Common Sense Health: Poverty and the failure of medical care in North America

By Dr. Gifford-Jones and Diana Gifford-Jones on October 18, 2024.

Recently, The Globe and Mail, Canada’s national newspaper, reported on a depressing study about diabetes and it’s costly and horrendous medical complications. Readers of this column would already know it. Fifty years ago, and countless times since, that same newspaper and many others printed my prediction that obesity and diabetes would bring the health care systems of both Canada and the U.S. to their knees.

Years ago, when I was in London, England to interview a researcher, I stayed at a hotel close to Westminster Abbey. I attended the Sunday church service there. One thing I’ve never forgotten was the sight of the children in the choir. They had been educated at the best schools, but as they marched down the aisle, it was obvious to me that many were chubby, well on their way to obesity and Type 2 diabetes in adulthood.

The Globe and Mail article discussed the poor health plaguing indigenous Canadians. The thrust of the article was a dismal failure pertaining to diabetes. It is evident in the swift one-hour surgery to remove one or even two legs of diabetic patients. In effect, it was easier to amputate than to fight this preventable disease. It’s a horrific truth that there is little rehab in these circumstances before these patients are out the door and left to a dismal future.

The article noted disparities in access to surgery across Canadian provinces and highlighted the crisis among indigenous populations. One in four residents in Sandy Lake First Nation have Type 2 diabetes. In the U.S., accessibility to treatment affects nearly half of Arizona’s Pimas, a group having among the highest prevalence of diabetes.

What was lacking in the analysis? It’s the straightforward message that people don’t like to hear. To fight obesity and Type 2 diabetes, everybody should be stepping on the bathroom scale every morning. The scale does not lie. If it indicates weight gain, intake of calories must be decreased, and exercise undertaken. Eliminate high-sugar desserts and increase dietary fiber. Stock up on motivation, and never, never believe that calories do not count.

Shakespeare was right when he wrote, “The fault, dear Brutus, is not in our stars, But in ourselves.” The point is illustrated by what I found years ago when I spent three days on the USS Nimitz aircraft carrier. Several dentists onboard could not keep up with the dental decay of sailors whose average age was only 19! Yet, this powerful ship, with massive technology aboard, could not teach sailors to brush their teeth! Yet again, the cost of so much health care service could not be achieved for lack of five or ten minutes daily of sensible prevention.

Can we decrease amputations? COVID infection, for instance, lasted just three years, killing millions. But obesity and diabetes increase year after year with no vaccine to stop it. Unfortunately, until obesity and diabetes complications strike, no one listens. Too late to act, people become blind, develop kidney failure, or lose legs.

Napoleon was once reprimanded, “Sire, worse than a crime, you have committed an error.” Society has committed a bundle of them. Poverty, a lack of nutritional education in schools, and simple carelessness have not helped. To repeat, a simple scale is an inexpensive start to better health for millions.

Unless humans get smart, there’s one hell of a train wreck ahead. Millions will suffer and die early. The medical profession will finally admit failure to resolve a disaster knowing this plague of negligence should never have happened.

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