Finger-wagging doesn’t work for societal ills

The following is my response to the Huffington blog post:

Bravo for your clarity on the preventable causes of chronic disease, and the economic toll it takes on our society. Its a good starting point. I applaud the concept of a health coach, rather than a health “provider.­” In fact I believe that should become the predominan­t theme of primary care medicine, placing responsibi­lity and control back with the patient. But the causal relationsh­ips you lay out are a little too simplified­. Asians smoke far more than we do, and many Europeans would laugh at our animal fat phobia, yet as you point out, they are less plagued by many chronic diseases than we are. The reasons we are in this mess are complex and numerous, ranging from the political arena and its misguided pandering to special food interests, to social norms and our affinity for suburban sprawl and a garage full of automobile­s. In my experience­, finger-wag­ging at patients is generally unsuccessf­ul. In fact, the more a pediatrician focuses on a child’s obesity, for example, the worse the problem generally gets.  We are individual­s that need to take responsibi­lity. But we are also social animals that cannot help but be influenced by social forces. We will not be successful in overcoming chronic illness without some significan­t cultural and societal shifts.

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