The burden of chronic health issues is massive: 90% of the nation’s $3.3 trillion in annual health care expenditures are for people with chronic and mental illness, according to the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).
Even though in the United States we spend over $10,000 on health care every year per person, which is more than any other country, our life expectancy is below the average of other high-income countries. The most prevalent diseases include heart disease and stroke, cancer, diabetes, obesity, and arthritis.
Not only does bad health cost us our well-being, it also hurts the economy. According to a 2018 report by the Milken Institute, the total costs for direct health care treatment for chronic health conditions total $1.1 trillion annually, which is equivalent to almost six percent of the nation’s GDP.
It’s a big deal.
Why are we so sick? Obesity is by far the greatest risk factor contributing to the burden of chronic diseases in the U.S. In addition to being a risk factor, obesity is also considered a disease in and of itself.
What if, instead of paying for chronic illness, we redirected these massive funds to ensuring that our population has universal access to healthy foods? Could this make us better?
According to the United States Department of Agriculture (USDA), in 2017, U.S. consumers, businesses, and government entities spent a total of $1.62 trillion on food and beverages in grocery stores and other retailers and on away-from-home meals and snacks. A lot of that money was used to purchase ultra-processed foods.
Ultra-processed means that foods have been significantly changed from their original state with salt, sugar, fat, additives, preservatives and/or artificial colors added. They are less expensive in part because they are engineered to have a long shelf life, making them cheaper to store and transport.
According to research published in Cell Metabolism, limiting ultra-processed foods could be a key to weight loss. In a recent study, participants were given a diet of either ultra-processed or unprocessed foods that were matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber for two weeks. Participants were asked to consume as much or as little as they preferred. Not only did participants exposed to the ultra-processed diet consume more calories, they also gained weight.
These foods don’t just impact our waistlines. According to research by the BMJ, these foods also lead to an increased risk of cardiovascular, coronary heart, and cerebrovascular diseases and an increased risk of early death.
Despite these risks, these foods have become staples in our diets.
Almost 60% of calories consumed in the period 2007–2012 came from ultra-processed foods. Not surprisingly, sociodemographic factors greatly impact the level of consumption of ultra-processed foods, which were found to decrease with higher education and income levels.
In other words, the more money individuals have, the more fresh and perishable food they can afford.
When it comes to healthy eating, money matters. Increasing the money spent on food is linked to a better diet that includes more fruits and vegetables and results in a healthier weight and a decreased risk of obesity, diabetes, and cardiovascular problems.
A Spending Shift
Could shifting our spending from chronic disease to healthy eating fix our problems? In part, yes, but it’s not that easy.
When Americans have limited resources that they must stretch for groceries, it means purchasing less expensive options, like frozen meals and snack items. We need better standards for our grocery store aisles, meaning that food companies need to reduce the amount of salt, fat, sugar, and other unhealthy additives in their products. It’s a tough sell for companies that have spent years developing these additives and addictive combinations of salt, fat and sugar. Formalizing food standards that limit ultra-processed foods would require an expansive industry shift.
Making healthier foods more available in grocery stores, however, is just a start.
While whole foods and home cooking might seem like the obvious solution, again, it’s not that easy. Americans face other obstacles, specifically lack of time to prepare whole meals with work and school schedules. Shifting habits within families is particularly important; children learn from their parents about quick foods, and the cycle continues. Employers can help by shifting work culture to allow flexible schedules that make it possible for parents to prepare whole foods for their families.
Enacting policies that support family units goes beyond the dinner table to paid sick time and family leave— again, expensive.
An enormous selection of cheap, unhealthy foods paired with little time for proper food preparation creates a cycle of unhealthful eating that is making us sick. Even though it will be a hard cycle to break, shifting the trillions of dollars we spend paying for chronic illnesses to regulating ultra-processed foods and changing employer culture could work. After all, old habits die hard. But they have to die, or we will, sooner rather than later.