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When COVID hit, Americans watched the news in horror as the death toll rose and rose again, with thousands of deaths per day across multiple waves. The deaths from the virus were sudden and tragic, but today we live in a slower pandemic that also results in the tragic loss of life every day – from chronic, preventable diseases.
These deaths are often hidden in plain sight. For example, nearly a thousand deaths a day are linked to diet-related diseases — heart disease, complications from type 2 diabetes and liver disease. Diet now overtakes smoking as the leading cause of death worldwide. Chronic stress fueled by poverty and racism also contributes to preventable loss of life.
Chronic disease deaths aren’t tragic, but the tragedy is that despite having the most advanced healthcare system in the world – great doctors, top-notch hospitals, and plenty of medical breakthroughs – the United States as a country is not improving in health.
The pandemic was a wake-up call in many ways. Americans’ life expectancy fell during the pandemic, making a historic turn for the worse. And while countries around the world saw a recovery in life expectancy during the pandemic’s second year after vaccines arrived, the United States has not. This is especially true of Native Americans, whose life expectancy has dropped to 65.2 in 2021.
Variations within zip codes can be seen in the same case, as the life expectancy tracker shows. If you take a moderately wealthy zip code — 08542, for example, in Princeton, NJ — the people who live there can expect to live to the age of 90. Meanwhile, not too far away in less affluent Camden, New Jersey, life expectancy is much lower—around 74, a stark reminder that where you live affects the longevity you live.
And while access to health insurance and quality medical care is important, it does not guarantee good health without access to some basics, such as having a job, a safe place to live, and going to school. In fact, much research shows that poor health is driven by major social determinants such as stress, trauma, social isolation, racism, poverty, and lack of access to healthy food and other resources. For many Americans, the system is often stacked against their efforts to stay in shape. So what does it take to make the healthy choice the easy choice?
This year, NPR is publishing an ongoing series of stories called “Living Better: How Americans Can Regain Their Health.” We will tell the stories of communities and individuals who are bucking trends, by improving people’s health and life outcomes. And we’ll share the good new ideas that deserve to be spread, and the smart policies that deserve funding. The series begins with a collection of stories about children, because childhood is where health and wellness inequalities begin.
There is plenty of evidence that eating a healthy diet and incorporating movement into your life can help reduce your risk of disease. For example, the results of the Diabetes Prevention Study 20 years ago showed that changes in diet and lifestyle were more effective than metformin, a leading drug, in reducing the risk of developing the disease among people at high risk.
Long-term follow-up shows that the benefits can last. The challenge is obesity and diabetes rates continue to rise. So, what is the best way to motivate, educate, and empower people to follow recommendations to eat better and adopt other healthy habits? One way is to expand programs into community settings, such as incorporating the DPP program into YMCAs.
In addition, many healthcare providers are experimenting with ways to support healthy behaviors by providing medically designed meals or prescription fruits and vegetables, which aim to incorporate the food into medical care to treat or prevent diet-related illnesses. This is part of the growing Food is Medicine movement, and last year at a White House conference, the Biden administration announced more than $8 billion in private and public sector commitments to advance the agenda for ending food insecurity and promoting nutrition and health.
Another way is to take advantage of our understanding of human behaviour. Our habits are contagious. There is plenty of evidence that the people closest to us influence our daily choices. If you are around happy people, positive vibes can spread. If you stop smoking, it is more likely that your spouse or roommate will stop smoking too. Referring to your diet with a friend or family member can improve your odds of success. Social media habits can also be contagious.
Our coverage explores all factors that influence health, both on a personal level and within communities. Despite the challenges and barriers to good health, there are still reasons for optimism, and things we can do to thrive.