Happy New Year!

So it’s the time of New Year’s resolutions (and if you live in Wellington grumbling about the weather).* The newspapers didn’t have much copy over the last couple of weeks, so they were full of: “50 ways to be healthier in 2010.”

So I was delighted to see this post on The Fat Nutritionist called Don’t be Poor (and other New Year’s Resolutions):

The traditional 10 Tips for Better Health

  • 1. Don’t smoke. If you can, stop. If you can’t, cut down.
  • 2. Follow a balanced diet with plenty of fruit and vegetables.
  • 3. Keep physically active.
  • 4. Manage stress by, for example, talking things through and making time to relax.
  • 5. If you drink alcohol, do so in moderation.
  • 6. Cover up in the sun, and protect children from sunburn.
  • 7. Practice safer sex.
  • 8. Take up cancer-screening opportunities.
  • 9. Be safe on the roads: follow the Highway Code.
  • 10. Learn the First Aid ABCs: airways, breathing, circulation.

The social determinants 10 Tips for Better Health

  • 1. Don’t be poor. If you can, stop. If you can’t, try not to be poor for long.
  • 2. Don’t have poor parents.
  • 3. Own a car.
  • 4. Don’t work in a stressful, low-paid manual job.
  • 5. Don’t live in damp, low-quality housing.
  • 6. Be able to afford to go on a foreign holiday and sunbathe.
  • 7. Practice not losing your job and don’t become unemployed.
  • 8. Take up all benefits you are entitled to, if you are unemployed, retired or sick or disabled.
  • 9. Don’t live next to a busy major road or near a polluting factory.
  • 10. Learn how to fill in the complex housing benefit/asylum application forms before you become homeless and destitute.1

[these are quoted from a wikipedia article.]

There’s a visual illustration of the same idea at the food for thought pyramid. I disagree with the proportions, but I think it’s kind of beautiful. I particularly appreciate the large space given over to luck.

Oh and if you obsess over what you eat and exercise and still get cancer – it must be your attitude. “Healthy living” has to be a goal that is always out of reach, a set of behaviours that can always be added to.

The endless health tips and New Year’s advice are about policing, and making people feel bad so they will buy products (if you stop drinking one soda a day I will gratitously link to a Sarah Haskins Video). But that’s not the only purpose they serve.

The reason for repeating over and over again that we can individually control our own health, is to hide the fact that we can’t. It is to hide the fact that collectively, societally we could do heaps to improve people’s longevity and quality of life and we don’t.

I’d make a New Year’s resolution to write more about that, but I probably wouldn’t keep it.2

  1. It’s a great, but obviously incomplete list – don’t have ancestors who were colonised, be selective about the country you were born in… we could go on and on. []
  2. For the record my New Year’s resolution is to keep up with what Joss Whedon is doing. I’m setting myself up for success. []
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30 Responses to Happy New Year!

  1. 1
    Odoacer says:

    “don’t have ancestors who were colonised”

    Well, that would exclude pretty much everyone in the world. A Spaniard or Portuguese would have ancestors who were colonized by the Celts, Romans, Vandals, Visigoths, and Arabs. England was colonized by Romans, Saxons, Angles, Jutes, Danes, and Normans. (Asian) Indians have ancestors who were colonized by Aryans (the real ones, not the blonde ones), Greeks, Scythians, Pashtuns, Mughals, Portuguese, and English. There probably isn’t a country in the world that was not colonized at one point or another… maybe the Nordic countries (except Finland and Estonia) or Japan.

  2. 2
    Diatryma says:

    Odoacer, I see a distinction between migration and colonization. It’s a kind of blurry distinction, given the marauding-horde type of migration/invasion/colonization, but it’s there.

  3. 3
    Jeremy P says:

    “Odoacer, I see a distinction between migration and colonization. It’s a kind of blurry distinction, given the marauding-horde type of migration/invasion/colonization, but it’s there.”

    I don’t. What is it exactly?

  4. 4
    Robert says:

    Migrants come and live in an existing inhabited place, generally coming to join or work in that place, with no particular intention of replicating their original culture in their new home. My great-grandparents migrated from Italy to Mississippi, hoping to become Americans and get rich farming (1 out of 2 isn’t bad). They did not intend to make Mississippi part of Italy.

    Colonists come and live in a place with the intention of making it their own place, regardless of who lived there before. European settlers in New England were not coming to live with the Manhattan tribe; they were coming to take over Manhattan, intending to make it an extension or offshoot of their host country.

  5. 5
    Silenced is Foo says:

    @Robert

    All European nations still colonized each other, even by that definition (and Spain colonized by North Africa). The English language itself is an obvious product of that. The difference is time.

