Happy Martin Luther King Day, Nation! In the spirit of speaking up for what you believe in and speaking out on injustice, I have a little rant to share today:
My town of New York City really likes to get involved in the health of its citizens. From banning smoking in nearly all public places (most recently in public parks) to requiring restaurant chains with more than seven locations to display calorie counts, it seems like every time I turn on the news, NYC is enacting, banning or monitoring something.
The Department of Health (DOH) has done quite a bit in terms of diabetes, too, including launching an A1c Registry to keep tabs on how the PWDs in the city are doing with their glucose management. The program launched in 2006, though I'm not sure how helpful it's actually been. I know at least one fellow NYC blogger, Scott Strumello, is none too happy about all the Big Brother activity on things the DOH doesn't really have a right or need to monitor.
For the most part, I haven't minded the new rules and awareness campaigns. But when I spotted this new public service announcement (PSA) from the DOH linking sugary sodas to diabetes amputations, I'll admit, it pushed me a little too far... Take a look:
And the NYC DOH isn't the only one receiving criticism for their no-holds-barred ads on the obesity epidemic. Earlier this month, Children's Healthcare of Atlanta started circulating these PSAs on childhood obesity, all part of the new campaign, Strong4Life, launched because Georgia has the second highest rate of childhood obesity in the country.
Ouch! I was once an overweight little girl and right now, she's crying a little inside... I think these PSAs are targeted toward their parents, but still. Children can read, folks. They know what you're saying about them and you're not helping. Why do you think diets are on the rise in young girls? Journalist Kellee Terrell, in an article on the Georgia campaign, writes, "These ads don't really empower or promote healthier lifestyles, just more guilt."
Yes, and we need less guilt and more empowerment.
Honestly, I think you would be hard-pressed to find an overweight person who doesn't realize why they might be overweight. That's the easy part. The hard part is doing something about it. There are financial restraints many low-income families would have to overcome. There are safety issues that many of these families contend with, such as living in a neighborhood where it's unsafe to exercise, like the Projects in NYC. There are budget shortages that have eliminated many health programs critical to families. Healthy food and athletics are expensive, and often not readily available.
Not only that, but science is showing bit by bit just how difficult it is to lose weight for people who do not have these resources. It is far easier to prevent being overweight than to lose weight, but once someone is overweight — whether they have a diagnosis of type 2 diabetes, pre-diabetes, or no diagnosis at all — it's incredibly challenging to simply reverse the course.
So fat-shaming anyone, adults or children, isn't helpful. Because there are thousands of people who have recently made the commitment to lose weight and who may find it very difficult to see any results, even if they do nothing but shop at Whole Foods and go the gym regularly.
Now, obviously I'm not a proponent of excessive consumption of fast food, sodas and junk food that has clearly caused an increase in obesity in America. Exercise and healthier food help in more ways than just weight control. That much is obvious. What I do have a problem with is using scare tactics — or in the case of the DOH's 2009 campaign, gross scare tactics — to achieve this goal. I also have a problem with the huge jump to conclusions between drinking sodas, type 2 diabetes and amputations.
Dr. Thomas Farley, NYC's health commissioner, argues, "We are warning people about the risks of super-size portions so they can make more informed choices about what they eat. Consuming too many calories can lead to weight gain, which greatly increases the risk of type 2 diabetes. If New Yorkers cut their portions, they can cut their risk of these health problems."
That's like going from A to N in the alphabet and then jumping directly to W. There is a lot more to type 2 diabetes than just drinking too many sodas, and the DOH's oversimplification of the situation does nothing but perpetuate myths and misconceptions about how people get diabetes, and how it can affect a person living with the disease. How might someone feel if they had just been diagnosed with type 2 diabetes and were now seeing these patient-blaming ads warning that amputations are in their future? It's likely to make anyone feel depressed, hopeless and defeated. That doesn't sound terribly healthy to me! How does this empower people?
Now, I'm not saying that there aren't kernels of truth in these ads. Obesity is clearly on the rise and fast food clearly isn't healthy for anybody. But given the complexities surrounding diabetes and living a healthy lifestyle, I think it's almost a cop-out to just circulate some advertisements for a few weeks saying, "Don't do this! It'll kill you!" Does the DOH actually think that's going to save lives? Preventing diabetes is more complicated than just saying "Don't drink sodas" or "Take the stairs" (or "Just say no"). Couldn't this money be used toward programs aimed at more beneficial, long-lasting results?
In an article in the Atlanta Journal-Constitution, Karen Hilyard, a health communication researcher at the University of Georgia, says, "We know from communication research that when we highlight a health risk but fail to provide actionable steps people can take to prevent it, the response is often either denial or some other dysfunctional behavior."
I'm left wondering what the NYC DOH and Children's Health of Atlanta are hoping to accomplish and what kind of metrics they're using to judge how successful they are. This isn't the first time the NYC DOH has used these scare tactics, so what measure of success convinced them to do it again? I suppose they think if they say "Being fat is bad" enough times, there will be less fat people. Right?! I don't get it either.
When will we see these organizations stop with the lip-service and actually provide tangible resources so we can see real improvement in the health of our country? And more importantly: what will that look like?
Just some "food" for thought...