Ezra Klein talks to Ezekiel Emanuel, health care policy advisor to the Office of Management and Budget, in a recent Washington Post article. Emanuel doesn’t address the impact of corporate food marketing on our eating habits, but he offers excellent perspective on the disconnect between the health care debate and food, as well as cultural obstacles to encouraging better food choices.
The Obama administration is raising awareness about healthy eating through the high profile White House Garden and new local food campaigns such as Know Your Farmer. It’s a good start, but, as Emanuel notes, “lifestyle issues are hard for the government to address.”
Along these lines, Adam Corner proposes that psychology is the missing link in the climate change debate: …while the consensus may be growing on the need for changes in behaviour, we’re no closer to understanding how we’re going to do it. Attempting an unprecedented shift in human behaviour without the input of psychologists is like setting sail for a faraway land without the aid of nautical maps.
Excerpts from What’s Missing in the Marketplace:
Our political system is a lot more comfortable talking about health care than about health. We’ll pay enormous amounts of money to treat diabetics, but we don’t do much to change people’s diets to prevent diabetes. That’s a strange use of resources: Focusing on health-care coverage without doing more to address the factors, such as diet, that determine our health is a bit like buying fire insurance while ignoring the fact that you have a gas stove and a large fireplace in a wood cabin. A dry wood cabin.
…”My own view,” says Emanuel, “is we know there are large parts of health that are primarily best approached as a public-health issue and not as a doctor-patient issue. Nutrition, wellness, exercise and smoking, for instance. But lifestyle change is hard to accomplish. What smoking showed is it’s not a single thing. It changed from being socially acceptable and doctors would recommend it in the ’50s to being scorned and barred indoors.”
The smoking case is an interesting one. Emanuel brings it up repeatedly as one of the few examples where public-health advocates managed to change the culture around a previously unexamined act, which is exactly what they’re going to have to do with diet. “On smoking, there are a combination of things that had to happen,” he says. “We had to make smoking socially unacceptable. We took it outside the building. We raised taxes on it. It became linked to cancer.” But as he admits, “you can’t take eating outside the building.” Nor can you demonize it entirely. Certain products can be attacked, but in a world of organic Oreos and Splenda with added fiber, it won’t just be an uphill climb. It’ll be a climb with constantly changing footholds.
Moreover, as Emanuel says, lifestyle issues are hard for the government to address. They’re personal, for one thing. Whether it likes it or not, the government is fiscally invested in the way we eat because it pays for the consequences of a bad diet. But few feel comfortable with the government’s involving itself in the choices that lead to that bad diet.
…So where does that leave us? “You have to change the whole culture around this stuff,” Emanuel sighs. “That’s a complicated thing. It’s even more complicated than how to change the health-care system, if you can believe it.”
Klein piece via ethanagri4 on the Comfood listserve
Corner piece via the foodtimes
