Category Archives: Public Health

Health Justice: Sugar-free, Please!

Recent moves by leaders in New York City and Richmond, California, to address damage caused by the dominance of sugar-laden beverages represent brave steps toward addressing mounting health injustice and should be applauded by everyone who supports good health in America.  

On May 30, New York Mayor, Michael Bloomberg proposed to ban sodas and other sugary drinks in containers 16 ounces or larger.  Municipal leaders in Richmond, Calif., also announced a November ballot initiative for a one-cent-per-ounce tax on sugar-sweetened beverages. Both measures aim to stem the growing incidence of obesity, diabetes and other ills linked, in part, to the flood of sugar poured by an industry, some are now calling Big Soda.

As in the case of Big Tobacco, proposals to improve the public’s health with awareness campaigns, bans or taxes have prompted the same old defense strategies among soft-drink-industry giants. They typically respond by offering one or more of the following:

  1. The Corporate Freedom Argument – Let market forces meet the public’s needs.
  2. The More Research Is Needed Argument – Where’s the evidence of negative health effects?
  3. The Affront To Personal Freedom Argument – Get the nanny-state out of the public’s way.
  4. The Class Warfare Argument – The poor are overburdened by such interventions.

While these arguments may hold some sway–with government trust at historic lows and faux science in vogue–they are invalid at best and at worst, represent willfully deceptive diversions.

Regarding business leadership on health, in the faces of growing pressure to contribute to the anti-obesity movement, the fast food industry has mostly made self-protective gestures. For example, while McDonald’s now offers a variety of salads and added apples to their Happy Meals and oatmeal for breakfast, their core menu remains high in fat and calories. The movie concession vendors push their version of value with soda sizes ranging from a “small” 16 ounce to “upgrades” all the way to 44 ounces (with 550 calories or more). And 7-Eleven’s 1.5 liter Double Gulp fountain drink (a repackaged version of the Extreme Gulp) holds up to 800 calories.

In terms of the research, the link between high soda consumption and negative health effects is overwhelming. And there’s a growing body of evidence that show price policies and attention to portion size can and do reduce consumption of sugary sodas and other beverages, which can play an important role in reducing rates of obesity and related conditions like diabetes.12345

Finally, I find the argument that encouraging the public (including the poor) to substitute soda for healthier choices is a discriminatory burden, to be the most troubling. Richmond, Calif., City Councilor, Courtland Boozé, a vocal opponent of the soda tax, is quoted as saying, “We are primarily an economically suppressed community. It will be a huge hardship.” I wonder if he’s considered the health burden levied on the youth of the Richmond community.

According Dr. Wendel Brunner, the local director of public health, 52 percent of the region’s elementary school students are overweight or obese. That’s an individual and community hardship that no one can afford.

According to Margo Wootan, Director of Nutrition Policy at the Center for Science in the Public Interest, “… sugary soft drinks are the number one source of calories in our diets. We get more calories from sodas and sugary drinks than any other individual food – cake, cookies, pizza, anything.”

My rebuttal to all these arguments against promoting less sugary drinks is that it’s time for a bigger helping of health justice. We need to create an environment where living healthy is the default choice. If asked, “Would you and your family like to live in a community where it’s easy to find good food that’s good for you at a good price?” Most of us would say, “Of course!” We all deserve equal access to the ingredients that help us live a good long life.

The proposed policies in New York City and Richmond, Calif., won’t fix the obesity problem on their own. But, they are bold steps in the right directions. Now that we’re focused on the value and cost of health and health care, it’s time to serve up some real health justice.

“Come On Out Fat Albert!”

