Wednesday, May 4, 2011

Our Taxes - Are They Making Us Sick?


When it comes to spending money, you're making a conscious decision on whether or not the goods and services you're purchasing are worth your hard earned dollars.  You want to feel like you've made a smart decision that contains some sort of value.

I'm sure you would find this same concept true when it comes to your overall health.  In essence, you want to make good decisions and investments which help you feel better, live longer, and avoid the chronic diseases that plague most of our society.  And the most important investment you can make, when it comes to determining how healthy you are, is in the form of the foods that you purchase and consume on a regular basis.  So how are the prices of various foods determined?

You may or may not realize that this is largely determined by how our tax dollars are spent with respect to the different subsidies paid to the food and agriculture industries.  Common sense would tell us that we would want our government to subsidize the foods that increase and promote overall health the most.  However, in reality the exact opposite is true.  In fact, the rise in obesity and decline in public health is directly correlated to the increasing availability of low-nutrient, inexpensive food that is high in fat, sugar, and refined grains [1].  On the contrary, foods found to have the highest amount of nutrients per calorie (fruits and vegetables) cost much more per calorie than their lower nutrient counterparts [2] even though they play a vital role in promoting health and wellness.

So how exactly does this all fit together?  And what does the breakdown look like when it comes to our tax dollars being divvied up to their respective recipients in the food and ag industries?  Let's find out as we take a deeper look into these very issues.


Eating Our Way Into A Healthcare Crisis

We are now living in a time of unprecedented human suffering and disease.  Two-thirds of all Americans are currently overweight with just over a third of Americans categorized as obese [3].  If that wasn't enough, we've also seen a new and frightening trend being reported in our nation's youngest population as a third of all children in the U.S. are now considered overweight with 1 in 5 classified as obese [4].

All of this extra weight has led to an alarming increase in cardiovascular disease, cancer, and diabetes just to name a few of the chronic diseases associated with obesity [5].  While some people would like to blame the rise in obesity on the lack of physical activity alone, recent data looking at the rise in obesity over the past 3 decades has shown that it is primarily due to our increased food intake [6].  In other words, we have literally eaten our way into the current healthcare crisis.

To gain a better understanding of just how significant our food choices are on our current and future state of health let's take a look at some eye opening numbers:

-  According to the CDC, cardiovascular disease and cancer are the #1 and #2 leading causes of death
   accounting for half of all deaths in the U.S. in 2008 [7].
-  There are 25.8 million people diagnosed with diabetes in the U.S. and another 79 million estimated to
   have prediabetes.  For those who have diabetes 84% of them are on oral medications and/or insulin to
   help control it.  The risk of death for those who have diabetes is twice that of those in a similar age
   group who do not have diabetes [8].
-  Total cost of diabetes (both direct and indirect costs) equaled $174 billion dollars in 2007 with $116
   billion coming in the form of direct medical costs [8].
-  Diabetes is associated with a number of complications including heart disease, strokes, nerve pain,
   blindness, infections, kidney disease, high blood pressure, dental diseases, and limb amputations [8].
-  In 2010, the American Heart Association reported that the total cost (both direct and indirect costs) of
   cardiovascular disease and stroke was an estimated $503.2 billion dollars [9] making it the costly
   disease group of any other diagnostic group.
-  The American Cancer Society reported in 2010 that the estimated overall cost of cancer was $263.8
   billion with $102.8 billion coming in the form of direct medical costs [10].

The costs and prevalence of these diseases is almost incomprehensible when you think about it.  There's not a day that goes by when we as individuals or our nation as a whole isn't affected by this phenomena.  The rapid rise in health care costs are leading to higher premiums, deductibles, and co-pays for everyone while we continue to see our health deteriorate at an alarming rate.  You may recall a few years ago a report being released by The American Journal of Medicine on bankruptcy in the United States.  In this report, it was found that illness or medical bills contributed to 62.1% of all bankruptcies in 2007 [11].  The degree of enormity of these overall costs are crippling us individually and collectively as a whole and our current path is simply unsustainable.

Food Choices And Disease Correlation

The chances of being diagnosed with one or more of the chronic diseases now commonly seen in western cultures is heavily determined by the foods that you eat.  The western diet, consisting mostly of processed foods, meat, dairy, and eggs, plays a huge factor in the current disease epidemic seen in today's modern society.  What is being left out of our diet is just as important though.  There is a huge shortfall of health promoting, plant-based foods in western diets.  This often comes in the form of fresh fruits and vegetables along with whole grains and legumes.

