Posts about Public Health

Investments in traffic safety finally began to matter in 2004. According to the Brookings Institution, "driving, as measured by national VMT, began to plateau as far back as 2004 and dropped in 2007 for the first time since 1980," obviously due to rising gas prices. As a result, the rate of traffic fatalities per 100,000 population finally began a much steeper decline in 2004 compared to earlier periods when safety improvements had been largely undermined by VMT increases.

But did this demonstrate the urgency of reducing traffic? Not according to NHTSA Administrator David Strickland, who said the following in a press release celebrating the decline:

This continuing decline in highway deaths is encouraging, but our work is far from over. We want to see those numbers drop further. We will not stop as long as there are still lives lost on our nation's highways. We must continue our efforts to ensure seat belts are always used and stay focused on reducing distracted and impaired driving.

Attributing the recent decline in traffic fatalities solely or primarily to safety improvements is not only sloppy statistics given that safety improvements have lead to steady declines in fatalities per VMT for decades. It also sends the wrong message—people can feel safe driving, as driving itself is not part of the problem—a message which will only increase VMT further and bring a halt to reductions in traffic fatalities.

Attributing the declining fatality rate to safety improvements also allows the myth to perpetuate that moving to the suburbs is safer than living in the city, a myth that, left unchallenged, increases VMT and undermines safety improvements. This myth was exposed by the New York City Department of Health, which recently revealed that their low VMT per child made NYC a much safer place for children than the rest of the country.

So why does the CDC, WHO, NIH, NHTSA and probably every other public health agency treat poor traffic safety as the preventable cause of the top killer of children worldwide, and not traffic as well? And how many children will have to die for this to change? Are we serious about public health? The sooner we start demanding honesty about the causes of the top killer of children here and abroad the better, because during the 2 minutes you spent reading this article, another child died in a traffic collision.

Compare the possible benefits of a soda tax to the cigarette tax. Taxing cigarettes has proven to be highly successful in reducing consumption. For every 10 percent increase in the price of cigarettes reduces sales by 3 to 5 percent and has lead to better health outcomes. Sugary beverages like soda can lead to negative health outcomes for children and adults. Obesity-related medical expenditures cost tax payers approximately 74 billion a year through Medicaid and Medicare.

A reduction in child obesity could lead to major savings for DC tax payers over the long term. In 2008 36 percent of high school students were clinically overweight and obese. If we assume that the patterns of obesity are the same among younger children, then about 41,000 children 18 and younger are overweight or obese in the District.

Researchers estimate that the cost of health care associated with obese children in 2008 is $15.97. If we multiply the number of overweight and obese children in the District by $15.97, then the total cost of obesity related health care is approximately $655,000.

While a small tax can generate millions, will it actually have the effect of reducing soda consumption? Most likely not. Studies indicate that a tax of at least 18 percent would be needed. Experts at the Rudd Center for Food Policy and Obesity argue that the tax needs to be high if we want to change American's addiction to sugary drinks. However, city council members and the voting public may be less willing to accept a tax much higher than 1 cent. Only those who truly think that obesity is a major problem for the district would be willing to pay a higher soda tax.

Opponents of a soda tax argue that a tax would disproportionately hurt the poor who spend a larger proportion of their income on food. This may be true, but only for poor people who consume more soft drinks. The bigger problem for low-income households is having access to grocery stores that offer healthy, affordable food options. It is no coincidence that areas of the District that lack access to grocery stores (mainly in Wards 5, 6, 7, and 8) tend to have higher rates of obesity than wards in the upper Northwest. Hopefully Cheh's program could be extended to provide food subsidies to families living in areas with few healthy food options.

The beverage industry is fiercely opposing the proposed tax. The Maryland-Delaware-D.C. beverage association and more than three dozen city grocers and restaurants have formed a group called No D.C. Beverage Tax. The group has run full-page ads in the Metro along with other local papers and radio spots.

The Campaign for Healthy Kids argues that the American Beverage Association has spent $5.4 million to fight various state and local initiatives to tax soda, and that DC is now it's new target. They have started a petition to urge the City Council to pass Cheh's proposal.

While much of the debate regarding the soda tax is focused on the "tax" itself, proponents of the tax need to focus more on the public health message. The purpose behind the Healthy Schools act is to fund nutrition programs and reduce consumptions of unhealthy products. Hopefully it will be the public health message, and not the industry message, that will resonate with city council members when the act is up for a final vote later this month. Pass the soda tax, it's good public health policy.

Petitte even gets it wrong, saying that the charge is for non-recyclable bags, while in fact it's for all bags. That means even if this bill had been far, far less impactful, she would still have been whining.

It certainly appears that area editors handed out assignments to "write about how bad new fees are." What else would explain this lede from Michael Laris' article in the Washington Post on the same topic:

Speeding drivers, tow truck operators and fast-food fans who prefer not to be confronted with calorie counts are among those who might be frustrated by new laws in Maryland in the New Year.

The law in Maryland mandates disclosure of information to consumers. It took quite a contortion for Laris to fit that into his list as something that could be bad for Marylanders. Next, will we see a story with a lede like, "Parents who prefer not to know about the lead content in toys their children put in their mouths might be frustrated by a new product safety initiative from the Obama administration"?

Most of these whiny articles don't bother to delve into the reasons behind the laws. They could have interviewed supporters and opponents of each to try to explain the arguments for and against, but that would just get in the way of phoning in the article and getting on with the holiday break.

The most content-free piece was the City Paper's "Confessions of a Wi-Fi Loafer" column, in which Christine MacDonald writes a whole post about how one Petworth listserv poster said charging for Saturday parking "completely sucks." I know it's the holidays and nobody wants to actually work, but the City Paper is still a newspaper. Are they thinking that some blogs involve people posting their quick reactions to items without any serious thought, and therefore they ought to get in on that?