On June 18, Richard Jackson, MD, addressed a small audience of policy-minded professionals at the Upper Kirby Room (located below Houston Tomorrow’s offices) after a similar meeting with health professionals gathered by Houston Tomorrow Board Member Winnie Hamilton at the Texas Medical Center. These coffee-and-cookies affairs preceded another presentation by Dr. Jackson at the United Way that evening.
During these presentations, Jackson characterized the state of public health in America as a “perfect storm,” an allusion to the massive 1991 storm off the coast of Maine. The collision of urgent health, economic, and environmental challenges must be acknowledged, or society will suffer irreparable damage. Even the famed 19th century landscape architect Frederick Law Olmsted understood this.
He criticized the “medical care” industry (as opposed to the preventative “health care”, arguing that it has turned America’s economy into an economy of service. “Of the 4,800,000 jobs created between 2000 and 2005,” he argues, “40% were in ‘medical care’.” There is no financial reward for performing dialysis on a 75-year old. Thus, Jackson believes that it is essential to “create real jobs that produce real wealth.”
Medication will not heal individuals living in environments that are detrimental to their health. Human beings are very adaptable, and do not realize how much the built environment shapes them. Jackson characterized the built environment as “social policy in concrete.” Even the strongest medication cannot correct social policy.
During the evening presentation, Jackson advanced his thesis with a hypothetical example of an overweight child. This child is in the 95th percentile for weight, and has elevated blood pressure. The environment is also “rigged” against him – he has limited access to healthy food, and cannot walk to school.
People become overweight from living in cities that are not walkable, he continued. (During the afternoon lecture, Houston Tomorrow President David Crossley mentioned that Houston’s lack of “walkability” was a product of “design”). In 2003, only 13% of children walked to school, and the average teenage girl has gained 16 pounds over a generation.
Jackson also cited a litany of grim fast-food statistics. Paying 67 cents to “supersize” an order adds an average of 36 grams of adipose tissue, a 20 ounce soda contains 17 teaspoons of sugar, and the per capita annual consumption of high fructose corn syrup is 63 pounds. He also argues that television advertising has changed children’s diets. “Someone that puts red dye and blue dye into a drink - and calls it berries – should be put in jail,” he exclaimed.
Jackson emphasized the need to focus “upstream,” finding the root causes of health problems.
The state of public health in America is bleak, but Dr. Jackson believes there are solutions. Bad food should be demonized (he calls it “doof”), additives should be taxed, classrooms should be lit with natural daylight, and students should walk or bike to school. By addressing the health impacts of urban form and taking these corrective steps, Jackson’s hypothetical patient has moved his weight into the 65th percentile. There is still work to be done, but at least Jackson’s patient “has a girlfriend.”
Video of Dr. Jackson’s talk, Part 1 of 2
Video of Dr. Jackson’s talk, Part 2 of 2
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