The United States Department of Agriculture (USDA) has been keeping records of America's food consumption since 1909 [12].  From 1909 to 2007 there has been a marked increase in the following categories:

-  Meat intake went from 123.9 lbs to 200.6 lbs per year
-  Cheese consumption increased 8 fold from 3.8 lbs to 31.4 lbs per year
-  Use of oils more than doubled from 35.4 lbs to 86.7 lbs per year
-  Use of sweetners increased from 119 lbs to 136.4 lbs per year
-  Frozen dairy consumption went from 1.5 lbs to 25.3 lbs per year

Cardiovascular disease has been directly linked to the consumption of animal-based foods (including all meat, dairy, and eggs) and oil consumption [13].  The complete reversal of this disease has been documented in a 12 year study conducted by Dr. Caldwell Esselstyn in those following a low-fat, plant-based diet [14].

Cancer and the role of one's diet is also closely correlated with one another in the scientific literature.  It's estimated that 30-40% of all cancers could be prevented by nutritional means alone in Western cultures [15].  An increase in breast, prostate, colon, pancreatic, lung, endometrial, bladder, and renal cell cancers have all been seen with consumption of animal-based foods [16-22].  However, plant-based foods including fruits, vegetables, and legumes have all been shown to decrease a number of different cancers [15,16,23-26].

Diabetes has been directly linked to a rise in obesity and a person's dietary habits.  A 2009 study looked at 5 different types of diets as they related to body mass index (BMI) and the prevalence of type 2 diabetes [27].  The five diets included nonvegetarian, semi-vegetarian, pesco-vegetarian (consume fish, dairy, and eggs but no red meat or poultry), lacto-ovo vegetarian (consume dairy and eggs but no meat of any kind), and vegan (no meat, dairy, or eggs of any kind).  Only those who were in the vegan group were able to achieve of a body mass index below 25 kg/m² which is considered healthy.  The prevalence of type 2 diabetes was as follows - 7.6% for nonvegetarians, 6.1% for semi-vegetarians, 4.8% for pesco-vegetarians, 3.2% for lacto-ovo vegetarians, and 2.9% for vegans.

Where Your Tax Dollars Go - The Breakdown of Food Subsidies

Food subsidies play a major role in determining which foods are grown and in what quantities on farms all throughout the country.  Farmers are going to grow whatever generates the highest amount of income for them.  I'm sure you would do the same if you were in their position.  Since the output of American farms is determined largely by what crops are subsidized it goes without saying that subsidies invariably dictate what ends up on millions of people's dinner table at the end of the day.

Unfortunately, our tax dollars end up subsidizing crops that lead to the increasing availability of cheap foods that end up causing disease instead of promoting health.  These foods include meat and dairy products along with refined grains, fats, and sugary sweeteners.  Furthermore, the foods that actually promote health (nutrient dense, plant-based foods) get little to no subsidy support from the federal government.

During the 15 year span from 1995 to 2009 the USDA gave out a total of $246.7 billion in subsidies [28].  The top 10% of farm program recipients received 74% of the total subsidies handed out.  This means that smaller, independent farmers trying to make a living on their own were basically left to fend for themselves while large corporate operations made out very handsomely.

In addition, 70% of these subsidies supported the production of commodity crops.  The five most heavily subsidized commodity crops were corn, wheat, soybeans, cotton, and rice.  The vast majority of these commodity crops were used for animal feed instead of being consumed directly by humans.  The Institute for Agriculture and Trade Policy reported in 2006 that 60% of all corn and 47% of all soy produced in the U.S. was used as feed for domestic livestock production [29].

Dairy products have a couple of different subsidy programs set up to ensure their continued use and profitability.  The Milk Income Loss Contract (MILC) program protects dairy producers by providing direct payments to them when the average price of milk drops below a minimum level [30].  Another program called the Dairy Product Price Support Program allows the USDA to set a minimum price for nonfat dry milk, butter, and cheese.  Under this program the USDA will buy any excess dairy products from producers and store these excess products in warehouses until the products are sold or donated [31].  Both of these programs help to protect dairy producers from losing money while encouraging excess production of dairy products.

