How can we improve public health?

Dr. David L. Katz, MD, MPH
Preventive Medicine
Here’s what I would do if I were the philosopher-king of public health:
  • I would eradicate tobacco use. Those currently addicted to tobacco would need authorization from a physician to get it and would at the same time receive every assistance modern science can offer to help them quit. But the substance, and any marketing of it, would be banned for all others. No young person should ever again be seduced into this toxic boondoggle.
  • I would make everyone a nutrition expert by putting an objective, evidence-based, at-a-glance measure of overall nutritional quality on display everywhere people and food come together, and thus close every loophole to marketing distortions. Then, I would attach to this metric a system of financial incentives so that the more nutritious the food, the less it costs. The incentives would not constitute a new cost, but rather an opportunity for savings. They would be paid by the entities that currently pay the costs of disease care -- insurance companies, large employers, and the federal government. 
  • I would make physical activity a readily accessible and routine part of everyone’s day. This can be done in schools with programming that embraces the time-honored adage: sound mind, sound body. This can be done in a way that honors personal preference for different kinds of exercise. Every school would have such programming. So would every worksite. And every church. This would cost money in the short term, but save both money and lives over time.
  • Robust economic modeling would be conducted to guide biomedical research so that it translated most efficiently into measureable and meaningful improvements in the human condition. We would prioritize the practices subtended by the best data, not propagated by the loudest shouting or dictated by the deepest pocket.
  • Every clinician would be trained to be expert in lifestyle counseling and serve as an effective agent of health-promoting behavior change.
  • We would shift subsidies, and marketing, from foods with the longest shelf lives to foods that extend the shelf lives of the people eating them! We would pursue our health in conjunction with efforts to preserve the health of the planet. We would do what it takes to find ourselves eating food, not too much, mostly plants.
  • We would do this, and more, until the 80% of all chronic disease we know we can eliminate were eliminated. Until forces that conspire against years of live, and life in years, were banished.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.