Has anything changed since 1996?

Who remembers Luther Terry?

In June of 1962, Surgeon General of the U.S. Luther Terry called a group of experts together to review the connection between smoking and “the epidemic rise of lung cancer.”  In 1964 Terry (while smoking a pipe) released his committee’s findings which “hit the country like a bombshell.”

The report stated that smoking kills.  The report revealed that cigarette smoking was responsible for a “70 percent increase in the mortality rate of smokers over non-smokers. The report estimated that average smokers had a nine- to ten-fold risk of developing lung cancer compared to non-smokers: heavy smokers had at least a twenty-fold risk.”  Terry’s report left its mark.  “A Gallup Survey conducted in 1958 found that only 44 percent of Americans believed smoking caused cancer, while 78 percent believed so by 1968.”

So what?

Right now, you are thinking, “the link between tobacco and cancer is common sense, why don’t you tell me something I don’t know?”  Ok, I will.  In the summer of 1996, then Surgeon General Audrey Manley released her own ground-breaking report called “Physical Activity and Health: A Report of the Surgeon General.”  It was called, “a landmark review of the research on physical activity and health.”  (While the Surgeon General was fit and trim, as she released the report, most of the other leading government dignitaries standing with her were overweight or obese).  Hmmm, the more things change the more things stay the same.

This truly outstanding report had powerful information.  It indicated that regular physical activity reduces the risk of dying from heart disease, complications related to diabetes and high blood pressure. It also noted that exercise helped reduce the risk of low back pain and weight gain.  At the time of the report’s release the leading cause of death in the United States was heart disease.

So where are we now?

Since the 80’s, the CDC has listed the three main risk factors for developing heart disease as obesity, lack of regular exercise and smoking (this remains true today).  For most people all three of these risk factors are connected to lifestyle choices. Sadly, the leading cause of death has gone unchanged since Manley’s report. In fact, things have gotten worse. The rate of obesity has increased with leaps and bounds and the amount of Americans not getting enough exercise has decreased only slightly.  Currently, the percentage of Americans not getting sufficient levels of exercise is around 62%.

The connection

After Luther Terry’s 1964 report public opinion about smoking slowly started to change.  The public became aware of the dangers of smoking. Negative advertising toward smoking, the stopping of advertising tobacco products on TV and elsewhere, warnings of the health dangers on tobacco products, substantial evidence showing the incredible health challenges that tobacco products create are just a few of the things which brought about change.

The most significant wallop against smoking occurred with the realization of the dangers of second-hand smoke.  Soon people were restricted from smoking on planes and then in selected businesses and restaurants. Today, smoking is not permitted, in virtually all public places. Many states heavily tax tobacco products further giving tobacco products “persona non grata” status.  Smoking is no longer “cool”.  We have created an environment in which smoking is actually a hassle.

Our current situation (the obesity epidemic)

Despite similar origins (Surgeon Generals reports), condemning research and cultures which have changed (at one time it was hip to smoke and fat was a sign of success; now non-smoking and being active are stylish) why hasn’t Manley’s report had the same effect as Terry’s?  I think it’s because we have not made serious efforts to change the actual environment.  In the past 30 years we have been raising a couple of generations of very fat kids, who will and/or have become even fatter adults.  How did this happen?

1. Parents shuttle their kids between home and school to gymnastics, soccer etc., etc., etc. to get exercise. In reality these are scheduled exercise sessions in which some kids play and others do not.  It is not the “free play” of past generations where kids played outdoors all four seasons expending real energy.
2. Physical education programs have been reduced or eliminated
3. Many recreation programs have disappeared
4. Children are chauffeured almost everywhere
5. Playground time is eliminated
6. Kids rarely ride or walk to school.
7. Free play after school is curtailed till parents get home.  In the 21^st century free time is screen time.
8. The average child drinks 2-12 ounce cans of soda pop a day
9. School canteen and vending machines abound
10. Even children who come from impoverished neighborhoods are obese.  In fact, they may suffer from more obesity than other populations.
11. Research shows that most parents do not see their children as overweight

I could add 10 more items and the list would not be exhausted.  Because of the above, the average child burns off about 400-600 fewer calories than did children of 70 years ago.  Not good, 400 to 500 fewer calories a day amounts to 40 to 50 pounds a year!

That is why we have been unable to “jump start” getting kids to move.  The tobacco effort centered their successful effort on changing the environment.  With physical activity we have changed the environment to make kids more sedentary and eat the wrong kinds of food.

We (health professional, government leaders and parents) have failed in the drive to get children active and drop excess pounds.  We need programs, facilities, and environments which encourage the learning of physical skills for all children.  We need to provide school, club, community and home environments to help kids be truly active.  We need less talk and more action.  We need leaders who are willing to do something worthwhile, not just mouth words. We need a nation that will face the difficult tasks of requiring people, starting with children, to learn how to be responsible about their health.  This will not be an easy fix.  In fact, it will be extremely challenging

Post Note: Were you offended in paragraph 3 that I called many of the government dignitaries overweight and obese?  Why?   It didn’t seem to matter that I ridiculed Luther Terry (paragraph 1) saying he smoked as he gave his report.  Let’s get honest as a nation.  We have a problem.