January 4, 2021
Activities: Disease / Medical Disciplines, Food / Agriculture / Nutrition, Health
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Image source: Unsplash
A lot has been said about personal choice and resulting health impacts. That your zip code is more likely to determine your health outcomes than your genetic code, is no longer rhetoric, but reality.
A study conducted by Harvard Medical School estimates the cost of poor decisions, especially diet, costing Americans over $50 billion per year.
Highlighting the study and the conversation previewed below are a few key points. Though personal decision and habit play a big part in eating healthy (or not), cost of healthful food can’t be ignored.
While insurers and governments may find incentivizing healthy eating in everyone’s best interest, a lot more work needs to be done bringing down the cost of healthy foods like fruits, vegetables, nuts, lean meats, and so on. It’s not merely bringing the cost down to an even basis with unhealthy options, but ideally even lower (incentivize supply!).
Read excerpts from a conversation with the researchers here:
I spoke with Dr. Thomas Gaziano of Harvard Medical School — senior author on the study by Tufts and Brigham and Women’s Hospital researchers in this week’s PLOS Medicine — about what the findings mean for people and policy.
It’s a lot — $50 billion — but I’m actually surprised it’s not more, because we tend to blame a lot of heart disease and diabetes on diet.
Actually, there are estimates that an unhealthy diet accounts for probably 40 to 45% of health care costs for chronic cardiovascular diseases. We have restricted this to 10 items where there’s the most robust data on the types of food, and we have done a meta-analysis to confirm the exact effects of reductions in stroke, heart attack, blood pressure, obesity.
There are also effects of diet on cancer and other diseases. This study is really restricted in terms of cardiovascular care. So yes, there are estimates that are much higher than the 20%.
So this was quite a conservative calculation. What were the elements that made the most difference?
On the positive side: fruits and vegetables, nuts, whole grains and seafoods that are rich in Omega-3 oils; on the negative side, processed meats and sugar-sweetened beverages.
How much of a difference would those make if we all ate optimally?
If you’re eating enough fruits and vegetables, the whole grains, the nuts, and the absence of the sugar-sweetened beverages would add up to about 75 or 80% of what we discussed.
What do you see as the biggest take-home messages from this?
At the policy level, there are immense potential levers that the government can introduce that would be revenue-neutral. We’ve looked at a SNAP program that would be able to incentivize the purchasing of healthier foods by up to 20 or 30%, matched with increasing the pricing or taxing of the unhealthy food items that we evaluated. That could remain revenue-neutral for people who are in the SNAP program.
We found the biggest gains for people who are older or poor. People receiving Medicare or Medicaid had almost double the gains of the average population. So programs that incentivize prescriptions through Medicare and Medicaid program are other alternatives for encouraging people to eat healthy foods and restrict the unhealthy choices.
So is this a trend that’s coming? Prescriptions for healthier food?
Providers are always talking about healthier diets. If I were able to give patients a prescription that was backed up by store discounts, through Medicare or Medicaid, that would be far more powerful because then they would have a significant incentive to carry out that prescription.
Our grandmothers say to eat better, our doctors say to eat better, and we try really hard, but there are obstacles. It’s not just taxing and subsidizing foods, but through the farm bill and other activities we need to make sure that these foods are available at the grocery stores, that we don’t have tariffs on foods coming from Mexico or other places so that healthy foods can be cheap and available.
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