Take a Hike
By Nicholas D. Kristof
New York Times, op-ed
January 31, 2006
First, a quiz: What “vegetable” do American infants and toddlers eat most?
Weep, for it’s the French fry. A major study conducted by Gerber found that up to one-third of young children don’t eat any vegetable daily, but that the French fry is the single most common one they do consume. And among children age 19 months to 24 months, 20 percent eat French fries at least once a day.
President Bush is slated to discuss health care in his State of the Union address tonight. It’s about time: it’s scandalous that babies born in the United States are less likely to survive their first year than babies born in Slovenia. But the solutions to the health crisis lie less in reorganizing medical treatment than in improving public health — such as steering kids away from French fries.
Think of two of the biggest breakthroughs in improving Americans’ health over the last generation or two. They had nothing to do with doctors, but arose from higher cigarette taxes and other efforts to discourage smoking, and from compulsory seatbelts and improvements in auto safety.
So what can we do? In my last column, I praised Gov. Mike Huckabee of Arkansas for leading a series of initiatives to confront obesity and lack of exercise. Health experts suggest a variety of others (a book by Tom Farley and Deborah Cohen published last year, “Prescription for a Healthy Nation,” offers excellent ideas). Building on them, here are my suggestions:
Ban soda, potato chips and other unhealthy snacks from American schools, and discourage them in the workplace. It’s unforgivable that our schools help to send children on the road to diabetes. Obesity kills far more Americans than heroin does.
Sell cigarettes only in pharmacies and raise cigarette taxes. Smoking still kills 440,000 Americans a year, including 50,000 nonsmokers. One study found that raising the federal excise tax on cigarettes by 75 cents a pack would generate $13.1 billion in additional revenue per year and cut youth smoking by 13 percent and adult smoking by 3 percent, saving 1.2 million lives. Let’s do it.
Tax junk foods. Some 19 states already impose taxes on particular junk foods, like soda, and a nickel-a-can tax on soft drinks would generate $7 billion in revenues. In particular, we should tax high-fructose corn syrup, which is used as a sweetener in a vast array of products and is a major culprit in the fattening of America.
Promote jogging and biking. Since we pay for all the consequences of inactivity (like those heart bypasses), we should encourage exercise. We should build more bicycle paths and turn more streets over to bikers, skaters and pedestrians — starting with Sixth Avenue in Manhattan.
Encourage exercise breaks. Governor Huckabee gives state employees a 30-minute daily “exercise break” that is modeled on the smoking breaks that smokers take. It’s a good idea.
Distribute fruits and veggies to certain low-income people, as Maine does in FarmShare, a potent antipoverty program.
Expand P.E. It’s ridiculous that schools have been cutting back on P.E. when students need more of it. Likewise, kids should be encouraged to walk to school. When my eldest son attended a Japanese elementary school in Tokyo, the school required him to walk or bike to school beginning in the first grade.
Design better stairways. The default system for getting from one floor to the next in America (but not the rest of the world) is the elevator. Let’s encourage stair use instead, by having new buildings constructed with open and appealing stairs that are actually meant to be used — while perhaps making elevators dark, dingy and out of the way.
I’m sure there are other creative approaches. I’ve thought of subsidies for running shoes, which make more sense than subsidies for corn. And since the average American child spends 24 hours a week sitting in front of a television, how about developing televisions for kids that are powered by Exercycles?
Look, personally I’m convinced that we need universal health care based on a single-payer system. But that is not politically feasible now, while a systematic assault on the causes of American ill health could make a big difference.
Granted, a War on Sloth isn’t as dramatic for the Bush administration as a War on Terrorism. And for Democrats, attacking junk food isn’t as attention-grabbing as denouncing corruption in Congress. But there is perhaps no area of public policy where it would be easier to save the lives of countless Americans than in promoting public health.