  6. 6
    Robert says:

    The difference is also in the appropriate response on the part of the people already living in a place. You should screen migrants, make sure they aren’t carrying terrible diseases or whatever, and then make them right at home and welcome their contribution to your society.

    You should shoot colonizers.

  7. 7
    Dianne says:

    How about “Don’t have ancestors that survived evolutionary pressures totally antithetical to current evolutionary pressures” or something to that effect, but more readable? I’m thinking in particular of US-American blacks descended from survivors of the middle passage and salt retention/hypertension.

  8. 8
    RonF says:

    The reason for repeating over and over again that we can individually control our own health, is to hide the fact that we can’t.

    What do you mean by “control” in this context? There isn’t a person on earth who can absolutely control their own health regardless of their income. Otherwise Ted Kennedy would still be with us. So I’ll agree that we can’t control our own health. No one can. Now, can we do things to improve and maintain our health? Of course we can. Do the things we can do overcome the things we cannot control?

    Maybe. That’s in part a function of our economic status. If you were born in a house on property soaked with dioxin or downwind from an asbestos-processing factory, by the time you get control over your own economic status and move out it may well be too late. And such properties are for various reasons undesirable, thus cheap, thus are owned by poor people. Yes, being born poor has added risk.

    But “being born poor” != “staying poor” or “ignorant”. People can and do improve their economic and social status over that of their birth. They can study in school, poor though that school may be. They can not become a parent before they are able to get married and support the child. They can not abuse drugs. They can put priority on healthy food over consumer goods. They can continue to get training/education throughout their lives rather than expect that the skill set they first entered the employment market with will sustain them for the next 40 years. They can decide that they should focus on taking responsibility for their own actions rather than focusing on external factors affecting them. They can take steps to improve their health habits.

    Is being born poor a disadvantage? Sure. I’m sure there’s a correlation and likely even a causal relationship between being born in poverty and having some health issues. I’ll agree that there’s good reasons both practical and compassionate to dedicate public funding and action towards things that alleviate conditions (e.g., making and enforcing laws against pollution). But that doesn’t mean that poor people have no control over their health. I find this statement too absolute.

  9. 9
    Phil says:

    I’m not sure how to interpret the tone of this list. Is the reader meant to infer that the first list, “10 Tips for Better Health,” is wrongheaded or inappropriate? Or is it reprinted in full just to show the template for the second list?

  10. 10
    Elusis says:

    Ron, let me interpret your comment here:

    “Bootstraps bootstraps bootstraps bootstraps bootstraps.”

    Saves space.

  11. 11
    Mandolin says:

    Of course, the economic system is built around the necessity of maintaining both a class of people who is poor and a class of people who is jobless. Even if everyone fulfilled their blah blah blah, there are not enough spots up the class ladder for everyone to be non-poor or for all job-seekers to work. So, since there is an inevitable class of poor and jobless people, perhaps we ought to help them, since no amount of bootstraps will strap everyone out of it.

  12. 12
    chingona says:

    Just to give a real life example, I was listening to Talk of the Nation the other day, and they had a fairly long segment on diabetes. Just about everybody hears all the time about how obesity is leading to an explosion of Type II diabetes. What was brought up in the segment is that Type I diabetes also is exploding, and that there is increasing evidence that both types of diabetes may be influenced by the presence of a variety of chemicals in our environment (I think it was agricultural run-off, but I don’t have time to find the segment and listen to it again right now. If I get time later, I’ll update.) So what do we hear about all the time? About how fatties need to show some self-control and eat less. What do we never hear about? Pollution. Which is individual and which is collective?

    Or look at cancer risk. Sure, don’t smoke, eat a low-fat diet, etc. But what about not living within a half-mile of a gas station? That can be hard to do if you live in a city. Should I not buy food that’s packaged in plastic? That’s pretty hard to do, too.

    It’s not that individual actions count for absolutely nothing, but that all our focus is on the individual when the collective actions could help a lot more people in more significant ways. But they would cost money and require political will. So we hardly ever talk about them. How convenient.

  13. 13
    Elusis says:

    Mandolin, I’m sorry, but I can’t hear you. My bootstraps are creaking too loudly.

  14. 14
    RonF says:

    Someone’s going to have to explain this “bootstraps” thing to me.

  15. 15
    Ampersand says:

    From phrases.org:

    Pull yourself up by your bootstraps

    Meaning

    Improve your situation by your own efforts.

    Origin

    The origin of this descriptive phrase isn’t known. It refers of course to boots and their straps (laces) and to the imagined feat of a lifting oneself off the ground by pulling on one’s bootstraps. This impossible task is supposed to exemplify the achievement in getting out of a difficult situation by one’s own efforts.

