Updated: Feb 19
Ethical Science : An Approach Towards Responsible Health Care Practices
I remember one of my elementary school friends telling me she was a vegetarian, something I have never heard of before. Later, I told my parents about my friend, and they chuckled. I realized there really isn’t such thing as “vegetarianism” or “veganism” where they come from. It’s much more common in the United States than in Colombia or Ecuador. Growing up in a Hispanic household and raised in a predominately white community, I am mixed culturally and it has been difficult to adjust to both lifestyles. As I grew more conscious of the roles of my race, gender, and economic status, I realized how much these factors both directly and indirectly shape an individual.
Fast forward a couple years and I’m sitting in my middle school health class watching a documentary called “Forks Over Knives” on the consequences of meat consumption and its impact on health. It was then I decided to go vegetarian and, after a year, I switched to vegan for health reasons. Transitioning to both diets was difficult: one, my family had a hard time figuring out what to feed me and, two, at the time I became a vegan it was uncommon. There weren’t all these vegan alternatives we see today and a lot of stigma came with the diet.
For the past four years, I have researched this diet extensively and learned that this transition is more than just a diet, but perhaps the answer to some of the world’s problems economically, environmentally, medically, and ethically. This is also when I realized how big of a role culture and tradition play in our lifestyle choices, even if they have negative consequences. Too many Americans are severely affected by malnutrition and cardiovascular disease as a result of poor diet, inaccessibility to quality food, and lifestyle. This problem needs to be addressed by examining wealth inequality and what exactly makes health food more expensive and less accessible to the economically disadvantaged.
The number one killer in the United States is heart disease, which is unfortunate because it is largely preventable. According to Heart Disease and Stroke Statistics— 2018 Update by the American Heart Association, the cost of cardiovascular disease and stroke in the United States annually is an approximate $329.7 billion. This estimate includes $199.2 billion in expenditures (including costs of medical professionals and physicians, hospital services, prescription medication, and domestic health care) and the remaining $130.5 billion accounts for lost future productivity as a result of premature cardiovascular disease and stroke mortality (Benjamin e-480). Now consider that saving rates have decreased since 2005, with 40 percent of participants in a survey saying they only have $4,000 in life savings (Frank 79). With these figures, how are the economically disadvantaged supposed to cope with unexpected emergency expenditures? Why are so many Americans dying from preventable disease?
The Supplemental Nutrition Assistance Program (SNAP) is a federal nutrition assistance program that aids millions of economically disadvantaged Americans. Although the program has managed to keep food in the stomachs of many Americans, studies show that the economically disadvantaged are more prone to spending their money on calorie dense foods that don’t have much nutritional value, resulting in worse health and increased healthcare expenditures. According to commentary in the American Journal of Preventative Medicine by clinical researcher Dr. Neal Barnard,
Based on data from the 2003–2010 National Health and Nutrition Examination Surveys for 4,211 low-income adults, and using the Healthy Eating Index 2010, a 2014 analysis showed that SNAP participants had poorer overall dietary quality and worse scores for intake of fruits and vegetables, seafood and plant proteins, and empty calories. Similarly, a 2015 U.S. Department of Agriculture study compared SNAP participants with income-eligible non-participants, finding that SNAP participants had poorer overall diet quality and consumed more calories from solid fats, added sugars, soda, and alcohol and consumed fewer vegetables and fruits. These nutritional differences were deemed responsible for the higher obesity rates observed among SNAP participants. The differences in diet quality that fall along economic lines are paralleled by differences in disease prevalence. In 2010, economically disadvantaged Americans had approximately 70% higher prevalence of diabetes and a 19% higher prevalence of hypertension, compared with the highest-income population. (Barnard S103)
These statistics and findings, according to Barnard, should be “interpreted with caution” since there is immense importance to and reliance on the program. There has been reluctance to initiate a controversial conversation on any of these major concerns; calling out the program’s contribution to health problems could be risky, especially since funding is a major political issue. Barnard proposes a restructuring of the program to make it more responsible and reliable in improving diet quality. In turn, the success of making such initiatives would translate into better health and a reduction in health care costs while reducing hunger within the US and ending this epidemic.
One factor to blame concerning the costs of health foods is government subsidies, the sum of money granted by the government or a public body to assist an industry or business so that a price of a commodity remains lower or competitive. These have reduced the price of foods most correlated with the development of diabetes and obesity. According to the an article in the Environmental Health Prospectives Journal, the food market contains an overwhelming number of products made from highly subsidized crops. These cheap foods include sweeteners such as high-fructose corn syrup, hydrogenated fats made from soybeans, and feed for animal agriculture. As a result, highly processed pre-packaged foods, sodas, meats, and fast food have become significantly less expensive, de facto encouraging poorer families to purchase the foods that meet their budget, regardless of the dangers and health risks associated with such foods (Fields 1).
