Solving America’s Obesity Problem

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Revenue-neutral suggestions for solving America’s obesity epidemic. Lets start by looking at why we have this problem in the first place.  Our obesity is caused by a combination of social, cultural, and political factors.  I’m not a doctor, nutritionist, or sociologist – I’m an engineer.  I’m good at analyzing problems and coming up with solutions.

First thing we need is data –  we need to find a similar country that does not have an obesity problem and then examine the differences to see what our problem might be here in the USA.   I have seen a fair amount of the world over the last three decades and of all the countries I have visited, the most similar to the USA in terms of standard of living, educational level, and health consciousness is my homeland, the Netherlands.   Lets start by comparing the extent of the obesity problems in America and the Netherlands.

Netherlands America
Percentage of population obese 8.1% 23.9%

Similar countries, huge differences in the obesity problem. America has three times more obese people than the Netherlands. Lets look at why this might be the case by comparing some differences between the countries:

Netherlands America
Percentage of population obese 8.1% 23.9%
Amount of sugar in diet 13.5% 18%
% of GDP spent on McDonalds food  .043% .109%
liters/year/person soft drinks consumed  96.1  216.0
hours TV watched per week  20.0  28.0
Percent of trips taken by public transit 5.0% 2.0%
Percent of trips taken by bike 25.0% 1.0%
Percent of trips taken on foot 22.0% 9.0%
distance average person walks per year 377km 141km
distance average person bikes per year 848km 40km
Countries ranking of bike friendliness  #1  off bottom of chart

And we wring our hands wondering why America has an obesity problem?  Seems pretty clear to me from looking at this data!  Of these two similar countries, America is three times fatter than the Netherlands because:

  • we watch 40% more TV
  • we drink 200% more soft drinks
  • we eat 33% more sugar
  • we spend 2.5x more at McDonalds
  • we only walk 1/3 as much
  • we only bike 1/20th as much

Add that all up and you get an obesity problem!  In summary, America is fat because our nutrition is bad and we are sedentary.  Nothing earth shattering nor complicated.  OK, the problem is clear but now comes the hard part – how to solve the problems.  To solve the United States obesity problem requires that we attack both factors – we have to increase physical activity and we have to improve nutrition.  Funny, anybody got deja-vu?  On the top of my losing weight and getting 6-pack abs I say that losing weight is simple as 1-2-3, exercise a little bit more, eat a little bit less, and drink lots of water.

By this point a few of you who disagree with me are fuming.  You say that as an engineer I am not ‘qualified’ or capable of analyzing something this complex.  You say that teams of researchers with doctorates have not been able to come up with the solutions so how could a lowly engineer have anything valuable to say?  Let me tell you why, the solutions ARE simple but the problem is that they are very expensive and there are very powerful lobbyists who do not want changes.  Obesity is big business.  Fast food is big business.  Gastric bypass surgery is big business.  Soft drinks are big business.  Diabetes and heart disease drugs are big business.  All these groups contribute to PACs and make it clear to the politicians they support that the status quo is good for them.  A lean healthy population is not profitable!  The other huge problem we face in solving obesity is that America is incapable of long term thinking.  Like our corporations, our horizon only extends out three months to the end of the quarter.  We would gladly save one million dollars this month even if it costs us a billion dollars ten years from now.  Many politicians seem to only care about re-election and anything that happens after the election is somebody else’s problem.  So having got that out of the way, lets look at how I would solve our obesity problem if I was given a magic wand.

Eating Less

Education is key to improving the nations nutrition and helping them to consume fewer calories  I know our schools are cash strapped and many schools don’t even seem to have enough money to teach the kids reading, writing and arithmetic but we need to teach our kids about health and nutrition.  Thats the job of the parents you say?  Well its clear from our skyrocketing obesity rates that the current generation of parents know very little about health and nutrition so how can they possibly teach their kids?  Yes, parents *should* teach their kids about nutrition but since the government picks up the expensive health care tab when the parents fail, its in America’s financial interest to step in and teach the kids.  Kids should be able to read nutritional labels and analyze list of ingredients.  They should be taught about the value of high fiber unprocessed foods in reducing weight.  They should be taught about fats and simple carbs.  I would make the final exam 20 pictures of various foods and they would be required to estimate the calories in each to within 25% and write an essay explaining what they think are the three healthiest and three unhealthiest foods. Functional, practical nutritional knowledge.  Yes, these health classes would be very expensive but if you look at the long term health care savings and increased national productivity – its clearly an excellent financial decision.

