Obama Health Spending: 4 Innovative Solutions to Improve America's Waistline and Reduce Health Spending

Much has been written about the epidemic of obesity in this nation. It has been estimated that 21% of the healthcare dollars spent in the United States are related to obesity. That translates to $190.2 Billion dollars spent every year in our already overburdened healthcare system to combat obesity related illness.

While there is little that the president can do to directly stem the tide of obesity-related illness, he can begin the process of setting up frameworks around which environments that promote healthy eating and lifestyle decisions can be built, improve access to healthy food, limit the influence of big agriculture corporations, and get people moving again.

1) Reform the farm bill


A good place to start combating American obesity is with the stalled farm bill. Though an extension of the farm bill was passed as part of the recent "fiscal cliff" legislation, the fundamental change that is required, to lessen the impact of over processed food on the American waistline, was missing. The bill, as it stands and as it has stood for decades, heavily subsidizes commodity crops making them artificially cheap. This rewards companies for producing and marketing copious amounts of fattening food that contribute to obesity rates. These foods are semi-addictive, according to some studies, and their very ubiquity presents what amounts to an illusion of choice.  

"Big Ag" is a powerful force in governing what gets on grocery shelves and restaurant plates. The food and beverage industry spends millions each year lobbying Congress to ease rules and increase subsidies. Conversely, the Center for Science in the Public interest, which is one of the leading lobbyists for healthy food spend (just $70,000 in 2011), is trying to persuade Congress to tilt the scales more in favor of healthier foods. While there are positive things to be said about efficiencies of scale in the food system, low prices being chief among these, the lessons of Big Ag show that we need to lessen the influence of the agricultural lobby in our politics and in our grocery carts.

2) Build cities that encourage activity


Another key component of the rising tide of obesity in America is the increasingly sedentary nature of the American public.

According to a recent report by Nielsen, the average American watches in excess of 32 hours of television a week. Rampant suburban sprawl guarantees that most citizens will commute by car an average of 25 minutes per day (based on data from 2009). With an average work day of 8.8 hours, Americans sit for 78 hours per week. This equates to nearly 40% of our time in a sedentary state. The health implications for such inactivity are deadly. 

Michelle Obama’s Let’s Move campaign seeks to combat this inactivity in children, but what about adults? A redesign of our cities and towns to make them more walkable, by creating what Congress or the New Urbanism calls "livable streets," building multi-use developments, and bringing the services that people need nearer to the places where people live and work, is key to fighting the obesity inducing potential of inactivity.

In addition to redesigning our cities for walkability and human scale mobility, our cities need to become greater producers of the foods that they consume. There exists within cities tremendous potential for urban agriculture. In New York City alone a group called 596 Acres has catalogued (you guessed it) 596 acres of vacant, mostly city owned land that is suitable for urban agriculture. As a social movement, urban agriculture has taken off in recent years as more and more people begin to understand the perils of the broken food system under which we now live. Farmer’s markets are popping up in record numbers, community and market gardens are spreading as people seek to grow their own and source local, sustainably raised foods for their kitchen tables.

New technologies and techniques for growing food even in space constrained places make the production of food in cities even more feasible. These are not pie-in-the-sky, uber expensive vertical farming fantasies. These are real, working technologies that are producing food in cities right now. Technologically focused companies such as Bright Farms, PodPonics, and The Plant Chicago are growing healthy food and profits right now. The potential for growing healthy food in cities is tremendous and President Obama can contribute toward creating the regulatory structures that promote such enterprises.

3) Promote local and regional food systems


One of the problems that drives obesity is the emphasis on incentivizing chain grocery stores like Wal-Mart to locate in areas where obesity is a major issue. Many of these areas tend to be mired in poverty and majority minority. Though the Obama administration touted Wal-Mart’s plan to open more than 300 new locations in food deserts around the nation, new evidence has shown that the plan has actually resulted in relatively few new stores opening. But even if new stores do open in obesity plagued areas, many of them just serve to exacerbate the problem. Most chain stores, focused as they are on profit, tend toward retailing foods with low perishability and relatively high margin. This equates to store shelves that are packed with highly processed, highly palatable foods that are marketed far more heavily than healthier alternatives.

A better plan for the administration to pursue is to promote local and regional food systems and community based initiatives to provide communities that are struggling with obesity related health issues with healthy, affordable, and satisfying food alternatives. In short, new grocery stores are not necessarily the answer. Concepts like The Food Commons provide for novel public-private partnerships that are geared toward sustainably and profitably producing, processing, and distributing healthy food within defined geographical areas. Coupled with the burgeoning urban agriculture movement, local food systems can provide relief in many areas by providing jobs to unemplyed and underemployed individuals, increasing activity levels, thereby reducing obesity rates, and improving urban and suburban environments through soil remediation and carbon capture.

4) Make it a radical redesign


A radical redesign of our food system as I have proposed will have effects that reach far beyond the national girth. With more regional and local farms and markets will come more hiring and the economic boost that comes with a greater percentage of the workforce being gainfully employed. As food miles drop and cities become more walkable environmental issues ease. As massive industrial farms shrink our water ways and air will become cleaner through the lessening of fertilizer runoff and farm equipment emissions. Another byproduct of the shrinkage of industrial farms is a lessening of our dependence on fossil fuels and a corresponding shift in the connected foreign policy.

There are many reasons that President Obama should tackle obesity in America. A multi-pronged approach has the potential to solve many problems in one fell swoop. But, in order to be affective at lowering obesity rates and creating a population that is healthier and wealthier, the approach must be comprehensive and integrated.

His second term is the ideal time to begin the tough reforms needed to begin swinging the American waistline back toward a more trim, healthier size.

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Nate Abrams

I'm a systems guy, which means that I look at almost everything in terms of interconnections, feedback loops, architecture and scale. In other words, I look for the big picture and the deeply buried reasons for why things are the way they are.

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