During my two years of public health studies at the University of Washington School of Public Health, I and all students in the programs have been exposed to our growing public health crises concerning chronic disease, the obesity epidemic in the United States, and our apparent inability to turn the tanker on these problems.
A fundamental debate to these problems is whether individuals or systems are responsible, and to what degree. A lot depends on your political point of view. Many persons who could be classified as liberals or progressive and perhaps Democratic attribute problems to complex processes, like the role of the Farm Bill in creating subsidies that have led to the overproduction of unhealthy processed foods. Those who might be considered conservative and Republican frequently point to the responsibility of individuals in making food choice decisions and controlling their level of physical activity.
I’m a firm believer that our built environment plays perhaps one of the largest roles, along with cheap energy (measured by pump and meter prices) and the ill effects of our corporate food production system. However, I also believe that people are capable of making smart food choices, and do not do that. When we have discussed “behavior change theories” in my class, I am led to believe that people must go through many stages of change before they can succeed, in say not eating junk food or in cooking food. I have challenged these ideas in my classes, and my peers in my program literally laughed at my face when I criticized this model and suggested that, yes, individuals actually can choose to eat good food, if they wanted to.
While I think the behavior change model has validity, I do not think that wipes clean the responsibility of individuals to turn off their TV for 4-6 hours a day (the average in the U.S. according to research), get out and take a 40 minute walk, and spend an hour cooking something cheap, healthy, and nutritious, like lentils and vegetarian red sauce with pasta. In many ways, I think such ideas are anathema to current public health models and thinking at respected institutions like the UW SPH (my school). I find myself swimming against the current as I am being taught how we can turn the tide on the health crises that are bankrupting our country and that are transforming us into a nation of unhealthy, overweight, gasoline-addicted citizens who apparently can do nothing to control the destinies of their own bodies.
Even though many poor persons cannot access completely healthy food, nearly everyone can likely get the following food items, even at bad food stores: red sauce, dry lentils, pasta, and perhaps a few vegetables (onions, carrots, maybe even a green pepper) and garlic. Spices cost extra. I have priced out what it costs me to make a large batch of red sauce and pasta for 10 meals: usually from $12 to $15. A batch of lentils, cooked into a soup or thicker stew, will cost less, perhaps at most $10 to $12, figuring the cost of rice or tortillas, which is what I eat them with. These prices can vary by location. Both dishes take no more than one hour to cook, if you soak the lentils for 24 hours or longer. My thesis completely contradicts arguments of respected faculty at my school, who suggest that lower-income persons eat high-calorie, low-nutrition food because it is a better dollar value per calorie (I reject this idea).
And what do you get when you cook them? Healthy food. Lentils are high in fiber (prevents coronary disease,) vitamin B6 (highest in any plant food), protein, and iron. And they help with digestion. Lentils also are practically fat free. As for vegetarian red sauce (I do not use meat), it is a staple of the so-called Mediterranean food pyramid, which is associated with much less risk of coronary disease, longevity, and good health. Yes, you can eat well, eat cheaply, and live better . But that requires you first to turn off your TV, take the time to cook, and realize that, yes, you are in control of what you put in your mouth.