US Government Not Promoting Healthy Living Says Cancer Panel

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Main Category: Public Health
Also Included In: Nutrition / Diet;  Cancer / Oncology
Article Date: 17 Aug 2007 - 3:00 PDT

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The US government should be doing more to promote healthy living says a new report from the President's Cancer Panel (PCP) out this week.

Cancer kills more than half a million Americans every year, and nearly three times that number are diagnosed annually with the disease.

Two thirds of cancer deaths and thosands of new cases could be avoided by changing the lifestyle of Americans: tobacco use and passive smoking account for nearly one third, and unhealthy diets account for another third of all cancer deaths in America today says the PCP.

The President's Cancer Panel (PCP) has three members: Lance Armstrong, cancer survivor and campaigner and cycling champion, Dr Margaret L. Kripke, chief academic officer at the MD Anderson Cancer Center in Houston, Texas, and Dr LaSalle D. Leffall Jr, professor of surgery at Howard University in Washington, who chairs the panel.

The PCP was set up in 1971 and meets four times a year to review progress across the nation in the fight to eradicate cancer.

Previous reports from the PCP have looked at one particular theme on cancer, this time the panel has taken a deep look at the "macroenvironment" of people's daily lives and the opportunity that government has to make changes that would have a significant impact on the nation's cancer burden.

The report says that most federal funding for cancer research is for projects targeted at genetic and biological intervention, looking for ways to interrupt the progress of the disease at the cellular level. However, while acknowledging the importance of this work and saying that it should be supported, the report criticizes the fact that:

"It ignores the macroenvironment and the physical, social, and cultural contexts within which food choices, opportunities for physical activity, and tobacco use and smoke exposure occur."

Also, the benefits of the currently sponsored research will not be felt by the population at large for decades, while the opportunity to effect social, behavioural and environmental change through policy intervention is here and now. This would make a considerable impact, sooner, in reducing the nation's burden of lung and many other cancers, says the report, especially by focusing more on preventing disease as well as treating it.

As an example of how the health system is geared more toward treatment than prevention, the report points out that doctors are trained to treat illness and not prevent it. The health care system is a sick care system and not a well care system. Doctors don't spend enough time with patients helping them to make changes in their lifestyle that would stop them having to visit the doctor so frequently, they only have time to treat the symptoms, resulting in a vicious cycle. The system needs to change to place more emphasis on prevention.

The medical insurance system suffers from a similar malaise, says the report. While it covers treatment for acute conditions, other services that offer interventions that promote "wellness or prevent disease, such as counseling, education, outreach, and behavioral or psychosocial interventions" are not covered.

The PCP acknowledges and praises the efforts of many government and employer schemes to promote a culture of wellness, but says this is not reaching many millions of Americans who are "living in neighborhoods in which it is unsafe to exercise outdoors and where fresh food access is limited", or who are in part time jobs with no insurance cover, and have fewer opportunities such as access to computers to take advantage of the many IT tools now available, and in many cases their English is poor and the services are not designed for them.

Nearly two thirds of Americans are overweight, half of whom are obese. By 2010, this figure is set to be three quarters of the population overweight and one half obese. Obesity is the second leading cause of premature death in the US, tobacco is the first, says the report.

Research shows that overall cancer death rates are 50 per cent higher among obese men compared to normal weight men, and more than 60 per cent higher among obese women.

In a way these statistics are not surprising, because government policies at all levels have helped to create an environment that makes it hard for Americans to make the right choices, be it in food (healthy food is expensive), exercise (physical education in schools is at an all time low), and as already discussed, the health care system.

Poor and ineffective policies, together with insufficient regulation in the marketing of unhealthy foods and beverages have "spawned a culture that struggles to make healthy choices" says the report.

Targetting obesity and tobacco are the two main action points the report makes. It suggests a number of opportunities to make changes that would promote a culture of wellness. For instance, changing the way that food is marketed to children, where currently too much junk food is promoted and not enough healthy foods. Another avenue of opportunity is school meals, where breakfasts and lunches are not geared toward healthy eating.

Another area where government intervention could make a big difference is to coordinate public health policy with agricultural policy. An example of how this is not currently working to promote healthy living is the heavy subsidizing of food such as corn and soy that are then processed into high fructose corn syrup, hydrogenated corn and soybean oils, and other foods known to contribute to obesity and related chronic diseases such as cancer. Where are the subsidies for the healthy food products?

An opportunity to "strongly increase support for fruit and vegetable farmers, improve the national food supply, and enhance the health of participants in the national school lunch, food stamp, and Women, Infant, and Children food assistance programs" is about to present itself to the government in the form of the upcoming reauthorization of the Farm Bill (the Farm Security and Rural Investment Act of 2002).

The report makes a number of other recommendations, including one that may be at odds with President Bush's own views: to increase the tax on tobacco.

One of the panel members is reported to have said in a telephone interview with Reuters news agency that perhaps America does not have the political will to protect the health of its citizens.

In delivering the report, the panel has urged the President to use the power of his office to empower Americans to make healthy choices and seize this moral obligation to protect the health of the nation.

Click here to read the full PCP report (PDF reader required).

Written by: Catharine Paddock
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