Tax return errors. Environmental-movement backlash. “Irresolvable conflicts.”
President Obama’s first 100 days saw more than their share of mini-scandals, and these are just the ones surrounding his cabinet nominees. But the one recent nominee that should have come under greater fire is New York City Health Commissioner Dr. Thomas Frieden, who will begin his new job this week as director of the Centers for Disease Control and Prevention (CDC).
As the architect of New York City’s smoking ban, cooking-oil crackdown, menu labeling mandate, and 5-year plan to reduce salt consumption, Frieden has clearly earned his nickname as the city’s “health czar” (a moniker he doesn’t seem to mind).
But the trouble with the czar’s new gig goes beyond Frieden’s record of culinary party pooping. The controversial new CDC director is assuming his post at a watershed moment for U.S. public health policy.
Since modern medicine freed us from killers like typhoid and smallpox, addressing lifestyle choices has been rising to the top of America’s health agenda. At the CDC, those gears were set in motion long ago. (Congress added the words “and Prevention” to the agency’s name back in 1992.)
Seventeen years later, the President’s ambitious health care plans are among several factors that have brought a new sense of urgency to the prevention of cancer, diabetes, and other chronic diseases. At this crucial juncture, President Obama is handing the public health reins to the wrong doc.
Frieden’s overall goal of bringing disease prevention to the next level is actually right where it should be. The problem, though, is Frieden’s blueprint for how to get us there.
Food bans, sin taxes, mandatory recipe requirements, and other command-and-control measures have a punitive aspect which doesn’t belong in public health policy. Punishing junk food junkies by taking their snacks away, altering their recipes, or taxing them into submission is profoundly intrusive, arrogant, and likely ineffective.
For instance, the National Weight Control Registry collects the success stories of people who have lost at least 30 pounds and kept it off for a minimum of one year. Its co-founder, Dr. James Hill, is one of many experts (the American Dietetic Association) to dismiss the good-food vs. bad-food approach to health: “We focus too much on diet and not enough on physical activity.”
State obesity statistics support this conclusion. Of the top 10 most-obese states, government surveys show nine of them are also the most sedentary. The residents of the most obese state, Mississippi, report the lowest rates of leisure-time physical activity in the country.
The way to encourage healthier lifestyles isn’t an iron fist. It’s a velvet work glove. Or a batting glove. Anything to get our bodies moving again, which is the only way to cure what ails us as a nation. And it’s education. It’s positive incentives.
Whether public health officials should favor the stick or the carrot in their efforts has been hotly debated. But the likelihood that Frieden’s restrictive policies could backfire – a problem that Department of Agriculture’s Economic Research Service highlighted in a 2005 report on menu labeling and snack taxes – suggests that the carrot may be our best option. Dietary needs vary widely enough that a heavy-handed government approach could actually be dangerous. (Several epidemiologists have taken issue with Frieden’s salt enforcement scheme, for instance, noting that the scientific support for sodium interventions is shaky at best.)
Promoting the notion that consumers aren’t responsible for their own choices – a natural outgrowth of government making the “right” choices for us – is a recipe for disaster. But even more alarming is Frieden’s apparent sense of duty to assume that national responsibility personally. He famously told the Financial Times in 2006 that “when anyone dies at an early age from a preventable cause in New York City, it’s my fault.”
By focusing on maximizing life expectancy (its “quantity”), Frieden ignores the “quality” side of the lifestyle equation. And many Americans-most Americans, perhaps-are inclined to accept the tiny health trade-offs associated with perfectly legal lifestyle choices that give them pleasure. People who are more concerned with being happy than with living an extra month at age 90 shouldn’t be shushed by government officials who want to assume more responsibility for their health.
Do Americans really share Frieden’s ambition to prevent every disease at any cost? The doc’s killjoy reputation strongly suggests that the answer is “no.”
J. Justin Wilson is the Senior Research Analyst at the Center for Consumer Freedom, a nonprofit coalition supported by restaurants, food companies and consumers to promote personal responsibility and protect consumer choices.