Globalizing Health

The United States spends considerably more on health care (actually, disease care) than any other country in the world.  So, is all this money buying us the best health in the world?


Last week, the Centers for Disease Control and Prevention released a report showing that recent immigrants reported significantly better physical and mental health (such as lower rates of obesity and high blood pressure) than their U.S.-born counterparts, despite having limited access to health care and little or no health insurance.  The study found that people from other countries (African-American, Asian and Hispanic) who move to the United States become progressively less healthy the longer they stay in the country.  Those who were U.S. residents for five years or more were 54 percent more likely to have high blood pressure and 25 percent more likely to have cardiovascular diseases, for example, than those who lived here less than five years.

In other words, moving to the United States can make you sick. 

Why?  The diets and lifestyles in many other countries are much healthier than in the United States.  In our research, my colleagues and I found that an Asian way of eating (predominantly fruits, vegetables, whole grains, legumes and soy products) and living (moderate exercise, stress management and strong communities) may stop and even reverse the progression of coronary heart disease as well as prostate cancer. These lifestyle changes may also help to prevent or reverse diabetes, hypertension and obesity, as well as reduce the risks of the most common forms of cancer.

Unfortunately, the trend is moving the other way.  Other countries are beginning to eat like us, live like us and die like us.  They are rapidly forgoing their own healthier diet and lifestyle and copying ours.  As a result, a globalization of illness is occurring that is almost completely preventable.

In only one generation, cardiovascular disease, diabetes, obesity, and other chronic diseases have gone from being among the least common to the most frequent causes of premature death and disease in most of the developing world.  Cardiovascular deaths now equal HIV/AIDS deaths in most African countries.  It used to be uncommon to see an overweight person walking down the street in China or India, but not any more.

But because this is a recent phenomenon—they are on the steep rise of the exponential curve—intervention now can make a powerful difference.

A recent study found that reducing deaths from chronic disease by only 2 percent annually would prevent 36 million premature deaths in just 10 years.  Most of these benefits will be in low-income and middle-income countries, and almost half will be in people younger than 70, despite the common misconception that these chronic diseases are found mainly in old, affluent people.

This is an extraordinary opportunity to practice preventive medicine on a global scale.

It costs less to eat and live more healthfully.  Walking, loving, meditating, and quitting smoking are free and require no special equipment.

In contrast, it costs thousands of dollars per person per year for lifesaving drugs that are needed to treat HIV/AIDS, malaria, and TB in developing countries.  Thus, using diet and lifestyle changes to prevent and treat chronic diseases can free up significant resources for treating HIV/AIDS, TB, malaria, and other illnesses that do require expensive medications.  And these drugs work better when combined with good nutrition and healthier lifestyles.

Unfortunately, developing countries are now beginning to spend billions of dollars on angioplasty, bypass surgery and medications--much of which could be avoided by going back to their original diets and lifestyles.

Multinational food companies can play a large role in helping to prevent chronic diseases around the world by offering healthier choices in the United States and abroad.  For the past several years, I have been consulting with the CEOs of major food companies such as PepsiCo, McDonald’s, ConAgra, Safeway and Del Monte.  I thought that if they would make and market foods that are tasty, convenient, and healthful; educate people about the powerful health benefits of nutrition and lifestyle; and use their considerable marketing resources to make it fun, sexy, crunchy and hip to eat this way, exercise, stress less and love more, this could make a powerful difference in the lives of millions of people each day, both in this country and worldwide.  They can provide a full spectrum of choices from indulgent to healthful.

These companies are finding it’s not only the right thing to do, but also it’s good business as well.  Last year, for example, PepsiCo reported that 67 percent of its revenue growth came from its healthier foods.  McDonald’s introduced a Fruit and Walnut Salad with apple slices, walnuts, and grapes that’s become so popular it’s made McDonald’s the world’s largest purchaser of apples.  ConAgra’s Healthy Choice line of foods had $1.5 billion in sales last year.  Safeway introduced a successful new line of organic foods.  Del Monte’s Fruit Naturals (personal servings of fresh fruit sold in individual containers) have become among its most successful products.  All of these companies are emphasizing the importance of exercise and energy balance as well.

Are these companies moving as quickly as I might like?  Of course not.  But they're moving much faster than I ever believed possible.

Ironically, more healthful foods and lifestyle choices coming from the United States may help people in Asia and other countries realize the power of their indigenous diet and culture.  They can copy our successes, not our mistakes.

This is a great opportunity for food companies to show global leadership.  They can get credit for helping to solve the worldwide crisis in cardiovascular disease, obesity, and diabetes.  Also, they can get credit for creating culinary and cultural diversity.

By working together with organizations like the World Health Organization, the Clinton Foundation, the American Heart Association, and others, food companies can help people in these countries realize the value of their traditional diet and lifestyle.  They can also help educate consumers about the short-term and long-term benefits of exercise, smoking cessation, and stress management, both here and worldwide.  Instead of globalizing illness, we can globalize health.