We also need to stop the advertisement of unhealthy foods to our youth.  Just as alcohol and tobacco ads targeted to kids are prohibited, we need to prohibit the advertisement of candy, soft drinks, sugar-cereals, and snack foods to kids.  To make things simple, I would propose that no food or beverage products can be placed in children’s programming at all.      To jump start the nation’s nutritional educational process, I would propose an ad campaign similar to the “stop smoking” campaigns that have been so successful in reducing teen smoking.

Bikes As Transportation

Exercising More

Lets start with PE class and after school sports programs.  In most of America, after school sports programs have been cut from the budget long ago.  Many kids are left without safe venues to play sports.  Again, this investment would require making a small short term financial sacrifice for a very large long term gain.    Providing parks,   sports facilities, and staff to run after school sports programs is expensive but obesity is even more expensive.  Happy, busy, tired kids don’t get in as much trouble as bored kids either :)

I am a product of the United States public schools and I can tell you that the PE classes I had were horrible – truly horrible.  I obviously overcame this and found my love of sports but PE class was so bad that i was nearly scarred for life.  My PE teachers took roll call then went inside to read the paper.  Teachers of PE class need to have impressed upon them the seriousness of their responsibility to instill the joy of sports upon the students.  Students need to be taught the rules of the games, coached in skill drills, and taught strategy.  PE should be fun both for the jocks and the clumsy lanky kids like me.  Kids who are given a positive experience in PE class will be more likely to be active and exercise more outside of school.

We also have to start educating people in America that transportation does not automatically mean “car”.  This is a huge cultural shift that needs to take place as the United States is a country defined by the automobile.    Transportation can be walking, public transit, or biking.  This training has to start with our youth as I mentioned in last weeks article, Is walking to school healthy or dangerous?  My suggestion is for parents to lead their kids by example and escort them to school on bike rather than driving them to try and break this cycle of  car-dependence.  Driving our kids to school starts a lifelong pattern of automobile dependence.  As soon as the kids are old enough to get a learners permit, most kids end up driving to school – why not, their parents drove them to school every day when they were kids and thats just the way you get to school, in cars.  Then the kids graduate from college and get their first job.  How do they get to work?  The way they always have, in a car.  For the sake of the nations health, we have to educate the next generation that walking, biking, and public transit are valid and excellent forms of transportation.  But wait you say, its not safe.

So why don’t Americans walk and bike more?  Because America is hostile and dangerous for cyclists and pedestrians.   Solving this safety issue requires two things: we need better drivers and safer bike lanes.  As someone who has been bike commuting for decades I can tell you that the cellphone revolution has made streets even more dangerous.  Texting and talking drivers seem oblivious to their surroundings and wouldn’t even notice if they ran me over.  The fines for texting and phone-to-head talking need to be made so expensive that people will stop doing this – make it an even $1000 to get peoples attention.  We also need a federal law stating that automobiles must give way to pedestrians in a crosswalk similar to the California law.  There are many places in the country where crosswalks are just a waste of paint.  Again, I would make the fine serious – a round $1000 is a good number to impress upon people the seriousness of keeping our pedestrians and cyclists safe.  So that takes care of the drivers but it still doesn’t solve the problem because in most places in America there is no safe path to bike on.

The Netherlands is rated the most bike friendly country in the world, its no wonder they bike 20x more than we do! In America, our government seems to think “transportation = automobiles” and thinks that biking is a recreational activity that we shouldn’t subsidize.  Biking IS transportation!  In Germany and the Netherlands, bike paths are typically specially designed small roads paralleling the street that are completely isolated from automobile traffic.  In America if  bike lanes exist at all they are nothing more than the narrow, bumpy, glass shard ridden shoulders of roads with a bit of faded paint labeling it ‘bike lane’.  Its no wonder Americans only ride bikes 1/20th as much as the Dutch!

