Friday, November 28, 2014

Tell Us Something We Don't Know

A recent report from Health Day tells us about new research on healthy eating.  Results were presented at the annual meeting of the American Public Health Association and revealed that “home cooking is better than restaurant fare, and that kids who are offered more nutritious food in school cafeterias rarely eat it.”  This is not exactly earth-shattering news.  It seems more like stating the obvious and backing it up with a couple of studies, however, the conclusions should be “viewed as preliminary until published in a peer-reviewed journal.”  That means they will not be sure until someone else has duplicated these studies and found similar results, but it makes perfect sense based on experience.

First, the idea that eating out rather than at home can be the healthier choice flies in the face of everything we have been hearing for the past decade.  The government has both pressured and required restaurants to post calorie counts and other information on the menu to give diners a chance to consider their options.  The Internet is filled with tricks and tips about how to eat healthy when away from home, strong evidence that it can be the less healthy option.  Here's a list of tips from the Academy of Nutrition and Dietetics that was reviewed two years ago, which implies that it was out for longer.  It lists activities for preparation, choosing a restaurant, ordering and recommends eating more slowly to avoid overeating.  Restaurants present more choices, more food and the enticement of a dessert – you don’t even have to get up to get it.

The potential dangers of eating too many meals at restaurants have been discussed for many years.  The healthy eating advocates and others have been encouraging more meals at home, especially more meals as a family, for several reasons including this one.  Unless you are very careful, too much restaurant eating leads to excessive weight gain (and it’s more expensive, too).  It’s not like this is a surprise.

Next we hear another example of how the government can’t legislate behavior.  When the government dictates menus to schools, in effect telling kids what they must eat, the kids will avoid or ignore it.  In my personal experience I’ve talked to a couple who volunteered to help feed the “food insecure” children in a summer program.  The program had to follow certain nutritional guidelines, but after the meal the trashcans were full of unopened vegetable cups.  In another case, a mother complained about having to give her daughter enough lunch money to buy two lunches because the girl found a single serving was not sufficient.  These may be single observations, anecdotal evidence, but I’m not surprised to find that it appears to be a universal problem.

Again, lots of experience tells us that it’s a challenge to get kids to eat their vegetables.  Some scholars even argue that it’s the result of ancient genetic programing for survival in case the green stuff is poisonous.  Left unsupervised (or un-nagged) most kids will figure out a way to dispose of the dreaded vegetables.

Thanks to the American Public Health Association we now have research to confirm (pending peer review) what we already knew and observed for many years.  Healthy eating is about behavior for both children and adults.  Researchers can publish studies telling us what we already know and government agencies can institute regulations, but any real and lasting behavior change must come from individuals who are motivated to change.   Until that happens, we will continue to get the same results in terms of overweight and unhealthy citizens.

Monday, November 24, 2014

Black Friday Choices

This Friday is Black Friday, so let’s talk turkey about holiday spending.  The New York Times tells us that falling gas prices will spur holiday spending.  Low- and middle-income families, “the most economically fragile part of the population (are) already feeling some relief, which is likely to lead to extra spending on a variety of other goods and services.”  The Wall Street Journal reinforces this notion by pointing out that October results show that “U.S. consumers are spending more at restaurants as gas prices fall.”  They are not alone in their predictions; we hear the same from other sources.

That’s probably good news for the fat-cat investors as retailers may surpass expectations and the stock market will continue to rise, but ultimately bad news for those low- and middle-income families who immediately spend the windfall.  According to these news agencies and the statistics they gather, Americans don’t have the discipline or willpower to put away the extra cash for emergencies.

Just last summer, a survey, based on telephone interviews with more than 1,000 adults, a reasonably large sample size, told us that only 23% of Americans had the recommended emergency savings to cover six months of expenses, and over one quarter, 26%, had no emergency savings at all. 

One in four, of these most economically fragile are living paycheck to paycheck.  Management theory tells us that people make changes only when the effort of changing is less than the pain of not changing.  Is the pain, fear, or insecurity of living paycheck to paycheck not great enough to motivate people, who find a little extra in their wallet after filling the car, to put some aside for a rainy day? – Apparently not. 

I remember back in earlier times when the gas prices spiked and there were more incidents of drivers out of gas on the side of the road explaining how they could only afford to fill the tank half way.  If all the extra money goes to gift buying and restaurant meals, how will they manage during another rebound in gas prices?  Furthermore, how will they be able to afford even higher deductibles on health insurance in case of a medical emergency?  (Last year the average individual deductible for ACA’s silver plan was $2907 and expected to increase.)   These are the things an emergency fund is used for.

Unspent gas money is insignificant compared to possible unexpected expenses.  Put it in the bank; stuff it in the mattress!  Those who just decide to spend it are making an unconscious decision to remain in that category referred to as "the most economically fragile."  But I guess the pain is not yet bad enough.

Friday, November 21, 2014

Objectives and Accountability

"I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to the earth.”  Everyone should recognize those as the words of John Kennedy.  When he made this declaration, it was, and still is, uncharacteristic of a governmental action.  It had a specific objective, to get a man safely to the moon and back.  It had a clear timeframe, by the end of the 1960s.  Everyone in the world would know if the US achieved its objective and would hold us accountable.  Such a commitment requires the people involved to develop a project plan with steps and milestones to be achieved by certain points along the way.  If these milestones are not achieved, an investigation of the causes for delay or failure leads to adjustments or mid-course corrections.

