Thoughts on PFCD launch

I attended the launch of the New Jersey chapter of Partnership to Fight Chronic Disease (PFCD-NJ) on Tuesday. The event had Dr. Fred Jacobs, David Knowlton, former Governor Jim Florio, and Dr. Richard Carmona, the 17th Surgeon General of the United States as speakers.

While the media was more interested in the political aspect of the initiative, the reports can be found in the Bridgeton News, in the Gloucester County Times, and in NJN News which is only temporarily available, I was far more interested in how the individual will be convinced in making the right decisions everyday of their lives.

I asked Dr. Carmona what was the biggest obstacle to the goals of PFCD-NJ. According to him, it was education, education about what chronic disease, educating all levels, from the individuals to the federal government. I, however, took this as the best-case scenario, that you only need to educate people and you can trust them to make the right decision. The problem with chronic diseases is that, it is very difficult as individuals to appreciate the long term consequences for choosing a hamburger over a salad. We are far more interested in instant gratification of our immediate needs/desires at the cost of longterm benefits. This isn't true just for our diet-health issue, but also true when it comes to energy-climate change, budget-economy, and so on. We attend to our immediate needs, whether it is in terms of food, fueling our SUVs, or purchasing houses we can't afford, and sacrifice the future to serious problems such as chronic disease, climate change, and collapsing housing markets. It is simply endemic to our national culture.

So, the question remains, how do we convince the individual to change their behavior? We are really asking for a cultural shift in making people think of their health as the framework in which people choose what to eat and in how much exercise they engage. While this is a the longterm goal, the intermediate step will require associating a cost for making poor health decisions. This is very similar to our current energy crisis. It took $4/gal for gasoline to bring about a cultural shift in how much we drive, how much we use public transportation, and what kind of cars we choose to buy. Similarly, the state of Alabama, on which I had written about earlier, is exacting a cost on its employees who do not meet certain health standards. This proactive program by Alabama has been misrepresented in the media as only targetting the obese, even though Alabama is one of the top states to suffer from the disease. The program looks at a wide range of factors that lead to chronic disease with BMI being one of the factors taken into consideration. Whether the program is successful in lowering the chronic disease and the cost associated with treatment will be known in the future. Not addressing the issue is simply not an option.

When it comes to New Jersey is this an appropriate model to follow as well? Unfortunately, this is a political decision and one which the political establishment has yet to take a serious look. Dr. Carmona is probably right in the end. Chronic disease is a serious issue but it is simply not being taken seriously here. Apart for a few leaders, we simply haven't entered into a discussion about this issue which will play prominent role in our state's economy in the near future.