Fat Albert & the Cosby Kids was the first black animated cartoon (1972-1985)

I was a fat kid. Big boneded, my mother used to say. For the most part, being fat at 12 wasn’t really a big deal for me. Don’t get me wrong, I knew I was big and was reminded of it often. Going to the “Husky” section of Sear with my Nana to buy corduroys was mortifying. Even worse, was hearing my friend say, “Hey! Hey! Hey! Here comes Craig!” when they heard the “weeeka, weeeka, weeeka” sound of my corduroyed thighs coming toward them. Still, I was a happy kid living in the ‘hood with good friends and a loving family. And, I secretly loved the Fat Albert comparison.

Fat Albert was my favorite cartoon. For those of you born after the era of four TV channels and Saturday morning cartoons, Fat Albert and the Cosby Kids was a popular cartoon in the early 70’s and 80’s. The show was sparked by a classic Bill Cosby comedy bit about a neighborhood game called, Buck Buck (something like Red Rover) that featured a giant neighbor kid – Fat Albert – who was so big he could literally squash any apposing Buck Buck team. Fat Albert always announced himself with a hearty, “Hey! Hey! Hey!” He made fat cool. He was the rare big boy who could do it all – play sports, sing, make you laugh, and he always saved the day. If cartoon characters could be heros, Fat Albert was mine. Probably because I saw him in my mirror. I couldn’t touch my other favorites: Batman, The Flash, Spiderman, The Green Hornet. But, Fat Albert was a hero nearer to my world. He didn’t have much, but he was popular and happy; everybody’s go-to-guy, AND he was larger than most lives (i.e. real fat!).

Those were the good ol’ days. Back then in Fat Albert’s world (and mine) fat was not a concern. The word “fat” didn’t have the social weight it carries today. I don’t remember Fat Albert’s fatness ever being mentioned on the show – his health was never an issue. If he suffered from the friction rash that plagued my thighs, he didn’t complain. And he certainly showed no signs of asthma, diabetes, or heart disease. The dude didn’t even sweat (Is that a superpower?)!  In the 70’s and 80’s weight was not the public health issue it is now. Husky departments were pretty small and hard to find. In truth, I was never as big as Fat Albert and as a kid I never saw a person his size. The word “obese” was rarely known or used.

But the world changed and so did I. The teasing “Hey! Hey! Hey’s!” were no longer funny and I was less comfortable in the skin I was in. So, to make a long story short, I began walking and then I began running and eating better and I lost so much weight between the ninth and tenth grades that many didn’t recognize me. My discovery of exercise lead to an interest in nutrition and a growing need to understand how my body works and how I could help it work better. My hunger for health knowledge launched my academic and professional careers and my commitment to health care and health promotion.

In 1985 Fat Albert was canceled, I became a nurse and things looked different. In retrospect, there were warning signs of things to come. I saw a growing number of patients with a constellation of preventable conditions including hypertension, heart disease, respiratory issues and diabetes. What’s more, patients were also growing in size. The overweight became the obese and then the morbidly obese. Obesity begot diabetes, limb amputations, strokes and sleep apnea, and on and on. Patients we saw once, we saw again and again. The once obscure word “obesity” was slowing becaming an epidemic. Fast forward to now, typing this post through a public health lens, I can’t help but wish I and others knew then what we know now. That the rising incidence of adult (and later childhood) diseases would be so connected to our societal, environmental and personal choices; and that it all would be so preventable, so persistent and so costly. I’m not sure the overweight kid I was in the 60’s and 70’s could have the same unobstructed health success in today’s environment. At the same time, even though Fat Albert and the simpler world of my childhood are gone, I am hopeful. That’s because many, my age and younger, from diverse backgrounds and disciplines, see these health challenges clearer than ever before. We’re bringing unprecedented levels of creativity and passion to the root causes and outcomes of obesity … and we’re making a difference. Interestingly enough, we need Fat Albert’s judgeless optimistic spirit now more than ever. I like to think he’s with me and the growing gangs of health promoters aimed at the challenges ahead. Maybe he’s still here. Can you see him? Can you hear him? … “Buck buck number six come in!” … “Come on out Fat Albert!” … “Hey! Hey! Hey!”

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