Janet Golden and Michael Yudell
In his 1938 book, My America, Louis Adamic wrote about answering the doorbell one morning during the Great Depression to be confronted by hungry children on their way to school. A girl spoke to him:“ Excuse me, Mister…but we have no eats in our house and my mother said I should take my brother before we go to school and ring a doorbell in some house…and ask you to give us something to eat.”
The following year, after having distributed some surplus commodities, through the Federal Surplus Relief Corporation, the United States Department of Agriculture (USDA) created an experimental food stamp program that lasted until 1943. Food insecurity was a problem then and it is today. A recent report found that 22 percent of Philadelphians were food insecure, lacking enough food for an active, healthy life. Yet the nation is in the midst of a congressional debate about the Supplemental Nutrition Assistance Program (SNAP), the descendent of the 1964 Food Stamp Act. A Robert Wood Johnson Foundation study of the impact of the cuts that some in Congress proposed found they would lead to greater poverty and food insecurity, with as many as 1.2 million children losing eligibility for free or reduced price school meals.
Opponents of the SNAP program claim it suffers from problems of fraud. That is not true; the rate is low and falling. Others claim that too many are eligible for SNAP. That is the result of our current recession, which began in 2007. Some wonder what people buy with SNAP. The answer is food—but no food that will be eaten in the store and no hot food. You cannot buy alcohol or tobacco products with SNAP.
We write about a lot of complex issues here at The Public’s Health. Issues that seem intractable, such as implicit racial bias and poverty. Issues that are ethically challenging, such as organ donation. Issues that have serious implications for future generations, such as climate change and fracking. Such complexity is the domain of public health.
Some public health issues, however, are more straightforward. The relationship between cause and effect is clear, as are the preventive actions that can be taken. This Fourth of July weekend, we revisit one of these issues—swallowing the wire bristles of grill brushes.
On July 4th last year, we posted a story about the dangers of swallowing the bristles of wire brushes that are used to clean grills. The small, but exquisitely sharp, bristles come dislodged from the brushes, rest on the grill’s surface, cling to food, and are ingested—potentially causing serious lacerations in the mouth, throat, and stomach.
I just got back from 10 days in France. Like John Travolta in Pulp Fiction, I was struck by all the little differences in Europe—how the toilets work, the way roads are designed, and the size of a meal. Wherever I went, the portion sizes seemed much smaller than what I was accustomed to in Philadelphia.
While visiting the École des Hautes Études En Santé (French School of Public Health) in the city of Rennes, I actually met a researcher who had empirically investigated my observation—he had walked around Philadelphia and gone to restaurants, not to eat, but to weigh the content of the food he was served. His efforts contributed to an interesting study, published a decade ago in the journal Psychological Science, which explored whether portion sizes are indeed larger in Philly than in Paris.
First, the researchers compared the weight of identical meals (e.g., pizza, chicken sandwich) at comparable restaurants in the two cities. On average, they found that portions were 25 percent larger in Philadelphia than in Paris. (Their data suggest that the Royale with Cheese in Paris was actually the same size as a Quarter Pounder in Philly, but a “medium” fries was 72 percent bigger).
What interests you: Disease sleuthing? Global bioethics? Protecting the food supply? Protecting yourself when you travel?
A new ranking of the top 30 public health blogs places The Public's Health at No. 14. The complete list is below. Lots of interesting stuff.
And if you want to go beyond reading about public health, join us at 6 p.m. Friday for “Blogging and Beer: Public Health in Philadelphia.” Also with us will be our editor at the Inquirer, public health writer Don Sapatkin, and some of our regular contributors. There is no cover charge for what we hope will be a lively discussion at Rembrandt’s Restaurant in Fairmount, one of several health offerings at the Philadelphia Science Festival that we mentioned last week.
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In just a few weeks, the City of Brotherly Love will welcome the third annual Philadelphia Science Festival — a 10-day-long, citywide celebration of science that features lectures, debates, hands-on activities, special exhibits, and a host of other science-related programming coming to a museum, bar, or random space near you.
We here at The Public’s Health will be participating in two events this year. On Friday, April 19 at 6 p.m. we will be hosting a discussion called Blogging and Beer: Public Health in Philadelphia. Our editor at the Inquirer, Don Sapatkin, will be joining us, as will some of our regular contributors. We expect to have a lively conversation at Rembrandt’s Restaurant in Fairmount. If you want to participate and enjoy good food and drink, please come! There is no cover charge.
On Thursday, April 25 at 7 p.m. I will also be participating in a wacky evening that is appropriately titled Sounds Made Up: Tales from the History of Science. It brings historians and comedians together at The Chemical Heritage Foundation at the edge of Old City to dramatize, in the silliest way possible, absurdities from the histories of science, medicine and public health. Last year’s rather risque event — the video above is from the year before — saw discussions of a medieval women birthing a cat, zombies, the history of the banana, and a discussion of Alfred Kinsey’s toothbrush.
In the wake of the New York State Supreme Court striking down New York City’s ban on sodas larger than 16 ounces, a surprising op-ed appeared in the New York Times. The essay encouraged New York City, despite the ruling, not to give up trying to limit the aggressive marketing tactics of big food companies and the soda industry. The surprise, however, was not the sentiment – after all, many public health leaders applaud Mayor Bloomberg’s latest effort to address obesity by regulating sales of super-sized sodas.
The op-ed, it turns out, was written by a former food industry insider, Kraft Foods executive Michael Mudd. Mudd had left the industry when he could no longer accept, as he called it, “a business model that put profits over public health.” Mudd argues that it is big food processors and soft drink companies who are the most culpable for the growth in obesity. “Over the years, relentless efforts were made to increase the number of eating occasions people indulged in and the amount of food they consumed at each. Even as awareness grew of the health consequences of obesity, the industry continued to emphasize cheap and often unhealthful ingredients that maximized taste, shelf life and profits,” he wrote.
Selling food and beverages to kids is big business. According to a recent Federal Trade Commission report, the food and beverage industry, including fast food restaurants, spent 1.79 billion dollars in 2009 to sell products mostly low in nutrition and high in calories, sugars, salt and fats to America’s children. Seventy-two percent of this was spent on fast food restaurants, carbonated beverages and breakfast cereals.
I am of two minds on the court decision Monday striking down the New York City Board of Health’s ban on the sale of sugary drinks over 16 ounces one day before it was to kick in. I applaud both the judge’s ruling and the mayor’s resolve.
The ban was declared “arbitrary and capricious” by New York State Supreme Court Judge Milton Tingling, whose ruling called attention to the ban’s loopholes, which “effectively defeat the stated purpose of the Rule.” Judge Tingling was referring to the fact that the ban limited sales at some locations (restaurants, movie theaters, and food trucks) and not others (corner convenience stores and supermarkets), that some sugary drinks were included and not others, and that there were no limitations on refills of smaller cups. The judge also ruled that the city Board of Health exceeded its powers in passing the ban. That power, Tingling argued, should lie with New York’s City Council.
Mayor Bloomberg has promised to appeal, calling the ruling “totally wrong.”
By Michael Yudell
Results of an important study out of Spain published last week in the prestigious New England Journal of Medicine suggests that a “Mediterranean Diet” supplemented by additional extra-virgin olive oil or nuts significantly lowered the risk of having a heart attack, stroke, or dying from heart disease.
But despite the media brouhaha—headlines like “Tasty Diet Curbs Heart Disease, Study Finds” and “Mediterranean Diet Study Rocks the Medical World”— the study's implications for you and me are still unclear.