    It was known by the early 20th century. James Joyce alluded to it in Ulysses, 1922:

    “There were others who had forced their way to the top from the lowest rung by the aid of their bootstraps.”

    A more explicit use of the phrase comes a little later, from Kunitz & Haycraft’s British Authors of the 19th Century:

    “A poet who lifted himself by his own boot-straps from an obscure versifier to the ranks of real poetry.”

    Some early computers used a process called bootstrapping which alludes to this phrase. This involved loading a small amount of code which was then used to progressively load more complex code until the machine was ready for use. This has lead to use of the term ‘booting’ to mean starting up a computer.

  16. 16
    nobody.really says:

    Do Amp and Ron disagree? Over the years I have understood them each to conclude that certain aspects of our lives we can influence through individual initiative. Certain aspects we can control through collective action. Certain aspects we can’t control. Does anyone dispute this?

    Rather than actual disagreement, I perceive a difference of emphasis. Some people have an ideological commitment to the power of individual initiative. They may seek to congratulate themselves or their loved ones on their own good circumstances, and to avoid having to bear costs related to helping others. Conversely, other people have an ideological commitment to focusing on the need for collective action, or on hopelessness. They may seek to console themselves or their loved ones over their poor circumstances, or to justify seeking assistance from others. But mostly people seem to acknowledge the existence of other points of view, even while retaining their own emphasis.

    Here’s where the rubber meets the road: What do I tell my kids tonight?

    I try to deliver a reasonable dose of praise to my kids. They know that I’m praising them because I’m their dad. But I suspect it also bolsters them. Nurturing, not objectivity, is my goal. Given this goal, should I tell my kids that a huge amount of their life circumstances are completely beyond their power to influence to any great extent? Or should I tell them that they can become anything they want to be if they work hard? Or something in between?

    I suspect that the most successful people in life grew up believing that success is entirely within their own hands. I don’t subscribe to this belief – but I suspect it’s largely adaptive. Indeed, like Sancho Panza, I can’t help but be attracted to people with this can-do attitude. Heck, I’m also attracted to people of religion faith. Whether or not I share their world views, these are often people who are DOING things.

    For what it’s worth, I largely don’t tell my kids what I think about this. I really don’t have a fixed world view to share. (My wife, a very can-do woman, finds this endlessly perplexing.) But the next effect is that I emphasize individual initiative most of the time, and trot out uncontrollable circumstances when consolation is required. There’s nothing disingenuous about this; I sincerely believe that both dynamics prevail. But I have to acknowledge that I’m feeding my kids a collection of Just So stories – philosophies that account for all circumstances, but really predict or explain none.

    Sweetheart, let’s try out that Wii Fit that Santa brought, ok? If we’re going to portage that canoe this summer we’ll need to get it in gear. It’s all up to us….

  17. 17
    Mandolin says:

    It may be adaptive to believe that your own success lies within your hands — at least to a certain degree, or this too can cause neuroses.

    However, it’s another thing to believe that others’ social ills are the result of their laziness or lack of initiative, and that this justifies the conditions which exist on the low rungs of the class ladder.

    Again: Our system is built so that it requires a certain number of people to be poor and a certain number of people to be jobless. It is *impossible* for everyone to succeed. So even if everyone had initiative and drive and bootstraps aplenty — and even if that actually corresponded 100% to people’s ability to climb the class ladder — there would still be poor and jobless people.

    Also, the implication of these arguments is that people who are still poor lack drive and initiative. The implication is that they have not worked hard enough to succeed. This notion is dangerous, prejudiced, and incorrect. There are people who are driven, have initiative, work very hard, and are still poor.

  18. 18
    Myca says:

    Mandolin is wise and everyone should start listening to her.

    A certain level of unemployment/shitty jobs/poverty is necessary for the function of our economic system. It’s necessary in a really mechanical way, to the point that a major role of government is determining exactly what level of unemployment is necessary and working towards it. This is something we can and do affect on a policy level.

    In a very real way, if you have a good job, a nice home, a big screen TV, a Wii Fit and a canoe … it’s because of the suffering of another. We all live in Omelas. It’s just the way things work, and no amount of Norman-Vincent-Peale-meets-The-Secret-power-of-positive-thinking rhetoric will change it.

    So, if that’s the case, the question, it seems to me, is now how much suffering is necessary … if some is, that’s one thing, but shouldn’t we try to minimize it? And, at the very least, shouldn’t we stop telling those suffering for our benefit that they deserve it?

