Killing ourselves with softness

Carolyn Moynihan
29 April 2011
Reproduced with Permission

On Wednesday this week, while the global village was consuming the last of its chocolate Easter eggs, a World Health Organisation forum on "the challenge of non-communicable diseases" opened in Moscow. The explosion of chronic diseases such as diabetes, heart disease and cancer -- in many cases diet-related -- is "an impending disaster", the UN body announced. "I mean a disaster for health, for society, and most of all for national economies," said WHO Director-General Margaret Chan in her opening address.

It must be at least a couple of decades since we started talking about "diseases of affluence", but that term is now obsolete. The chronic health problems of the most developed countries have spread to the developing world, outpacing communicable diseases such as malaria and AIDS in every region except Africa (and even Africa will catch up by 2020). Chronic diseases, many of which are preventable, accounted for 63 per cent of the 57 million deaths worldwide in 2008. Of those 36 million deaths, 80 per cent occurred in low or middle income countries.

As we know from the mammoth healthcare debate that the United States has been engaged in, even the wealthiest economies are groaning under the growing burden of disease. Average health spending in the OECD countries was 9 per cent in 2008, but the US figure was 16 per cent, or $7,538 per person. It will be more now. Factors driving this trend in the richer countries include technological change, people's expectations and population ageing. But unhealthy lifestyles are the biggest drivers of them all, and, sadly, we have exported this problem to the poor -- without the technology to palliate it on the whole.

The worst of it is that we know perfectly well what we are doing wrong: eating too much; drinking too much; eating and drinking the wrong things; consuming more calories than we can use through daily activities; smoking; watching television instead of exercising…

Is there anyone -- any adult -- in the world who is able to buy a packet of cigarettes, or a box of Kentucky fried chicken, or another bottle of vodka (remember, the WHO summit is taking place in Moscow, the world capital of deadly drinking), anyone who is able to turn on a TV set, who does not know that consuming that product to excess will damage their health? Young children might have an excuse for drinking too much soda pop and vegetating in front of the small screen (negligent parents) but, by adolescence, even third world youngsters are likely to have heard their first healthy diet messages from the authorities.

Even without public health campaigns the use of reason, the feeling that one's body has become a burden to carry around, or just looking in the mirror, should alert us to the need for restraint and moderation. The trouble is that those concepts confront us with the awful truth that we are not only physically unfit but also, and even more, psychologically unfit to look after our own health.

How many people under the age of 60 have heard of the virtue of temperance? How many have been brought up to exercise it? Of the billion or so people of any age who attend church or synagogue or mosque regularly how many even hear a homily on the subject?

On the other hand, how many in the younger generations have been reared and educated in the school of instant gratification, where a bit of nagging gets you all the TV time and all the bottles of pop you want, and where even the most dangerous and degrading forms of self-indulgence are condoned by the ethic of harm limitation. When adolescents are taught that it is fine to follow their sexual impulses so long as they use a condom, why should they say no to any other impulse? Why should they not stuff themselves with fast-foods, get drunk and smoke whatever is to hand? So that is what they do.

Since authorities at the highest level are implicated in the culture of self-indulgence, it is no wonder that WHO boss Dr Chan did not address it in her pep talk this week. Instead she lambasted "corporations that are big, rich and powerful, driven by commercial interests, and far less friendly to health" than public service entities. "Forget collaboration with the tobacco industry," she adds pointedly. "Never trust this industry on any count, in any deal." Well, some of us feel like that about the sex education industry.

What we need, says Dr Chan, is laws to control those demon industries, plus corner stores in slums that sell fresh produce and not junk food, urban design that encourages walking and cycling, safe playing areas, affordable essential medicines…

Certainly we need all those things. But we also need something more basic -- a philosophy of life and not just a philosophy of health. It is no accident that an irresponsible attitude to the body has grown as recognition of its Creator has declined. Even many apparently religious people don't seem to know that the fifth Commandment (Remember? Thou shalt not kill…) obliges us to respect and care for our bodies -- because we do not simply "own" them like a piece of property but receive them as part of the gift of life for which we must finally give an account.

That sort of talk offends many today, but it is difficult to see how the substitutes for religious duty can achieve the desired outcomes: walking/cycling past the fast-food outlets and eating our fresh vegetables and pulses at home. The "right to choose" doctrine tells us that our bodies are indeed private property over which we have sole jurisdiction, even to the point of disposing of another life in the womb. (Don't tell me what I can eat or not eat, whether I can smoke or not!) Evolutionary biology and psychology have sown the idea that we are merely the product of our genes and environment. (It's not my fault!)

What's left to do? Engineer genes and the environment to the point where we could not but make the healthy choice? But would not every government in the world be bankrupt before this brave new world was achieved?

Dr Chan says that the rise of chronic diseases "calls for some serious thinking about what the world really means by progress." She is right. I have done some thinking and here is my idea. Progress would be when the World Health Organisation recognises that not only food and tobacco corporations need to be controlled, but that individuals need to be controlled, by themselves; when the WHO tells governments to support families and institutions that teach their members self-control -- out of respect for their own bodies and the body politic.