package making it’s way from bill to law, President Obama has earmarked billions and billions of dollars for:

  • State fiscal relief through Medicaid

In this part of the plan, states would receive a temporary (27 months) increase in Federal Medical Assistance Percentage (FMAP) funding. The estimated cost of this plan is $87 billion.

  • Help for working families hurt by the economic downturn

The stimulus bill would help workers and their families hurt by the economic downturn by providing the following:

  • A 65 percent premium subsidy for individuals who lost their jobs after September to help cover the cost of COBRA premiums. This provision is estimated to cost $25 billion over ten years.
  • A temporary extension of Transitional Medical Assistance (TMA) This provision is estimated to cost $1.3 billion over ten years.
  • A temporary extension of the Qualified Individual (QI) program. This provision is estimated to cost $562 million.
  • An elimination of cost-sharing (co-payments) for American Indians and Alaska Natives in Medicaid. The estimated cost of this provision is $25 million
  • Job-creation in the Health Information Technology (HIT) Industry

This part of the plan focuses on the nationwide conversion of all health care records from paper based filing systems to an electronic system. This provisions is estimated to cost $17.9 billion and is supposed to create about 200,000 new jobs.

Whew!

That’s a lot of stimulus.

By my estimate, the health care portion of the stimulus bill is $130 billion. Of course we need to keep in mind that these numbers are only estimates. Who knows what the final numbers will actually end up at.

But, it’s health care.

That’s a good place to spend money, right?

We all want to live long and healthy lives.

And, considering that the current generation of American children are expected to die at a younger age than their parents, maybe America should move towards a Canadian or European model of health care.

fat-kids

Or maybe, instead of spending 96% of it’s health care dollars on treatments and only 4% on disease prevention, America could shift some money towards making itself fit and healthy.

And if Jim Riesberg, chairman of the House Health and Human Services Committee, has his way, that may actually happen.

As the chairman of the House Health and Human Services Committee, I will spend much of my time this year focusing on health care needs and our health care delivery systems. One of the first places we must begin is to recognize the impact that chronic diseases have on health and health care in the United States.

Chronic diseases are the No. 1 cause of death and disability in the United States.

One hundred thirty-three million Americans, representing 45 percent of the total population, have at least one chronic disease and chronic diseases kill more than 1.7 million Americans per year and are responsible for 7 of 10 deaths in the United States.

Patients with chronic diseases account for 75 percent of the nation’s health care spending.

During 2005, the United States spent almost $2 trillion on health care, and of every dollar spent, 75 cents went toward treating patients with chronic disease. In public programs, treatment of patients with chronic diseases constitutes an even higher portion of spending: more than 96 cents in Medicare and 83 cents in Medicaid. Neither our nation nor our state can effectively address escalating health care costs without addressing the problem of chronic diseases.

Two-thirds of the increase in health care spending is due to increased prevalence of treated chronic disease.

From 1987-2000 that increase amounted to $211 billion among the non-institutionalized U.S. population.

The doubling of obesity between 1987 and today accounts for nearly 30 percent of the rise in health care spending.

The percent of children and youth who are overweight has tripled since 1980.

If the prevalence of obesity was the same today as 1987, health care spending in the United States would be 10 percent lower per person — about $200 billion less.

The vast majority of cases of chronic disease could be better prevented or managed.

Link to entire speechpdf version

In my next post, I will outline some of the disease prevention/health promotion strategies being tested around the world.

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Reference

chronic disease

Chronic Disease and a New Approach to Healthcare

The World Health Organization reports that “chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths“.

WHO data also shows that the major risk factors for chronic disease are:

  • an unhealthy diet,
  • physical inactivity,
  • and tobacco use.

The WHO also claims that if the major risk factors for chronic disease were eliminated, at least 80% of heart disease, stroke and type 2 diabetes would be prevented; and 40% of cancer would be prevented.

However, without action, 17 million people will die prematurely this year from a chronic disease. 17 million people dying from diseases caused by their own lifestyles.

Maybe that video was a tad over the top; but you get my point.

In a recent press release, the Ontario Health Quality Council reported that:

  • Ontario is failing to meet the chronic disease challenge: nearly 8,000 lives could be saved annually and the quality of life improved for many more by better managing chronic disease.
  • 1-in-3 Ontarians suffers from chronic disease. Eighty percent of Ontarians over 65 have at least one chronic disease and 70 percent of these have two or more.
  • Fewer than half (47%) of Ontarians with diabetes have their blood sugar under control and just 28% have their blood pressure under control.

This is coming from one of the richest provinces in a country with one of the world’s highest Health Adjusted Life Expectancies (HALE).

So what does the Ontario Health Quality Council suggest to combat chronic diseases?

  • Improve patient access to doctors
  • Improve patient access to medical tests/scans
  • Implement a province-wide electronic patient/doctor information system
  • Citizens should strive to live a healthy lifestyle

Groundbreaking ideas… More doctors, more money, more tests, more money, more technology, more money, and live a healthy lifestyle.

Not very original – spend taxpayer dollars and tell them what they already know to be true – smoking is bad for your health, being obese is bad for your health, stress is bad for your health, etc.

Is there a Solution?

Instead of spending more taxpayer dollars on doctors, MRIs and health promotion commercials (Like this ,this, this) , how about we offer taxpayers who live a ‘healthy’ lifestyle a reduction in income taxes?

Behavior modification through reward rather than punishment.

Now if only we could create a global lobby group to push this agenda to our respective governments.

treadmill desk office

Employers get the fitness bug

Ahhhhh… the wonders of the free market system.

I was reading todays newspaper when I came upon this article .

For those of you who don’t want to read the whole article, here is a 10 second synopsis:

  • Employee fat and out of shape
  • Employee less productive
  • Company lose money
  • Company pays for employee to get in shape
  • Employee more productive
  • Company make money

Now, depending on the size of the company and the value of the employee to that company, funding for employee fitness can vary between a small contribution towards a gym membership to a personalized fitness consulting package including nutrition, personal training, fitness equipment and psychological support.

But at the end of the day, these businesses are looking at the bottom line. Their employees are valuable to them because of what they can or can’t produce. If an investment in their employees health will help them turn a profit, you can bet they will make that investment.

My question is: Why don’t most people make that investment in themselves?

Any answers???

family playground workout-health-healthhabits-fitness-exercise-public health-

Promote Health Habits with Outdoor Exercise

Around the world, city planners are embracing outdoor exercise and installing fitness equipment in public parks. Realizing that an active and physically fit population is healthier, happier and probably more likely to reward their fitness-promoting politicians with votes, it just makes good sense to jump on the fitness bandwagon.

What a great idea!

Especially considering that over the next 50 years, the cost of obesity and related illnesses to the U.S. economy could be as much as US$650 billion – equivalent to about 5% of current annual U.S. GDP.

Q:  And how much of that $650 billion is going to be spent on the prevention of obesity?

A:  I would guess that the bulk of this money is going to be spent on trying to correct problems that may have been preventable in the first place….with outdoor exercise equipment, better access to healthy food and a ton of education and motivation (brain washing).

We already know that individuals from lower income populations have higher rates of obesity. And since those higher rates of obesity lead to higher rates of diabetes, heart disease & cancer, we can expect that the social cost of not promoting healthy living is going to end us costing ALL of us.

Maybe it makes better economic sense to provide access to free fitness equipment and even subsidize healthy food…if it ends up reducing the overall health burden related to obesity….and extending and improving the lives of millions of people.