    —Myca

  19. 19
    Simple Truth says:

    Thank you, Mandolin. Just, thank you. I’ve been too pissed off by the privilege evidenced on this thread to put together a coherent post, but you’ve said it for me.

  20. 20
    Ampersand says:

    I agree with Mandolin, Myca and S.T.

    Myca wrote:

    It’s necessary in a really mechanical way, to the point that a major role of government is determining exactly what level of unemployment is necessary and working towards it.

    It should also be noted that our government is actually a lot more proactive and determined when it comes to keeping unemployment from being too low. Although there’s a little, tiny, not very enthused bit of movement from Congress and the White House to reduce unemployment, the people who could actually do the most to lower unemployment — the Federal Reserve — are completely uninterested in doing so.

  21. 21
    Myca says:

    Although there’s a little, tiny, not very enthused bit of movement from Congress and the White House to reduce unemployment, the people who could actually do the most to lower unemployment — the Federal Reserve — are completely uninterested in doing so.

    Right. And they’re keeping it high because of fears of … inflation. Which, were it to rise, would be good for those deep in debt, and bad for those with a lot of money.

    Which just reinforces the point. It’s a trade-off to some degree, and the choices we’ve made aren’t very good for aiding the poor and encouraging employment. A certain degree of humility an empathy on the part of those our policies tend to benefit is necessary.

    —Myca

  22. 22
    Robert says:

    Again: Our system is built so that it requires a certain number of people to be poor and a certain number of people to be jobless. It is *impossible* for everyone to succeed.

    Not really.

    Our system is built so that it requires differential reward to incentivize behaviors that people might not choose on their own, but that contribute greatly to social welfare in the short or long runs. That differential can be brutal, and brutalizing, for those on the short end of the stick.

    But the shortness of the stick is not built-in; it is contingent on the actual level of societal wealth. You can have a (more or less) capitalist system at a medieval, or even a classical/antiquarian age, level of wealth – and the bottom end is going to be awful. You can have a capitalist system at a “Star Trek” level of social wealth, and the bottom is going to look like utopia. We’re in between.

    In the end, the position of the very poorest is largely a question of the society’s performance at overall wealth creation and how that wealth gets spread around. The bottom line value is of course bounded by material realities, but more bound by the human capital possessed by the society’s members, and very tightly bound by the choices of social organization.

  23. 23
    Robert says:

    Myca – inflation might be good for people with debt, but it’s death for people on fixed incomes and the working poor. And even its debt-fixing properties are largely illusory beyond the shortest of short-term outlooks; great, you got out of those college debts because of the hyperinflation of 2011. Too bad your kid can’t go to college, because they all shut down, owing to the economic collapse brought on by the hyperinflation of 2011.

  24. 24
    Ampersand says:

    Rob, using the example of hyperinflation to argue that the gains of moderate inflation are “largely illusory” is intellectually unjustifiable.

    At a time of extremely high unemployment, an inflation target of around 3% would be extremely beneficial, on the whole (which isn’t to say it wouldn’t be bad for any individuals — but it wouldn’t be as bad for as many as the status quo is).

  25. 25
    Robert says:

    Mild inflation, in general, is bad for everyone, not good for everyone. The benefits go to a small number of people: those hired owing to Keynesian wage-rate adjustment and those in heavy debt.

    Everybody else gets a few percentage points poorer.

  26. 26
    Ginsu Shark says:

    “maybe the Nordic countries (except Finland and Estonia) or Japan.”
    iirc, the Japanese are the colonizers of Japan, taking it from I believe the Ainu who were already there…

  27. 27
    Robert says:

    The Ainu are probably descended from the original paleolithic-era inhabitants of Japan. If there was someone else there before that, we don’t know about it. The non-Ainu Japanese are a much later settlement wave; Japan is a colonized nation.

  28. 28
    RonF says:

    We’re getting a little far afield here. The original post says

    The reason for repeating over and over again that we can individually control our own health, is to hide the fact that we can’t.

    and I think that’s wrong. Can rich people do more than poor people? Yup. Money brings options. But to say that people (regardless of income, apparently, given the way the statement was worded) cannot individually exert at least a worthwhile level of control over their health is wrong.

  29. Pingback: Guest Post: Environmentalism Using Obesity Metaphors » Sociological Images

  30. 29
    nobody.really says:

    Hey, check out that link at 29, above.

    Environmentalists often use the metaphor of illness to illustrate environmental harm: planet earth depicted as as sad face with a thermometer in its mouth. More recently the metaphor for health has shifted to thinness, and obesity is the depiction of illness. This leads to a curious visual anomaly: Planet Earth depicted as healthy when it loses its round shape and develops a waist!