Skip to main content

Both/And: Personal & School & Social Responsibility for Health

Many people are promoting a false dichotomy for who/what to “blame” for decades of pervasive inactivity & unhealthy nutrition--the key preventable factors which have led to the majority of adults developing chronic disease.

Some believe that people with preventable chronic diseases made a series of unhealthy choices for decades, for which they need to accept personal responsibility for the consequences.

On the other side, a growing number of policymakers focus on the “social determinants of health.”  In other words, there are many things beyond your control, which impact what you eat & drink and how active you are.  This includes factors such as your family, neighborhood, school, employer, transportation, public safety, housing, community layout, etc. etc.  It’s those external social factors which determine your health destiny.  

Actually, the personal and social are inextricably connected--not opposite ends of the spectrum.  Let’s consider the role of schools.

Schools can help build up our personal agency--our ability to make our own individual decisions to improve our lives, even when other people are doing the opposite.  That has always been part of schools’ role--supplementing what parents are assumed to be doing.  This includes developing critical thinking and more broadly the ability to succeed in work, citizenship & life.  Increasingly, this needs to include building physical & social-emotional health “literacy” and healthy habits.  

With so many kids not developing healthier habits at home, as demonstrated by historically high prevalence of child & young adult chronic disease, schools are the only other realistic choice.  They alone are scalable & cost-effective enough, when the entire population is at-risk.  Indeed, schools are an indispensable place to develop agency systematically & sustainably for an entire society.  

Since so many parents & schools are not doing this, everyone’s health care bill is skyrocketing.  Families can’t pay for it, so healthier people and the government are picking up the tab.  Since the government won’t pay the full amount, it passes costs on to the next generation with deferred state spending (“pay now or pay later”) and federal debt.

Fortunately, in spite of decades of neglect, we have a both/and alternative future:  As healthier students join the workforce & electorate, have a family, and hopefully volunteer their time in the community, they can use their personal agency to responsibly help improve the social influences on our health & lives, too. 


Comments

Popular posts from this blog

Is it a “Miracle Drug”?...if it Costs a Fortune and Creates Lifelong Dependency...&...Saggy Faces!?

[It’s been a while since our last blog post.  A lot has happened since– including some “miracles” ! So we’re going to do two posts in a row…] Normally we should all be happy about miracle drugs... shouldn't we ? Yes, there is lots of upside from taking semaglutide (Ozempic, Wegovy), tirzepatide (Montjaro)--and upcoming new, even-more-miraculous drugs TBD:  losing huge amounts of weight quickly, a much lower risk of diabetes–and probably less heart disease and other chronic conditions as well.  But what if the “miracle” requires:   $200-300/week, with a lifetime cost of hundreds of thousands of dollars…  a drug that you can never quit…because if you stop taking it, you gain back all the weight it helped you lose–not to mention the chronic diseases which the drugs kept at bay… and it leaves your face (and the rest of your skin?) sagging …    (plus, it’s so new at such high dosages– who knows what happens after years of use…? ) No doubt, in spit...

Urban food myth #1: it costs more to eat healthy than to eat fast food

I get so tired of hearing this: "It costs less to buy a burger from McDonald's that to eat healthy food from the supermarket." "Low-income families just buy processed food, they don't cook their own food anymore." That always sounded questionable.  Here is a study showing in great detail that fast food is much more expensive than healthy food bought at the supermarket . Also, it turns out that the vast majority of meals eaten by low-income families are prepared at home: Blisard N, Stewart H. How low-income households allocate their food budget relative to the cost of the Thrifty Food Plan. Economic research report, United States. Washington, DC: Department of Agriculture, Economic Research Service, 2006;20. What is true is that buying healthy vs. unhealthy foods can cost $1.50/person/day more, at retail prices.  However, when health cost consequences are factored in, unhealthy foods cost twice as much .

Health "benefits"?: Oh well...

We meet them all the time:  people trapped in their job, in order to keep their health benefits.   We need a study on the negative impact on entrepreneurship and the economy from people health-handcuffed to their current jobs.  From my limited anecdoctal evidence, the costs are astronomical.   Two-income families have made the labor market much more geographically immobile, and now health insurance is exacerbating the job-jail. Modern Healthcare just summarized results of a new Peterson-Kaiser study  on employer health insurance and the actual cost to employee families, of the combination of employee share of premiums plus employee out-of-pocket health costs. Employers keep shifting more and more health costs to employees. The only good news is that employers are still paying a (fast-shrinking) % of premiums--so health costs are still cheaper than being self-employed.  [Also, if we end up back in the uncovered pre-existing conditions bad-...