What’s The Biggest Difference Between America Then and Now?
During my visit to New York in February, I had a very enjoyable dinner with two of my schoolmates from university days. One downside of living on the other side of the planet from your home town and alma mater is that you get fewer opportunities to relax with old friends and family, so you learn not to take such opportunities for granted.
My former college roommate is now a physician practicing in New York. He is also a lawyer and has a masters in public health administration. Over dinner, he asked me what is the single biggest difference that strikes me between the U.S. today and at the time when I moved to Hong Kong in the mid-1970s.
I responded that although there are a multitude of changes and differences, the most dramatic one is the increase in the incidence and degree of extreme obesity in American society. It is very noticeable each time I return, to a far greater extent than 20 or 30 years ago; and this observation is confirmed by public health statistics.
I’m not talking about moderately overweight people (a group I would include myself in), but the super jumbo sized folks you see in vast numbers in shopping malls and entertainment venues. A trip to Disneyland or any other amusement park is really shocking by virtue of the number of really, really super-sized people you see there.
According to the experts, someone who is 5 feet 9 inches tall and weighs between 169 to 202 pounds is considered overweight. Heavier than that would be considered obese.
Some people become obese due to chronic health issues, but for most it’s more a result of lifestyle. choices: diet and exercise, or lack of it. The foodservice and food processing industry doesn’t help by serving food portions in restaurants which are large enough for two people rather than one, and creating endless new variations of junk food high in calories and low in nutritional value.
This runs counter to the generally increased awareness of health risks and issues in America, as evidenced, for example, by the sharp drop in the number of cigarette smokers during the past twenty years. Most would argue that this healthier living trend is due to regulations prohibiting the advertising of cigarettes, and requiring explicit health warnings to be placed on cigarette packaging, not to mention sharply increased taxes which raised the cost of cigarettes to consumers (a pack in New York now costs about US$11).
Obesity does not occur evenly across all socio-economic strata in the U.S.; it is far more prevalent in middle to lower income groups. In terms of percentage of the population, it is most extreme in America’s southern states, but it’s serious in every one of the 50 states.
My doctor classmate said — as is well documented — there has been an enormous increase in the incidence of diabetes, heart attacks, strokes and other illnesses among Americans which are directly attributable to obesity. Obesity is considered the #2 preventable cause of death in America. The prevalence of obesity among American boys and girls has quadrupled over the past 25 years.
There are all kinds of reasons that widespread, avoidable obesity is neither a good nor healthy thing, not least of which the impact on a society’s health care costs and resources.
For many years the U.S. government took a relaxed approach which enabled the popularity of cigarette smoking. In films which depict the American way of life in the 1950s, men and women are smoking everywhere: at home, in the office, in restaurants, cars, trains, airplanes, etc. Cigarette advertising of that era depicts doctors in white medical gowns smoking, and even endorsing particular brands of cigarettes.
Finally the scientific evidence about the negative impact of smoking on health became overwhelming, eventually resulting in restrictive policies and higher taxes intended to curtail the habit. It seems to have worked. Critics may say that individuals have a right to smoke. That’s true, although it’s also true that in many parts of the U.S., the same can be said about the right to own a gun. In both cases, the devil is in the detail of what restrictions and guidelines should apply to those rights.
So, what of the future of obesity in America? Will it take extreme new laws aimed at more explicit labeling of fattening foods, curtailing food portions, raising taxes on junk food, or offering tax breaks for slim people? Or perhaps a new airline passenger ticket pricing policy based on the combined weight of the passenger and his or her luggage?
Or will increased consumer awareness eventually result in a change in lifestyle? I hope it’s the latter, for everyone’s sake.