Tuesday, January 12, 2010

Obesity the new #1 preventable cause of death - now what?

A study published last week in the American Journal of Preventative Medicine estimated quality-adjusted life years lost to both smoking and obesity.

Rather than going into the nitty-gritty of the study, and rather than opining on whether or not their stats are true or just statistical sleight of hand, I think the evidence would suggest it quite fair to simply conclude that obesity, like smoking, is very bad for your health.

So how many Canadians die a year due to obesity and diet related diseases? Conservative estimates ring in at around 25,000.

What about H1N1? Well according to the Public Health Agency of Canada H1N1 has killed 415 Canadians.

So how much money do you think the government has spent on H1N1 flu preparedness, immunization and awareness? I've seen television commercials, radio commercials, and print ads and I can't even begin to imagine the cost of immunizing the public and organizing the flu clinics. I can't fathom the dollars involved.

Want to make the argument that we didn't know how bad H1N1 would be and that we had to spend the money and the resources just in case? Fine. Let's talk West Nile Virus.

West Nile virus is probably a better comparison because just like obesity there's no vaccine and just like obesity public health campaigns consequently have to focus on education and prevention. Every summer there are spraying campaigns, television and radio commercials and print ads paid for by the Government of Canada telling us about the importance of bug repellent, long sleeves and getting rid of standing water. I'd be surprised if the government weren't spending between $50-100 million annually on West Nile related activities.

So how many people does West Nile Virus kill? Well, since 2002 there have been 38 West Nile virus deaths in Canada with the last death occurring back in 2005.

So 25,000 obesity and diet related deaths a year and what type of interventions are we seeing? None - except of course the most recent Ontario effort that ultimately will make bariatric surgery more difficult to get.

When are we going to start seeing hundreds of millions of dollars being spent on revamping nutritional education in schools, reforming school/hospital and city food, launching public health educational campaigns on the importance of eating frequently and understanding the energy in part of energy balance, legislation to put calories on menus, tax breaks for fresh whole foods, the creation of an evidence based and energy aware Food Guide, etc.?

Can you imagine how much money and resources would be spent and how much public awareness would be stirred up if West Nile virus killed 25,000 people each and every year?

Isn't it time to start taking the number one preventable cause of death in Canada at least as seriously as a disease that in the past 8 years has only killed 38 Canadians and in the past 5 has killed none?

Lubetkin EI, & Jia H (2009). Health-related quality of life, quality-adjusted life years, and quality-adjusted life expectancy in new york city from 1995 to 2006. Journal of urban health : bulletin of the New York Academy of Medicine, 86 (4), 551-61 PMID: 19283489