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How bad can America’s health actually get? And what shall we do?
All kinds of ill health are steadily increasing, from age-adjusted obesity to autism and depression. Anxiety in young adults nearly doubled in the decade pre-pandemic. Type 1 and type 2 diabetes has risen dramatically. Deaths of despair have also risen. There seems to be no actionable plan, ready for implementation, to halt the rising tide of ill health. The numbers are steadily increasing adjusted for age, with some numbers rising faster in the young than in the old.
I find the willpower discussions to be missing the point. Unless there is a plan that we can implement in schools to significantly increase or teach willpower, then it hardly matters whether the will is relevant. The diseased from poor choices and the diseased from poor environment equally hurt the security of the nation, costing trillions from decreased productivity, decreased fertility, and healthcare expenditure. It is curious how much discourse in America is spent quibbling on issues that are so much less important than the health question. Health is something that directly impacts every aspect of the country, not the least of which is the plain happiness and fertility of citizens.
What I would like to see is a harm tax put in place that adds onto every unhealthy item the cost per item of its societal harm: the projected healthcare costs, the loss from intelligent citizens working for corporations that poison us, the projected loss of productivity. Now, this will always be an estimate, but so are many taxes. I think this would largely make sodas prohibitively expensive.
This is regressive and will just make it so the lives of the poor are even worse. The amount of money some poor people spend on smoking and alcohol, most of it going to taxes, is likely enough to buy a house.
Further, most vices aren't increasing healthcare costs. Smoking doesn't. Most people will get cancer in their lifetime. Smokers will usually get it around the age of 65. In a few years they croak. We save on their future nursing home costs, their social security, etc. Similar with the obese. They are unlikely to make it much past 65. Old age is the most expensive period for healthcare.
Honestly, smoking should be encouraged, maybe even subsidized. It barely impacts productivity during one's work life, and it kills when people are more likely to retire and start hoovering up resources.
I'm cynical. I believe the plan is to get people so fucked that they need the government, and specifically a nanny-state, far-left, socialist government. It seems to me that activists push to make problems worse, so they can claim they are the solution. Find a thing you want to eliminate (single family homes, meat, cars), attribute everything bad in the world to it (climate change, cancer, inequality, racism, etc), and then work make those things worse (endless bureaucracy and permitting, dysfunctional layouts, taxes) so that eliminating it looks like a viable option. When it's gone, you apply all the bad things to a new target you want to eliminate.
Having a grand plan is antithetical to this.
I find this kind of a bizarre position to hold, because several of the alleged (and, in my opinion, quite possibly real) downsides of all of the 3 things you mention are the exact thing you claim are trying to be achieved.
Car-dependent sprawl and single-family-only zoning means nobody walks or bikes, which causes obesity. It also makes children less independent and capable, both physically and emotionally/psychologically. If someone is trying to make you more dependent on the government and less capable of being independent, then getting you away from a sprawling suburb is mostly counterproductive. Meat is more debatable, but meat with a high fat content is probably not great for you and at the very least we could use fewer agricultural subsidies. Moreover, getting completely rid of cars and single family homes is a weakman of most urbanists; to the extent that anyone is trying to achieve that, they're about as close as conservatives are to taking over academia. Right now, the overwhelming majority of bureaucracy, permitting, and taxes is applied to everything except single family homes and car infrastructure.
I've found single-family zones to be much more active. It only seems like dense areas are more active because of the higher population. But people feel less and less safe in high density urban environments.
I wouldn't ever consider someone who grew up in a city to be more independent or capable. My experience has been the opposite; people in cities are highly dependent on others, and far less capable. They have to rely on others, because they have less experience having to depend on themselves. They only feel independent because of systems that the government has built. I'm sure some people feel independent hopping on the subway to go get groceries. But those living with yards can be independent by growing their own food. Hell, I've noticed that most city folks don't seem to understand how to do this. Cities aren't even great places to grow gardens, since the fluoridated water absolutely ruins the yield. So you have to use a rainwater system, which needs a bit more space. Composting in dense cities? Nope. Can you keep a bunch of random crap to reuse at some point in your life? Doubt it. It all goes in the trash.
Dense cities suck. You're more dependent on the government. You only feel independent because you don't know your neighbours. And that's another major downside of cities. In a zombie apocalypse, I know my neighbour isn't going to rob me blind, they are going to help me build the barricades.
I can't speak to your experience, but I think the available evidence says that people are generally more active in walkable places. e.g. https://cs.stanford.edu/people/jure/pubs/activity-inequality-nature17.pdf
See also this video more generally.
Being near other people makes things safer. Think about an empty parking lot compared to a town square full of people. Which is safer? Urban environments only feel unsafe to walk in when everyone except the poor and homeless are in cars.
Again, I can't speak to your experience; perhaps we're using different definitions of "independent." In my experience, there are a lot of these people, who now live in the city as a young adult, but grew up in suburbs.
Being able to walk to school is one of the best things for children's independence and growth; see e.g. https://www.sciencedirect.com/science/article/abs/pii/S0272494402902434 or https://www.utoronto.ca/news/why-walking-school-better-driving-your-kids. And as one would expect, walking to school is correlated with living near school and low car traffic.
Ok, but what portion of them actually do this? It seems like you're using notions of independence that most people don't actually experience or engage in, regardless of whether they theoretically could or not. I grew up in the suburbs and I doubt anyone in my neighborhood could grow more food than a handful of tomato plants. Not one of them would survive a zombie apocalypse; to the extent they had extra space for storing things, it went to holding the kid's car, or a lawn mower, or useless old crap, not canned food and jugs of water (and I'm not sure anyone other than our family had ever even fired a gun).
The notion of independence I'm thinking of is making people capable of making their own decisions, evaluating and dealing with risks, handling disagreement, controlling their emotions, etc. But mostly in the context of every day life; I think a lack of independence in this sense is largely at the root of recent spikes in childhood depression and anxiety, in anti-free-speech behavior, in refusal to engage with the outgroup, etc. Being driven everywhere until you're 16 and not being allowed out on your own prevent children from developing these skills.
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This is such a silly thing to say in the modern day - everyone is dependent on government. In fact, the very existence of single-family neighbourhoods is dependent on government regulation and the banning of other types of housing.
As if you don't. Who maintains the suburban roads without which you wouldn't be able to get anywhere?
Growing vegetables in your garden is a hobby. A very pleasant one to be sure, but not a means of subsistence.
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