Now we obviously can’t fix this over night, I’m a practical kind of guy.  Retrofitting all our roads to be bike/pedestrian friendly would cost us even more than the Iraq War did and there is no way we can afford that. What we need is a new federal transportation act – “Scooby’s Transportation Act“.  A new federal law that states that anytime a new road is built or an existing road is widened it must provide at a minimum a 6′ wide bike lane (3′ wide each direction) that is separated from the road by a curb, low wall or crash rail.  In addition, an unobstructed 3′ wide walking path would need to be provided that is separate and distinct from the cycling path.  Fast bikes and pedestrians are just as incompatible as fast cars and bikes are – they need to be kept separate for safety.  Often this problem is solved by making half the path paved for the bikes and the other half bumpy cobblestones for the pedestrians.   “Scooby’s Transportation Act” would also require that every intersection have either a crosswalk and a “push to cross” button or a bike/pedestrian overpass/underpass.  You say we cant afford these bike lanes?  You say that bike lanes wont pay for themselves?  Infrastructure never pays for itself, its a cost of making a country productive.  Roads are necessary but they require huge subsidies,   the gas tax only pays a small fraction of the costs of our road infrastructure.  The bike lanes added by Scooby’s Transportation Act would slowly transition our sedentary automobile based culture to a more active one.  We would decrease congestion on our existing roads and people would exercise more and lose weight, win-win.

While I have my magic wand out, might as well improve public transit.  With a few exceptions of the larger cities like New York, Washington, and Chicago the public transportation system in America is an embarrassment.  People always use the argument that we can’t have good public transit like europe because we are so spread out.  I say thats an excuse.   If there are traffic jams everyday then that is sufficient proof that public transit is needed.  When people take public transit they end up walking more, they walk to and from the station on both ends.  Investing in public transit is investing in the nations health.

Summary of Proposals to Solve America’s Obesity Problem

  1. Require health and nutrition class in grade school and high school
  2. Prohibit advertisement of junk food to those under age of 18
  3. Nationwide campaign similar to the very successful “Stop Smoking” campaigns to provide health education
  4. Take PE classes seriously and teach kids to enjoy sports
  5. Provide after school sports programs to all youth
  6. Provide safe and viable alternatives to the automobile as transportation
    •  Invest heavily in public transit
    •  Require separated bike lanes and side walks on all new roads
    • Increase fines for texting and hand-to-head cellphone usage while driving
  7. Teach kids that bikes are transportation by escorting them to school on a bike rather than driving them.
  8. You could easily cost justify all the above expensive programs with the long term health care savings from reduced heart disease, diabetes, and other weight related diseases.   If you want to make this a revenue-neutral program from day 1 then simply add a national gas tax to bring our gas prices up to European levels.  That would provide more than enough money for all these programs and provide immediate incentive for people to reduce their auto-dependence.

 

I know many of you think I’m a liberal crackpot, dont worry, you are not alone as my own mother thinks that too :)  We are even though,  I think she is crazy for thinking that that market forces, good old capitalism, and spending more money on expensive drugs and gastric bypass surgeries will solve the nations obesity problems.  Mom and I will just have to agree to disagree.  OK, I’ll get off my soapbox now.  I’ve caused enough trouble for this month.  I am planning on doing a bike commuting safety video as part of 2012 bike to work day though.

 

References:

http://www.biomedcentral.com/1471-2458/8/200/figure/F1

http://policy.rutgers.edu/faculty/pucher/jpah08.pdfhttp://policy.rutgers.edu/faculty/pucher/ajphfromjacobsen.pdf

Top 10 Most Bicycle-Friendly Countries Outside the U.S.

World’s Most Bike Friendly Cities

http://www.nationmaster.com/graph/foo_sof_dri_con-food-soft-drink-consumption

http://www.nationmaster.com/graph/med_tel_vie-media-television-viewing

http://www.nationmaster.com/graph/foo_mcd_res_pergdp-food-mcdonalds-restaurants-per-gdp