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Fast Food – Our Habit of Convenience

Habits we acquire happen over a period of time. They typically begin with a cue and a perceived positive reinforcement of a reward.

Maybe we bypass going to the fitness center or take a bike ride because it is more pleasant to sit on the couch and watch Netflix. It’s just too convenient to press the TV remote (cue) and then become engrossed in countless shows that are entertaining, educational – or both (reward). Doing this too often may develop into a new habit that could detract from a previous habit (e.g. gym or bike). We exchange one habit (exercising) for another, less-healthy habit (TV binge-watching).

According to a recent Centers for Disease Control and Prevention report, 36.6 percent of Americans eat some kind of fast food* each day, with men being a bit less discerning about what they eat (37.9 percent) than women (35.4 percent). When you think about it, fast food is always accessible throughout the day, making it just too convenient for many of us to pass up.

On a typical day, almost 23 percent of Americans will eat breakfast from a fast-food outlet, while about 44 percent of us will pick up a ‘quick’ meal during lunch. Not to be left out, fast-food dinners draw another 42 percent of Americans.

Ethnic group and age also provide differences when it comes to the daily consumption of fast food.

Ethnic Groups:

  • Black Americans – 42.4 percent
  • Whites – 37.8 percent
  • Latinos – 36.5 percent
  • Asian-Americans – 30.6 percent

Age Categories:

  • 20–39 years-old – 45 percent
  • 40-59 years-old – 38 percent
  • 60+ – 24 percent

Take-A-Way from This Report?

The conventional wisdom about fast food is that people eat it when they can’t afford something better (and healthier). However, this report suggests this wisdom is not necessarily true. For example:

  • Higher income equates to more fast food: The more money we have or make, the more likely we are to eat fast food on any given day. For example, about 32 percent of people who earn less than 130 percent of the federal poverty level eat fast food daily. However, over 36 percent of middle-income families (earn between 130 – 350 percent) purchase fast food daily, while 42 percent of people with incomes above 350 percent consume fast food daily.

This finding is interesting because healthier food can cost a bit more than fast food, and yet, regardless of having the ability to pay for more expensive, healthier food, we often elect the more convenient food that is available at our finger tips (often using the drive through). Additionally, with our younger population consuming more fast food compared to older generations, younger families (and their children) will be more likely to establish unhealthy eating habits – creating health issues later in life (obesity, heart disease, dementia, etc.). The intake of calories, fat, and sodium eventually adversely affects our health in many different ways.

Iowa Youth Obesity Rate is High

Another report recently released by The National Survey of Children’s Health compares the obesity rates of children (ages 10 to 17) for all 50 states. Almost 18 percent of our youth in Iowa are obese, ranking our state as the 10th highest state for youth obesity. Iowa’s white (non-Hispanic) youth are significantly higher than the national rate.

The implications of having overweight and/or obese youth present future challenges to our state. For one, employers desire to have healthy and productive employees in their workplaces, and having unhealthy employees will continue to leverage up their health insurance costs due to higher healthcare usage. No one wants a poor quality of life, but often this is a result of the choices and habits that have been established much earlier in our lives.

Per a recent Harvard T.H. Chan School of Public Health report, we are still trying to come to terms with the dietary fat we consume – fat that is good and fat that is bad.

This much we know. Establishing a habit based on mere convenience may not be the smart choice we should make for ourselves, individually – or as a society.

Now, where did I put my channel changer…

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*NOTE: For this survey, fast food was broadly defined as any item obtained from a “fast food/pizza” establishment. It is possible that some people may interpret fast food differently from one another – e.g. takeout sushi, etc.

Confronting THE ‘Silent Killer’

Silent Killer

Keeping silent. What IS the third leading cause of death in the U.S.?

The safety of the people shall be the highest law.
Marcus Tullius Cicero

A democratic society values freedom of speech, protection from harm and unjust imprisonment. Unfortunately, one of these values has been glaringly absent for some time.

While preparing this particular blog, I am reminded that countless towns, cities and states have silly, if not outrageous ordinances and laws. Take Iowa – some laws have been on the books for many years and are grossly outdated – most likely due to oversight or just plain laziness. For example:

  • A man with a moustache may never kiss a woman in public.
  • One-armed piano players must perform for free.
  • Kisses may last for no more than five minutes.
  • In Dubuque, any hotel in the city limits must have a water bucket and a hitching post in front of the building.
  • Marshalltown forbids horses to eat fire hydrants.

If these comical, yet ridiculous laws are still in existence (some are now repealed), can you imagine just how many ‘violations’ have occurred since they were implemented? Having such laws or ordinances legislated to control harmless acts within our towns and state borders are quite meaningless, don’t you think?

So then, why are we not concerned about having legitimate legislation that attempts to protect every patient from harm, even when the harm is mostly ‘silent’ and assumed to be unintended? Allow me to explain…

If the Centers for Disease Control (CDC) were to include preventable medical errors in hospitals as a category, it would be the third leading cause of death in the United States, behind heart disease and cancer. When it comes to reporting these mistakes around the country, however, doctors and nurses have been fired when they speak up. This code of silence is, to say the least, deafening. Medical errors, no doubt, have become THE ‘silent killer.’

In its 1999 “To Err Is Human” report, the Institute of Medicine (IOM) called for a nationwide, mandatory reporting system for state governments to collect standardized information about “adverse medical events” resulting in death and serious harm. Interestingly, this call for a national reporting system was not implemented.

However, as of November 2014, 27 states and the District of Columbia now have variations of authorized adverse event reporting systems. Oregon’s reporting system is voluntary. As of this January, Texas now reports such events. Many of Iowa’s neighboring states, such as Illinois, Minnesota and South Dakota have reporting requirements.

What about Iowa? Not much.

To improve the care we receive, we first must understand how prevalent this problem is in Iowa and elsewhere. In 2010, Harvard published a report in the New England Journal of Medicine indicating that about 25 percent of all patients are harmed by medical mistakes. In 2014, Massachusetts completed a survey of its residents and determined that 23 percent received medical errors.

So are preventable medical errors in Iowa similar to these alarming reports, or is care provided within our borders somehow insulated from the dismal results found elsewhere? That becomes the big question – we simply don’t know. In Iowa, we have no independent trusted source to publicly provide ongoing transparency about this ‘silent killer.’

A quote from noted cancer surgeon, Dr. Marty Makary, refers to the importance of openness and transparency – which easily applies to this particular subject matter:

“Health care costs are not going to be reigned by different ways of financing our system, but by making it more transparent so that patients can fix the system. I’m convinced that the government is not going to fix health care. And doctors are not going to fix health care. It’s going to be the patients.”

There are different ways to scale over this ‘Wall of Silence.’ Perhaps a good, first step may be to establish reporting requirements, much like the other 27 states are now doing. By taking this approach, health workers who desire to do the right thing by reporting errors can be protected from workplace retaliations. Another, more immediate strategy is to ask Iowans about their experiences – a simple process that establishes a baseline for later, more deliberate, actionable solutions to make safety-of-care a statewide priority. To ultimately improve patient safety and quality, public reporting and provider feedback is critical.

We must not tolerate secrecy and demand ‘sunlight’ within the medical care we receive. A preventable medical error becomes egregiously INTENTIONAL when nothing is done to prevent it from occurring again in the future. By staying quiet, opportunities to learn and improve the quality of care will be lost.

Now, well into the 21st Century, it is time to assess which laws best serve our citizens. Limiting a kiss to five minutes does not have the life-changing consequence when compared to addressing and eliminating THE ‘silent killer’ of our time.

Isn’t it time to take action? I welcome your thoughts on this very important issue.

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