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Why is our health getting worse—and why are our leaders not reversing the trends?

The consensus diagnosis sounds simple: we are not physically active enough, our nutrition is not healthy enough, and we have too much toxic unmanaged stress, for us to lead healthy lives.

We just need to “fix” those root causes. But, that’s easier said than solved.

Each year, hundreds of thousands of doctors and nurses strongly encourage their hundreds of millions of patients to become more active and eat healthier, and to relax and de-stress. Yet in the end, it’s all just talk: people’s behavior rarely changes, and for the vast majority their habits & health do not improve later in life.

Continuous Glucose Monitor on the upper arm

From Managing Our Diseases → Active Healthy People

The vast majority of the health system has “thrown in the towel” on helping people develop “healthier lifestyles.” Instead, health care agencies, plans and providers assume that most people will continue to have unhealthy habits and chronic conditions for their entire lives.

As a result, the health sector focuses predominantly on controlling the impact of those lifelong unhealthy conditions—a process known as “disease management”.  Indeed, they often say they are keeping people healthy, when actually they mean that they are managing their unhealthy chronic conditions so that people can live and work adequately —in spite of their chronic conditions.

With the help of schools, though, we don’t need to accept the health care sector’s disease management fatalism.  We can at a minimum postpone the on-set and reduces the severity of chronic health conditions for many years.  

But to reduce lifelong prescriptions and constant clinical visits to manage epidemic chronic conditions, we need more time in K-12 schools to develop healthier activity, nutrition, and mental wellness habits.

We used to have that time. What happened?

Seat-Time at School + Screen-Time at Home = Unhealthy, Underachieving Children

Our leaders and laws unthinkingly and unintentionally sent school boards, superintendents & principals the wrong signals.

In recent decades, states–cheered on and financially incentivized by the federal government–started “grading” schools based almost exclusively on their reading, writing and math standardized test scores.

Physical Activity Diagram
Recess dialogue

Ironically, and tragically – it turns out that all that extra “seat-time” at school actually may have hurt test scores more than helped them—and that “overdose” of seat-time also killed many students’ motivation & brain energy.  (When test scores did improve, it turned out that it was improvements in teaching & learning quality—not the quantity of minutes taken from recess, arts, health ed & PE—that worked.)

That makes common sense to parents and teachers, who know how hard school would have been for them with little or no recess or “gym”.

That common sense is now backed up by decades of MRI brain scans and other research evidence.

Brain scans

Of course, parents would never have assented to endangering their children’s health—but they were never asked.  Governments never bothered to figure out what the consequences would be of less recess & arts ed and little or no PE or health education—and they were in denial that their policies could harm kids more than help them. 

In fact, governments and school leaders never seriously investigated the potential downside from such radical surgery on their school schedules.  And they continued to ignore both the health consequences and the negative academic impacts, even as the unintended consequences became clear to those who were paying attention.

And health plans and providers did not warn governments of the potential for epidemic chronic disease from sedentary schools.  (Some public health authorities pushed against the excess seat-time…but were ignored.)

Worse Health For Better Test Scores…Not!!

Any parent will tell you: 

Nothing else that a school can do academically, can make up for my child developing diabetes, heart disease or cancer in their twenties or thirties, because schools have stopped preparing them for healthier lives.”

Worse health for better test scores?  No one would take that “deal”—especially since that tradeoff doesn’t even work.

To reinforce that point, let’s contrast the data on the tiny cumulative 1-4% growth in standardized test scores over the past 40 years, compared to the catastrophic worsening of teen health, including >300% growth in teen prediabetes:

Depression, Prediabetes and Obesity grpah

And parents did not push back enough with school administrators—often apparently assuming that kids were getting physical activity at school…because the parents themselves had had plenty of activity when they were students.

Meanwhile, screen-time took up more and more time at home. Tablets and smartphones and videogames and social media were just too tempting for the kids. They also made for convenient low-cost babysitting for younger children, and perhaps seemed safer than having kids out of the house in the neighborhood. 

