The bitterness of US the election and the damage wrought by hurricane Sandy don’t have an obvious connection. But in the Guardian last week author and activist Naomi Klein argued that one thread linking them was the ability of large corporations to avoid paying for their mistakes.
It’s an analysis that also provides a useful way of looking at some of the health care problems facing us in the UK, such as who pays to research non drugs treatments and the widespread availability of foods guaranteed to pile on weight and push growing numbers in the direction of diabetes and cancer.
In response to the hurricane, Klein pointed up the injustice of a system that allowed large corporations to ignore the effect of their actions on global warming – quite possibly a factor in the power of the storm – and then to promote themselves as the ones to be paid repair the damage with private finance initiatives (PFI) and a suspension of laws governing working conditions and corporate taxes so as to get the job done as fast (and profitably) as possible.
I don’t think it is too fanciful to suggest something similar goes on with our diabetes and obesity epidemics. Food companies have pretty much a free hand in what they sell and advertise, despite reams of evidence of its contribution to what you could call internal global warming – the inflammation and rising markers for ill health that lead to a diagnosis of metabolic syndrome.
Fridges to cool the Arctic
The job of repairing the devastation, for which the food companies aren’t held to be liable, is turned over to the drug companies who have no expertise or interest in what caused the problem only in how to bring down some of those internal global warming markers. The global equivalent could be huge refrigeration plants for cooling down the Arctic It seems as hard to wean us off poor, high glycemic food as it is to give up coal fired power stations and tar sands.
Even when a drug is clearly linked with a deadly side effect, which the company knew about but kept quiet - the diabetes drug Avandia and heart attacks is one example, there is no enquiry or retribution either
Klein’s solution to the ability of companies to continue damaging the environment with impunity is to “vastly expand” the public sector and “regulate the hell” out of the companies. Rather than power being consolidated in the hands of the few, she calls for it to be dispersed among the many; economics would be “reinvented” so commercial success was no longer an “endless expansion of consumption.”
Some elements of that package are already familiar to UK health campaigners, although there has been little action. Cutting the availability of junk food and sweetened drinks and imposing taxes on damaging foods have been widely discussed. So has improved and independent regulation of drug companies to limit fudging and hiding of data. However it’s hard to see how either of these approaches are likely to get much political traction under the current government.
Rising drug consumption not the answer
The second part of her remedy – shifting power from the few to the many –isn’t so immediately familiar but ultimately more important for health. Promoting healthy living as a life skill is one of the 10 Secrets of Healthy Ageing. We believe you need to take responsibility for ageing well rather than just relying on drugs from the doctor and hoping for new drug company magic bullets. Not least because an “endless expansion” of drug consumption is certainly not going to solve the obesity/diabetes crisis since it is rooted in the way we live.
The death toll from infectious diseases was dramatically reduced in the first half of the last century by large-scale public health campaigns, only a similarly focused government involvement is going to have a real impact on our rising tide of chronic diseases.
Right now that looks pretty utopian. Not only is the government ideologically opposed to intervention but the medical professions habitual reliance on drugs for prevention means its attempts at lifestyle change is often ineffective or simply wrong. This hospital recommended diet for colon cancer patients is just one tiny example.
“Tinned macaroni cheese, spaghetti or spaghetti Bolognese, Instant potato mixes, frozen or ready meals that can be baked or microwaved, tinned or packet soups made with fortified milk and tinned fruit in syrup.”
Contrast that with this headline over a report of research done at the Dana Farber Cancer Institute and published this week: “Starchy, high carbohydrate diet associated with recurrence of colon cancer”.
Tailoring nutrition to genes
Not only does the latest report fly in the face of the outdated idea that a calorie is a calorie and best you can do is to get enough of them into a sick person, but it also is one of a growing number that suggest nutritional approaches can be tailored to individual variations and disorders.
An example is this straw in the wind – the finding, also published this week, that if you have a variant of the ApoE gene -ApoE4 that raises your risk of heart disease and Alzheimer’s – you’re likely to respond better to a diet low in carbohydrates than one low in fat. It was done at the Department of Food and Nutritional Sciences, University of Reading.
We are not about to hear the sound of marching nutritionists feet any time soon but the changes needed to create a more democratic health service rooted in prevention mirror the wider struggle to change an economic system that grants huge benefits to the few.