Ah, my home state has made me proud again. The New York Times just reported on a recently implemented program in Massachusetts that is working through local health centers to increase the consumption of fresh fruits and vegetables as a means of curtailing obesity. Rather than outline the program (you can read the article), I’d like to reflect.
First, the program couches the ‘farm stand’ as a ‘new’ apothecary. The positioning of fresh produce as new sparked my interest, as it’s rather inconsistent with history. Overconsumption, oversalty, oversugary, superfatty food is actually new. Eating what you need; eating from the Earth; and then replenishing what you’ve consumed via contained agriculture is not new, is consistent with the way humans lived for centuries. I wonder how successful a campaign would be that framed such “new concepts” as traditional, as cultural consistent with worldview. Would folks shift the prisms through which they thought about what they consumed?
Second, throughout the article, there’s a narrative about fighting obesity as the end. Is decreasing obesity the end? Or should the “movement” be framed as one that focuses on fighting obesity as a means to an end. The end? Health, longevity, being a present parent and partner.
Third, it appears that the communities are taking a systems approach, which personally makes me feel all warm and fuzzy inside. They’re changing public schools. They’re changing how community land is used. The mayor is involved and is working with health centers. And probably most importantly, they’re increasing access—structurally—and letting community members be autonomous. Magnifique.
As amazing as the program seems however, and as systems-oriented as it seems, there’s one part of the system, a part of the system that the doctors, nor the program coordinators, nor the reporter touch upon in the article. The article states that childhood obesity results in 14.1 billion dollars in direct costs and 147 billion dollars in indirect costs each year. BILLIONS. Politicians and activists have pointed to such costs as reasons to fight the epidemic. However, costs are by definition paid to some entity. And it is in that entity’s best interest to sustain childhood and adult obesity. Obesity is profitable, albeit in human lives. Obesity is a money maker. And for any program to truly decrease the obesity crisis, it must influence, shape, restructure those powerful entities that are working on counter-efforts to sustain obesity, and to sustain money in their bank accounts.
My final comment pertains to the critics who argue that the program will not likely lead to lifelong behavioral changes. I think that a program like this absolutely could lead to sustainable change. I think that for some this program could represent a formative experience. I’ve wanted for years to examine how seemingly small, yet high impact, formative moments drastically change what seemed to be linear life trajectories. I’ve had many in my own life—a conversation at 15 with Ms. Keenan; the sight of market women carrying baskets on their heads in Fogo; meetings with Dr. Helms and Hassell at 21; a visit from a Black and blue butterfly last November; statistics from Super Size Me and The Future of Food and Food, Inc. Each moment induced drastic change. Lasting change. Changed me. Literally changed me. And so can a program like this literally change its participants. Life isn’t necessarily linear. And change isn’t necessarily incremental. There are jumps and spurts that create paradigm shifts. Particularly when those jumps and shifts come with new-found information. Like the importance of fruits and vegetables to healthy functioning. Like the years of life that you lose for each pound overweight you are.
Structural change + means + information (can) = sustainable, maintainable, transformable change.