The Center for Disease and Control estimates that eliminating “poor diet, inactivity, and smoking” would prevent 80 percent of type 2 diabetes, heart disease, stroke, and would also prevent 40 percent of cancer. Science has established that the adoption of a plant-based diet not only prevents the development of these diseases but can reverse them, something no other diet has shown to do. For example, Thomas Campbell argues that
In examining nutritional effects on the development of cardiovascular diseases, one must recognize the totality or ‘wholeness’ effect, as in a whole food plant-based dietary lifestyle. The comprehensiveness of evidence now available suggests that there is no other protocol—dietary or non-dietary—that offers the same health benefits. Perhaps the best testimonial for this whole food effect is its reversal of coronary heart disease during its advanced stages of development. The most recent of these studies included 196 patients, 177 who complied with the dietary advice. In 2–7 years, only one of the patients who complied suffered an event; in contrast, 62% of the non-compliant patients suffered an event. I am not aware of a single other cardio-therapy protocol that approximates such spectacular results. (Campbell 334)
This study provides additional medical evidence that animal products increase levels of cholesterol, build up fats and plaque which block arteries, and increase inflammation which all significantly increase the risk of developing cardiovascular diseases.
GROWING POPULATION & FOOD SECURITY
The problem of food security and food deserts in the United States is a major consideration regarding the health differences between those in more affluent areas and those in poorer areas. Food security is the state of having reliable access to a sufficient quantity of affordable and nutritious food. According to Senior Research Analyst Brynne Keith-Jennings at the Center on Budget and Policy Priorities, adults in households with food security are at least 40 percent less likely to develop chronic conditions (hypertension, coronary heart disease, hepatitis, and stroke) compared to adults in households with low food security (Figure 1). Her research also concludes that food insecurity is linked with less use of medication and treatment by cause of expense and also associated with a 45 percent increase on healthcare and medical spending (Keith-Jennings 1).
Food deserts also impact the availability of health foods. A food desert is an area of limited access to affordable and nutritious food, in contrast with an area with easy accessibility to supermarkets or stores with fresh foods referred to as a food oasis. People living in food deserts often resort to eating cheaper and less nutritious food as a result of their limited options which can have major health implications. In Nickled and Dimed, Barbara Ehrenreich describes her experience living as a person of low-wage by stressing the lack of means to buy quality food while having to worry about several other things:
What is harder for the nonpoor to see is poverty as acute distress: The lunch that consists of Doritos or hot dog rolls, leading to faintness before the end of the shift. The "home" that is also a car or a van. The illness or injury that must be "worked through," with gritted teeth, because there's no sick pay or health insurance and the loss of one day's pay will mean no groceries for the next. These experiences are not part of a sustainable lifestyle, even a lifestyle of chronic deprivation and relentless low-level punishment. They are, by almost any standard of subsistence, emergency situations. And that is how we should see the poverty of so many millions of low-wage Americans-as a state of emergency. (Ehrenreich 117)
In analysis by The Food Bank For New York City, research reports a similar scenario:
One key metric is the Meal Gap, which represents food insecurity as a number of missing meals that result from insufficient household resources to purchase food. New York City had a meal gap of 250 million in 2012, with 17.4% of residents categorized as food insecure.8 Food Bank For New York City tracks the meal gap in each community district to map the areas of greatest need. In the Bronx, 50% of community districts have a meal gap of 4 million or more meals, for a total of 53 million missed meals in the borough annually. The Bronx only has about 1.4 million residents,9 but a borough-wide food insecurity rate of 21.8%.10 Bronx County also has one of the highest rates of child food insecurity in the country. (Agi 2)
Ehrenreich also mentions that one “might discover that, nationwide, America's food banks are experiencing 'a torrent of need which [they] cannot meet' and that, according to a survey conducted by the U.S. Conference of Mayors, 67 percent of the adults requesting emergency food aid are people with jobs” (Ehrenreich 119). The economic, physical, and psychological issues related to food insecurity reflect a true and imminent crisis most felt by the economically disadvantaged. The inaccessibility to health foods whether it be related to expense or locality is a reality many low-income Americans face which affect them both short-term and long-term.
This crisis is not only specific to the United States but many countries alike where food availability is an issue. The high demand of animal products in developed countries like the United States consequently impacts developing nations as well. Senior Research Officer R. Sansoucy at the Feed Resource Group states,
Almost 50 percent of the grains produced in the world are fed to livestock, yet there remain about 800 million people suffering from hunger and malnutrition mostly in the developing countries… About 85 percent of total grains fed to livestock throughout the world are fed to livestock in industrialized countries, but at an enormous environmental cost in terms of fossil fuel. Grain importation into developing countries has steadily increased, however, particularly to feed animals that are consumed by the minority higher-income sectors of society. The problem is twofold: first, the poor cannot afford to purchase these cereals because of their low income, and, second, the importation of grains distorts the market for locally produced feed resources . (Sansoucy 1)
Economics is centered on human demand, mostly turning a blind eye on ethics and human (or animal) welfare. The figure below depicts the several costs of U.S animal food production.
