We Are The Worst?

I fantasize escape. My heart and soul point West ..to California or Oregon. Or further, to Vancouver…oh how I fantasize about Vancouver. Do you know how hard it is to emigrate to Vancouver? Hard. Very hard. My kids would have to move and then I could come along, like luggage. The Canadians have decreed me too unproductive to let in the door. I’m old. How sad is that? Talk about a reminder of mortality.

I'm rooted here by family, who are essential to my quality of life, but still, it is hard to live here. If the Neanderthal Kansas political climate isn’t enough to chip away at my sanity, here comes new data on the state of our local health.

The Kansas City school district is officially the worst in the nation.

Men’s Health magazine placed Kansas City in the bottom 10 for men. I have sons. This matters.

And were I to seriously ponder escape to Portland (if I could stand the gloom), there is this lede from today’s New York Times: “Harder For Americans to Rise From Lower Rungs”. Not that I’m into “rising” any more, but I hate it when options are cut off, don’t you?

Of course those loonies who’ve been camping out in cities across the country, those outraged 99 percent-ers, have been trying to tell us this. Those un-American, disaffected, lazy class warriors need to just suck it up and get a job. Fox News says so. It must be true.

You may be one of the lucky upper 5%; for you, the protest is moot. You can access the best food, education, and health care. Your kids have the best shot at living well. You’re set. You can write off those other folks because I’m pretty sure you’d agree that they are irrelevant to your quality of life.

May I share a lesson from medicine? The human body can’t survive with only one well-functioning body system, even if it’s a biggie like the brain or heart. The body will hang on as long as possible, but eventually it’ll succumb to the burden of too much gone wrong. The body politic lives and dies by the same rules. In time, a society with only one thriving class will begin slipping toward demise as the prime ingredients of a healthy society vanish.

Americans face a choice: delusion or action. But to make a reasoned choice, we first have to recognize that we are not exceptional. We are not exempt from the natural cycle of a civilization’s rise and fall. If we face reality, we can reject delusion and embrace the actions essential to reclaiming our communal health. We can fend off societal decay. People who survived a health crisis have two choices: actively alter behavior or passively swallow a pill. Most choose the latter. The pill gulpers feel better for awhile even as the clock counts down to the day when medicine won’t overcome the burden of bad choices.

Which choice will we make? To renew our society tackling all the sacrifices that entails, or to search for a soothing elixir? Our clock is ticking. And I'm pretty sure Vancouver won’t take us.

Just Put Down Your Fork! Obesity and the Health Care Debate

I like Bill Maher. I do. He supports PETA. He encourages vegetarian diets. He's rich. OK, so the last one is no reason to like him, but it's important to this post.

Recently on "Real Time", he got into a rant with Arianna Huffington about the role of personal responsibility in fueling health care costs. I'm sympathetic to the argument. It goes something like this: Obesity is creating an alarming rise in health care costs. Where there is obesity, there is diabetes, heart disease, kidney disease among others. We can lower health care costs by lowering our forks, giving up junk food, and using some old-fashioned will power to control our eating. The underlying premise is that obesity is primarily the result of overeating. As a health care practitioner, I like the simple elegance of that solution. A lot.

But there's more here than meets the eye. Really.

We're flooded with obesity statistics every day, usually accompanied by photos of fat people with their eyes conveniently covered by black bars. Or we get only their backsides. But if you want to see how large we're all getting, you don't need the media to tell you. Stroll through your workplace, the mall, your local grocery store. Look around at your fellow movie-goers. We are surrounded by fat people. What's worse, we don't even know who is fat any more. May I direct you to Match.com? Check out people's descriptions of their body type. Pay special attention to those who self-identify as "about average" or a "few extra pounds". Now look at the pictures. Often they are substantially overweight ("average") or morbidly obese ("a few extra pounds"). Uhhh, I thought average meant that they were not fat, not "toned", not "thin" ...just kinda in the middle, you know? Average. Then again, recall your stroll through your familiar haunts. What do most people look like? Yup. Big. Bigger than they used to be. Obesity is the new "average".

I'm biased. A "weight-ist", if you will. You probably are too, but won't own up to it. I absorbed a distaste for overweight people from my mother who had strong opinions about such things. I'm in my 60s. I remember when significantly overweight people stuck out in a crowd. The Conventional Wisdom of the time was that "those people" had no self-control. They were the poster children for the Deadly Sin of Gluttony. We felt little guilt for deriding them.

More than 50 years later, the belief still sticks: you're fat because you can't control yourself. Like every belief, this one is partly true. I overeat. Sometimes, I'm compelled ...like many people, I can slip into "emotional/stress eating". But is the secret to conquering obesity just exercising more willpower? Getting a grip? Perhaps, for some of us. But I don't think an epidemic emerged from a sudden inability to put down our forks. Especially among the poor, minorities, and the middle class.

