Is Mandatory Dieting and Exercise Next?


A new study published in the journal PLoS Medicine finds that changing four preventable risk factors could substantially increase average life expectancy and reduce disparities in life expectancy between ethnic groups in the United States. As ScienceDaily reports:

A new study led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington estimates that smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the U.S. by 4.9 years in men and 4.1 years in women…

Below is the number of years that would be gained in life expectancy in the U.S. if each individual risk factor was reduced to its optimal level:

  • Blood pressure: 1.5 years (men), 1.6 years (women)
  • Obesity (measured by body mass index): 1.3 years (men), 1.3 years (women)
  • Blood glucose: 0.5 years (men), 0.3 years (women)
  • Smoking: 2.5 years (men), 1.8 years (women)

Certainly these findings can be usefully publicized with the goal of influencing people and their physicians into making better lifestyle choices. The researchers, however, have other, potentially more coercive, goals in mind:

"It's important that public health policy makers understand that these behavioral and metabolic risk factors are not just personal choices or the responsibility of doctors," said Goodarz Danaei, a postdoctoral research fellow at HSPH and the lead author of the study. "To improve the nation's overall health and reduce health disparities, both population-based and personal interventions that reduce these preventable risk factors must be identified, implemented, and rigorously evaluated."

"… not just personal choices…?" Back in a 2006 column looking at the ongoing erosion of the distinction between public and private health, I noted:

If the United States finally succumbs to universal government funded health care, health bureaucrats will no doubt justify their intervening in the exercise, dining, transportation, smoking, drinking, and recreational drug choices of Americans on the grounds that they are saving taxpayers money. We might all live longer, but we will certainly be enjoying it less. "There are lots of good reasons to do this kind of thing, but the questions it raises all have to do with the nanny state: Should the government be collecting this kind of information? Should it be intervening like this?" said Lawrence O. Gostin, who directs the Center for Law and the Public's Health at Georgetown and Johns Hopkins universities in the Washington Post last month. "You can imagine it getting to the point where you have a public health worker showing up at your door and asking, 'Did you remember to exercise, eat right and take your medication today?' "

Coming soon: Mandatory daily calisthenics outside your home so that the authorities can monitor your compliance?

For more on the totalitarian implications of public health see my colleague Jacob Sullum's superb feature article, "An Epidemic of Meddling."