Physically AND Mentally Healthier

The risks to our children go well beyond their physical health. The percentage of teens who have been depressed or have seriously considered suicide increased by about 50% from 2009-2019—and this worsened during the pandemic. Much more needs to be done on an on-going basis through schools to improve our kids’ mental health, too.

image10 depression chart.jpg

Our bodies and minds are integrally connected: physical activity reduces ADHD, anxiety and depression for many children and adults. And much more can be done through mental health education in schools to improve children’s mental wellness.

Chart: ADHD, anxiety suicidal thoughts
Child in hospital bed

Preventing Family Financial Illness

American families are spending over $4 trillion per year—over $12,000 per American—on health care—more than twice as much as in 1980. This is more than twice per capita what other countries spend.  Now, consider that the median per capita household income is about $38,000 per American.  These economics do not work for families.

After decades of health care inflation, at far higher rates than wages, it’s clear by now that the health care industry is unable to control costs adequately for families.

Astonishing as this may sound: as long as we start early in life, it is much more feasible for us to develop healthier habits—and thereby reduce our health costs—than to expect the health care system to ever make our health care costs reasonable again. 

(To put it bluntly:  The industry has had 60+ years to slow health care cost growth, and failed miserably. In addition, the vast majority of their costs are labor costs—and no one in health care is volunteering to slash their salaries to save the rest of us money.)

Governments Under Growing Pressure, Too

Governments are under pressure, too. 

Health care is the largest component of federal spending, now even exceeding Social Security, thanks to:

  • Medicare
  • Medicaid (operating under AHCCCS, Medi-Cal, & other state-specific names)
  • the Affordable Care Act (“Obamacare”)
  • the Veterans Administration (“VA benefits”)
  • government employees including military personnel
  • and IRS health insurance tax breaks for employers, etc. (Yes, even employee health benefits are heavily funded by the government/taxpayers, through employer tax deductions.)

And health care is often the largest or second largest component of state government spending (after education).

The federal government is financing increasing health costs through much higher national debt. 

  • Political leaders refuse to increase taxes enough to pay for higher costs.
  • Yet they don’t dare cut federally-funded health programs such as Medicare, employer health benefit tax deductions, and VA benefits.

In other words, future taxpayers—meaning our children, grandchildren, and great-grandchildren—will end up paying what we can’t and won’t pay for our own health care.  We could have prevented so many of those costs, K-12 and beyond—instead, we have failed future generations.

We care… but how much do we really care? Let’s prove it!

Sinking ship

​Ever-increasing federal health care spending, including major recent health insurance subsidies (“Obamacare”) —plus massive tax cuts every 15 or so years to increase working- and middle-class families’ vanishing disposable income, to help them pay for higher health care costs—have been essential for keeping this Titanic afloat.

But they have also hidden the pain, and have helped our political system and society avoid dealing with the issue.

However, the number of musical chairs on the deck has fallen too low. How do we keep from sinking?

Peer-led physical activity, Sunnyside USD, Tucson, AZ (Reeves, 2016)

Peer-led physical activity, Sunnyside USD, Tucson, AZ (Reeves, 2016)

Systemic, Systematic, School-Based Solutions

Changing children’s health habits is a big complex challenge.  But we did it with teen smoking, now down 6x from where it was 20+ years ago.  And healthier habits in childhood made it easier to reduce adult smoking—from 42% of adults in the 1960s to less than 12% now.

How do we get there with our current major issues?

Get ready for a mouthful…  As part of our core mission, vision and values, our approaches will continue to be:

accountable, performance-based, highly-effective, affordable-for-all, super-scalable, move-the-needle-systemic, long-term, and sustainably self-funding—with a high, rapid, proven payback/ROI.

Our initial focus is on dramatically expanding & improving quality K-12 physical and health education, physical activity, healthy nutrition, & helping students deal with toxic stress—as an essential foundation for lifelong health.

While we start in K-12 schools, we look at health in its broader family, community, and socioeconomic context—and ultimately over the entire lifespan.

elements of a healthy community - graphic

Source: Vitalyst Health Foundation

We realize that healthy habits begun early in life, as children, must then be reinforced by other public policies and individual practices, as adults. This ensures that the healthy behavior begun in schools does not fade out and revert to unhealthy social norms in the future.  By doing so, chronic conditions and health care costs can be reduced an additional 30%–with the combined impact improving lifelong health and lowering lifetime costs by 50% of what will happen otherwise.