Livestock producers benefit from their own array of subsidy programs.  These programs provide marketing support along with emergency funds and price supports.  They include the Livestock Compensation Program, Emergency Livestock Feed Assistance Program, and the Livestock Emergency Assistance Program [28].  In addition to these programs, the Environmental Quality Incentives Program helps livestock producers reduce their production costs by providing funding to clean up pollution and reduce soil erosion caused by their operations in the first place [32].

And finally we've made it to fresh fruits and vegetables.  These wonderful, health promoting foods are considered "speciality crops" by the USDA.  And speciality crops get no direct subsidies.  The USDA has made it abundantly clear that fruits and vegetables are considered the red headed stepchild when it comes to the business of food and agriculture in this country.  In fact, the only form of subsidy support for speciality crops comes in the form of subsidized crop insurance which help compensate producers for losses due to weather or natural disasters [33].  What's even worse is that the government forbids farmers who participate in commodity subsidy programs from growing fruits and vegetables on their land.  Jack Hedin, a local midwestern vegetable farmer, learned this the hard way as he tried to grow watermelons, tomatoes, and vegetables on 25 acres of land he leased from two nearby corn farms.  You can read his story here - My Forbidden Fruits (And Vegetables).

To put all this in perspective take a look at the pie chart below summarizing where your tax dollars end up when it comes to food subsidies.



One of the most disturbing details about all of this is that the government entity responsible for shelling out all those tax dollars in the form of food subsidies is also the same entity responsible for setting the dietary guidelines for all Americans.  This entity would be the USDA.  Ever heard of the food pyramid? This pyramid, which has heavily favored the meat, dairy, and grain industry for many years, provides the foundation of what is supposed to constitute a healthy diet by which all health care providers and consumers live by on a daily basis.

The USDA's 2010 Dietary Guidelines for Americans sets an acceptable upper limit of 35% of the total percentage of calories to be derived from fat in the diet [34].  Another 35% of total calories can be derived from protein in the diet.  Following these same guidelines you can order the following for lunch from McDonald's - Premium Grilled Chicken Ranch BLT Sandwich, large order of fries, large Coke, and a hot fudge sundae for dessert.  This meal contains a total of 1610 calories of which 26.1% of the calories come from fat and 12.4% of the calories come from protein both of which are well below the levels set by the USDA.  Does this sound like a well balanced and healthy diet to you?

Perhaps we should give the responsibility for developing the U.S. dietary guidelines and food subsidy programs to an entity more in touch with the current state of disease and sickness going on in America.  Say an organization like the Centers for Disease Control and Prevention?  After all, the CDC's mission is "to collaborate to create the expertise, information, and tools that people and communities need to protect their health - through health promotion, prevention of disease, injury and disability, and preparedness for new health threats."  Seems to be a good fit don't you think?  And it's certainly a far cry from the USDA's mission to "provide leadership on food, agriculture, natural resources, and related issues based on sound public policy, the best available science, and efficient management."  Or how about the USDA's vision statement "to be recognized as a dynamic organization that is able to efficiently provide the integrated program delivery needed to lead a rapidly evolving food and agriculture system."  I don't see the word "health" included at all in either the USDA's mission or vision statement.

Conclusion

As you can see, the overall health and well being of each one of us individually and our nation as a whole depend largely on the foods that we eat.  And the foods that we eat are typically determined by the food subsidy programs that our tax dollars pay for.  We seem to be spending a lot of money subsidizing foods that produce devastating health consequences, increased medical costs, and a lower overall quality of life and not nearly enough on fresh, health promoting plant-based foods.  Our current path in regards to these matters is unsustainable.  Instead, we as a nation need to change the way we think, change the way we eat, and change the way we do business in order to ensure the prosperity and health of all for many years to come.

You can make a difference in these efforts by taking just a few of the following steps:

-  Write your elected officials and express the importance of revamping food subsidy programs.  You can
   also write to these same officials and request healthier options for kids in school lunch programs.
-  Shop at local farmer's markets or produce stands to support local farmers.
-  Eat a plant-based diet to improve your own health while decreasing the demand for currently
   subsidized, disease promoting foods (meat, dairy, eggs, refined grains, fats, and sugars).
-  Plant your own garden and enjoy the benefits of fresh fruits and vegetables from your own back yard.

America is a great place to live and work and with your efforts we can take back control of our nation's health and improve our financial viability.  I've said it before and I'll say it again... vote with your forks, knives, and spoons.  The impact that this has goes far beyond the benefits that you'll see individually.  May you and your family experience health, happiness, and live life to the fullest!







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by Dustin Rudolph, PharmD
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