Figure 2. meatonomics.com
According to this figure provided by Bruce Friedrich, executive director of the Good Food Institute, if American consumers had to pay the actual price of animal agriculture, animal products would be three times more expensive and far less in demand (Friedrich). These values however, do not capture the price of the millions of lives affected by the misrepresentation of the nutritional dependence of animal agriculture. Using feed, land, water, energy, and government subsidies on breeding animals that ultimately offer no nutritional benefit is irresponsible and unsustainable. By the year 2050 our population is projected to reach 11 million. Our current population is 7.4 million. Considering 800 million people globally are starving right now, we must find methods of ensuring that number doesn’t continue to increase, especially as resources become more scarce, population more dense, and land more occupied. Once resources do become depleted and methods of agriculture remain unsustainable, this no longer becomes an issue between rich and poor. This affects everyone.
The lack of government intervention and emphasis on addressing this food crisis is discouraging and irresponsible. Humans require food, shelter, and water. Without these necessities, it is difficult to survive. One shouldn’t have to worry about whether or not they can find the next meal, especially when an allocation of taxes and government funds can ease this problem. Below is a pie chart which shows the distribution of our current federal spending.
Figure 3. politifact.com
Food and agriculture only make up 4% of federal spending. Most spending is concentrated on health, defense, and social security (Jacobson). Our health expenditures are high (especially in treating chronic diseases) mostly because of the devastating effects malnutrition has on one’s health as a result of the expense of health foods. The redistribution of federal funding towards an improvement in food and agriculture would not have to increase the tax contribution per individual. Instead, a re-distribution of funds could improve the lives of millions of Americans while decreasing health expenditures.
The resources provided to the highly subsidized animal agriculture and crop industry (specifically soybeans, sorghum, rice, wheat, corn, milk, and meat) we can instead use toward more sustainable and nutritious crop farming to feed the 800 million starving people, slow the cardiovascular disease epidemic, and decrease healthcare expenditures. This is a hard transition for most Americans. Although the plant-based diet proves to be efficient and sustainable, our culture and tradition has normalized the overconsumption of subsidized products to the point where it is barely questioned and the environmental, economic, health, and ethical aspects are widely overlooked.
If there is no health benefit, no environmental benefit, and a distortion of the market, the only reason to continue consuming these products is taste preference shaped by the American culture. It’s time to change that and realize the true impact our tastebuds and culture have individually, nationally, and globally.
Barnard, Neal D, and Katz, David L. “Building on the Supplemental Nutrition Assistance Program’s Success: Conquering Hunger, Improving Health.” American Journal of Preventive Medicine, vol. 52, no. 2, Elsevier Inc, Feb. 2017, pp. S103–S105, doi:10.1016/j.amepre.2016.09.003.
Benjamin, Emelia J, et al. “Heart Disease and Stroke Statistics—2018 Update: A Report From the American Heart Association.” American Heart Association Journals, 31 Jan. 2018.
Campbell, Thomas Colin. “A plant-based diet and animal protein: questioning dietary fat and considering animal protein as the main cause of heart disease.” Journal of geriatric cardiology : JGC vol. 14,5 (2017): 331-337. doi:10.11909/j.issn.1671-5411.2017.05.011
Ehrenreich, Barbara. Nickel And Dimed : on (Not) Getting by in America. New York, N.Y. :Henry Holt, 2002.
Frank, Robert H. Falling Behind: How Rising Inequality Harms the Middle Class. 1st ed., University of California Press, 2013. JSTOR, www.jstor.org/stable/10.1525/j.ctt46n4jz.
Friedrich, Bruce. “Meatonomics: The Bizarre Economics of the Meat & Dairy Industries.” HuffPost, HuffPost, 7 Dec. 2017, www.huffpost.com/entry/meatonomics-the-bizarre-e_b_3853414.
Agi, Liz. "The Meal Gap Under the Microscope: New York City Families at the
Intersection of Food & Financial Security." Food Bank For New York City,
Nov. 2015, 1giqgs400j4830k22r3m4wqg-wpengine.netdna-ssl.com/wp-content/
Jacobson, Luis. “Pie Chart of 'Federal Spending' Circulating on the Internet Is Misleading.” Politifact.com, 13 Aug. 2015, www.politifact.com/truth-o-meter/statements/2015/aug/17/facebook-posts/pie-chart-federal-spending-circulating-internet-mi/.
Keith-Jennings, Brynne. “Food-Insecure Households Likelier to Have Chronic Diseases, Higher Health Costs.” Center on Budget and Policy Priorities, 22 Jan. 2018, www.cbpp.org/blog/food-insecure-households-likelier-to-have-chronic-diseases-higher-health-costs.
Sansoucy, R. “Livestock - a Driving Force for Food Security and Sustainable Development.” Livestock - a Driving Force for Food Security and Sustainable Development, www.fao.org/3/v8180t/v8180T07.htm.