September 21, 2019

BW photograph of a food stand at a fair as seen through a chain link fence.

Copyright 2019 Kevin P. Mick Photography. All rights reserved.

If you have been following the Democratic presidential candidate debates, then you know that health care is one of the major issues being addressed by those running.  Some want the Affordable Care Act (or ACA-often referred to as “Obamacare”) to be tweaked, others want what is referred to as “Medicare for All”.  There are some positions that are a hybrid of those two.  Republicans, for the most part, have been trying to eliminate the ACA since its inception, even though it was modeled on a plan implemented by Mitt Romney.

Yes, the administration and delivery of health care can do with a re-make.  There are plenty of issues with affordability, accessibility, and accountability-the very issues for which the ACA was devised.  I, for one, am pretty satisfied with the plan provided by my employer-it is purchased with payroll deductions and various co-pays.  When I have needed care, it has been provided.  When I have needed to contact them, I have found customer service to be responsive and thorough.

This coin, however, must be flipped over.  By that I mean, one must also look to the precursors of poor health and thus the need for healthcare coverage-one of which is the preponderance of unhealthy diets in the U.S.  (Stress would be another.  One overlap being that when one is stressed, “stress eating” can be one coping mechanism.  Such eating provides short-term relief in exchange for what may well be long-term health consequences.)  When considering high blood pressure, heart disease, diabetes, certain cancers, and obesity, just to name many of the more significant and common health problems, diet often plays a part in their creation, progression, and treatment.  Some of the presidential candidates have discussed this side of the problem.

The connection between diet and health can readily be seen when examining the proliferation of food deserts-PBS presented this report, which draws attention to the impact on health that occurs in the absence of a nutritious diet. While the report is a bit dated, the fundamental point is not.  Food insecurity is yet another side of the issue.  Senator Warren, true to form, has proposed a plan to address this…for college students.  At the other end of the political spectrum, the current administration has proposed cutting SNAP benefits.

As an important aside, it is worth looking at the income amount that factors into the eligibility for public assistance-please take a look at this link.  These are the numbers that would allow for one person, or a family constellation, to be considered living in poverty and thus eligible for SNAP and other federal programs.  For example, if you were a single person earning $15,000 per year, you would be ineligible for such assistance.  You would be making too much money.  Given the cost of housing, energy, and transportation, such a figure allows little room for food, let alone a healthy diet-hence the issue of food insecurity.  When you factor in the socioeconomic determinants that create food deserts, then eating well becomes quite impossible.  Diets full of Salt Sugar Fat, ingredients in heavily processed foods and the title of Michael Moss’ 2013 book on the subject, take consumers down the path of what can be catastrophic health consequences.

Of course, one does not need to be living in a food desert or concerned with food insecurity to eat in an unhealthy manner.  All that is required to truly understand that is to take a walk through a Giant or Mars or Safeway or other local grocery store.  Spend time going up and down the inner aisles, that is, those furthest from the produce sections, and randomly pull canned and boxed and bagged items from the shelves and read the ingredients.  Check the refrigerated/freezer sections and notice the amount of sodium and other chemicals in processed meats.  Pull a few cups of yogurt and check the amount of added sugar.  Be sure to also check the “serving size”.  For example, bottled juices often contain up to two servings-therefore, if the entire bottle is consumed, the contents and calories must be multiplied by the servings per container.  Interestingly, many bagged products, potato chips for example, are labeled with the total calories if the entire bag is eaten.  This is important information.

Healthcare delivery in the U.S. must be discussed as there are many, many issues with the current system.  However, placing an emphasis on preventative care, diet, in this case, would seem to be at least as important.

Take care.

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