Now I look at other government programs and private charities and wish for some movement in this direction.  Of course, I alone wishing is not going to make it happen, but with a nation full of critical thinkers, the pressure would be on to produce and publicize results and not rely on the feel-good messages that are intended to hook us and separate us from our votes or our dollars in pursuit of a noble, but vague cause.

The War on Poverty did not meet the same criteria.  It had an objective stated clearly by Lyndon Johnson in his State of the Union address:  “"Our aim is not only to relieve the symptoms of poverty, but to cure it and, above all, to prevent it."  Missing was a timeframe, so today we are still fighting.  No milestones have been set and mid-course corrections are ad hoc, moving us no closer to the objective.  Each one looks like a caring effort, so they are accepted as the right thing to do, but they don’t have objectives or timeframes of their own, so no measurement or critique follows.

This graph below shows that from implementation in 1967 to 2009, little progress has been made – the comparable 2013 census number was 14.5%.  not setting a timeframe leaves things wide open.

 A key program of the War on Poverty was Food Stamps, now renamed Supplemental Nutrition Assistance Program, or SNAP.  Though “supplemental” is part of the name, we still hear many politicians and reporters complaining that you can’t feed a family on the amounts provided.  The expectation, the objective seems unclear or it has changed in some people’s minds.  No wonder there is confusion.

Many charities have a similar issue.  The recommended way to judge them is by how much they pass along compared to how much they spend on salaries, advertising and other administration.  What about results?  Some charities are very clear about where the money goes, how many people they feed, how many trees they plant, etc.  On the other hand, if you give money to a charity to find a cure for a disease, do you know where the money goes?  What research is being supported?  How does that research relate to curing the disease?  When we hear on the news that a new breakthrough has been achieved toward the cure of a disease, they never tell us where the money came from to support the research.  How much coordination is there between research organizations vs. how much competition?  Is the competition a good thing, motivating scientists to strive harder, or is it counterproductive motivating them to hide partial findings?  It is surprising how much we don’t know once we have finished the walk and handed in the pledge cards.  It’s also surprising how few people are even curious about it.

Others promise to help veterans or to eliminate domestic violence, but the details are missing.  What veterans?  Help with what?  What are the plans for beneficial domestic violence interventions?  They can’t be held accountable with no measurable objectives.  When no one really knows how much progress is made with the donated funds, does it really matter what percent is used for administration?

Critical thinking makes us curious to get the facts, keeps us asking the next question instead of being swept away by the good feelings and virtuous intentions of the politicians and fundraisers.  More questioning holds them accountable, which results in better programs and more successes.  

Monday, November 17, 2014

More on Celebrity Hype

See how desperate the news media is to get our attention by attaching a story to a famous name.  Here is a headline about the brother of a former NFL player entering into a plea agreement.  I wonder how many times this type of plea agreement activity happens every day across the country.  But when there is some way to attach the name of a wrongdoer, ever so remotely, to an athlete, a movie star or a politician, it becomes what passes for news these days.

Similarly we very often hear news about the Royal Family.  America doesn’t even have a royal family so we have to borrow one from Great Britain.  It is a way of fulfilling the needs of little girls who dream of becoming princesses and satisfying others with their romantic concepts of royalty.

So when little Prince George goes on his first overseas trip, it’s covered on the evening news in the US and pictured in our newspapers just like regular news.  The only way some Americans knew that the UK sent soldiers to the Middle East is because Prince Harry’s deployment was featured in a news story.  The late Princess Di was so popular in the US that tabloid newspapers were paying big bucks to paparazzi for candid photos, a dynamic that likely contributed to her untimely death.

I needn’t dwell on how the activities and misadventures of our own celebrities are covered, especially after the fuss about George Clooney’s wedding, a story that was resurrected when the designer of the gown, Oscar de la Renta, passed away a few weeks later.

Many years ago these kinds of stories were covered by a small number of reporters known as gossip columnists.  They made a living by covering celebrity events along with the seamier side of Hollywood.  Today, with our far-reaching and instant mass communications, we have promoted so many people to celebrity status that a few columnists are unable to cover the whole gamut.  We worship, in a way, professional and top-tier amateur athletes, movie and television stars – even some manufactured stars on reality shows, corporate CEOs (such as Ted Turner, Donald Trump, Jack Welch, or Lee Iacocca), singers, dancers and models. 

It’s a little appalling to think that the gossip columnist of today are the AP and the “hard news” shows, but if you look at what they bring us on a regular basis, there is no getting around it.  Appalling, yes, but they do it for a good reason.  They are pandering to the low levels of perspective of the American people.  An aspect of perspective, remember, is the ability to separate the trivial from the substantial.  As long as corporations and politicians can feed our fascination with, in many cases addiction to, the trivial, even stretching it to formerly unknown relatives of celebrities, they can continue to sell us things we don’t need, including the news, by insisting on its importance.