Which leads me to three broader food-related issues that undermine our health and cost us money: 1) the poor quality of our food supply, 2) the near absence of people's ability to cook from scratch, and 3) the unavailability in most families (especially elderly and one-person families) of someone who has the time and/or energy to make a fresh, healthy meal. If we can't address these three, complex systemic issues we won't get very far trying to impose incentives for "healthy behavior" or for providing more efficient care to large numbers of people who have chronic conditions.

"Food, Inc.", a documentary on how our food is raised, concocted and engineered, is currently playing in our area. Go see it. It presents a visually compelling link between our consumption of food-like substances and the cost and quality of our health. I came to tears watching a lower middle class working Hispanic family shop for food. Two bottles of soda were cheaper that a bunch of broccoli. They had two children to fill up and with the cost of the father's medications, not enough money to buy the food that would avert further deterioration. One young daughter was perilously close to a diabetes diagnosis. The mother knew what she should be eating, but she couldn't afford it. They all worked 16 hour days, with no time or energy left for cooking at the end of the day. Three out of four of them were overweight or obese. This is not their fault. They want to do the right thing. The system conspires against them.

If you think this is a problem of poverty alone, you're wrong. While obesity declines as income and education climb, it remains higher than we can afford. And all those lovely kitchens in McMansions, are for show, not daily use. Those families eat out. A large proportion of adults my age are on multiple medications for high blood pressure, high cholesterol and depression (which is linked to poor cardiac health). Most of these illnesses are partially fueled by the hidden, unhealthy ingredients in food, the things we didn't eat 50+ years ago because they didn't exist. As an example, this week a study was released that revealed that the average American woman eats 22 teaspoons of sugar a day, almost all of it "hidden". Her healthy limit should be, at most, 6 teaspoons -- half that if she is sedentary. Flavored fat-free yogurt, a common health and weight loss food, contains the entire sugar budget for the day. Yogurt, for crying out loud.

So as you ponder your position on the health care reform debate, perhaps you need to challenge your biases. That's hard. For me, for you, for Bill Maher, who unlike most of us can afford to play the food game by "New Rules". But think about that Hispanic family, your co-workers, maybe your own family members ...and how difficult it is for all of them to buy, prepare or eat a high quality diet. Think about the cost of our heralded cheap food. Face the dirty secret that the decline in food costs almost directly mirrors the increase in health care costs. Then ask yourself who's to blame. Not so simple, is it?

Going Green - A Path Out of Poverty

It's easy to see "going green" as an elitist initiative. If you are committed to reducing your carbon footprint you can probably afford CFLs, energy efficient appliances, organic food. If you're poor or a vulnerable middle class family a Prius is not in your future. Buying organic food? Seriously ...just buying food is a struggle. But what if 'going green' was a path out of poverty or into a more sustainable job?

A new initiative hopes to enlist the masses in our country's transition to sustainable living . Green for All has a simple but ambitious mission: to help build a green economy strong enough to lift people out of poverty. Here is how they describe themselves:

By advocating for a national commitment to job training, employment and entrepreneurial opportunities in the emerging green economy – especially for people from disadvantaged communities -- we fight both poverty and pollution at the same time. We are committed to securing one billion dollars by 2012 to create “green pathways out of poverty” for 250,000 people in the United States, by greatly expanding federal government and private sector commitments to “green-collar” jobs.

Green collar. What a great idea!

However, before we get all enthusiastic, let's think about this: Blue collar is dying in this country, and with it, the middle class. Will the same thing happen to those with Green collars?

Union membership is shrinking, in large part because since Ronald Regean the Republican-dominated government and courts, have allowed service and retail industries like Wal-Mart to punish workers who attempt to unionize. The Clinton administration unknowingly accelerated the process by supporting free trade and globalization. As manufacturing jobs evaporated, so did unions. How can a union effectively advocate and negotiate for its members if 1) there are too few members to shut down business and 2) if they DO successfully negotiate better contracts, the corporation counters by exporting jobs to countries with cheap labor, no unions, and no environmental or health protections. The game today is rigged to fuel shinking unions and shrinking jobs and a shrinking standard of living.

Bottom line: we won't revitalize jobs if those jobs can be exported or can be done by low-wage non-unionized illegal immigrants. Unions need to be involved in the development of green industries from the ground up. As we train people to rebuild our infrastructure and green-up housing, we also need to organize them into effective bargaining units or they will be just another loosely employed group with low wages and few benefits (like the roofing industry, for example). The Culinary Workers in Las Vegas and the SEIU are two unions that have made a difference, whose aggressive organizing efforts among low wage workers have catapulted those workers into a more secure middle class life. I may disagree with their politics, but I support their overall objectives, like globalizing unions so that world-wide action can be taken against global corporations.

I know, I know. The unions have their own corruption, their disproportionately well-paid bosses, and a sense of entitlement that must be reconsidered. But with all their flaws, they had a substantial role in bringing the good life to our parents, who in turn, provided one for us. Our standard of living owes a great deal to the union movement.

So, while we support efforts to create green jobs, let's also support the renaissance of the good old-fashioned union label!