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Regulations and Fads

The first part of this chapter will examine the government’s role in propelling the occupational health failures of the country. The next section will discuss reasons the private sector gives for not supporting health promotion activities. The third section will look at health trends during the United States’ history. The cause and effect relationships of historical events and changes in our society’s health will be debated. The chapter will end by addressing the country’s future health goals.

The National Institute for Occupational Safety and Health was created by the Occupational Safety and Health Act of 1970 in order to reduce the number of safety and health hazards at places of employment (NIOSH). The Occupational Safety and Health Act was written to encourage employers to implement safety and health programs in their workplaces. The Occupational Safety and Health Act demanded full access to employers’ self audits and assessments to identify potential violations. Instead of motivating organizations to keep health records, OSHA discourages companies from conducting health and safety evaluations because they grow to fear being punished by the NIOSH (Ballenger). In 1995 Representative Cass Ballenger said, "I believe that the Occupational Safety and Health Act has become fundamentally misdirected, and instead of promoting and encouraging workplace safety and health, Occupational Safety and Health Act has become known for issuing silly regulations and is preoccupied with collecting fines from unsuspecting employers"(Ballenger). Instead of helping solve the problem, the government is making the solution more difficult to find.

A major reason why many economists and private industries argue poor health should not cause a need for change is the idea people who die earlier save money because they never draw social security benefits, receive private pensions, or have to stay in a costly nursing home (Miller). When economists hear that smoking causes over fifty billion dollars a year in medical bills and another forty-seven billion dollars in time off the job and four hundred-thousand smoking-related deaths yearly, they respond that nursing home and pension savings from tobacco-related deaths save thirty billion dollars yearly (Miller). Unarguably smoking saves the country money in several ways, but Jeffrey Harris, an MIT economist, points out that a civilized society does not engage in such an approach. He gives an example of breast cancer research. When Congress increases funding for breast cancer studies and treatments, it is not questioned whether or not more survivors will hamper social security (Miller). Others believe that the effects of second-hand smoking, increased hospital care for infants with low birth weights caused by smoking mothers, and general annoyance caused by smokers are not calculated in the total cost of smoking to society (Cooper, J). How many nonsmokers are eager to sit at a restaurant next to a table of smokers? This is an example of the nuisance smokers deposit on nonsmokers. A conclusion cannot be made without weighing all possible statistics and possibilities. The debate over this issue will likely continue far into the future, but it seems hard to believe American society would allow for any group of people to die a premature death simply because it saves money.

The principles of good health have been preached for thousands of years. Hippocrates was the first man to write about the dangers of poor physical health. Hippocrates’s writings concentrated on the dangers of being obese and believed those who were slender would live longer lives. His instructions for diet stressed a need for moderation and the belief that drastic changes should not be made in one’s diet. He believed even a poor diet was better than an overnight reversal of one’s dietary habits (Adler).

Obesity has been looked down upon in America since the colonial period, when overconsumption of food was associated with an inability to take on the responsibility of work (Goldstein 41). As early as 1830, Americans were beginning to believe its people were growing weak from lack of hard work (Goldstein 73). Religious factions rose to prominence in the first half of the century, notably the Christian Physiology Movement, and preached basic hygienic practices which would lead to a moral life (Goldstein 26). The religious leaders stressed the need for proper nutrition and frequent exercise. Notable philosophers also recommended the need for good physical health. Henry David Thoreau wrote, "I never feel that I am inspired unless my body is also" (Goldstein 75). It seems obvious that Thoreau knew exercise was necessary to lead a more complete life. America had never experienced a craze for one physical activity until the 1870’s when bicycling became the first exercise fad in the country (Goldstein 78). By the turn of the century, Americans began an emphasis on being slender which has continued to the present day (Goldstein 48). The appeal for a slender body propelled the health foods industry. C.W. Post and the Kellogg brothers were two competitors whose names are still well known today. Dr. John Harvey Kellogg preached the ills of meat, benefits of exercise, and the debilitating effects of sex at his Battle Creek sanitarium (Boyle 468). The new outlook on physical health also began changes in the workplace. American industry began to institute regular physical exams for prospective workers shortly after the turn of the century under the theme of "fit for work"(Goldstein 130). The government became involved with the nutrition of Americans in 1916 when the first official food guidelines were published by the Department of Agriculture (Goldstein 52).

An event which greatly contributed to a decline in Americans’ health is World War II. Before World War II the United States was still recovering from the Great Depression and Americans could not afford to buy large amounts of meat or butter, but after the war prosperity spread throughout the country and Americans could live the "good life." Jeff Galloway writes about the 1950’s, "The Air Force became concerned when its pilots started dying of heart failure, often bringing multi-million dollar planes down with them" (Galloway 19). During the war Americans had to ration meats, butter, sugar, fats, oils, and coffee which likely decreased the number of health problems experienced, but after the war they were free to buy whatever they wished ("Government Controls") . Technology increased rapidly, and the invention of the television gave Americans one more reason to stay home. An ideology of health explains the effects of the war and its aftermath. Michael Goldstein writes, "As society became industrialized, people grew apart from nature and became less healthier than before. Mass transit and automobiles made us give up walking; the family farm gave way to an agriculture industry with pesticides, frozen foods, and preservatives. Natural rhythms of daily life gave way to the stresses of career and the crowded, polluted urban environment"(Goldstein 29). The period after World War II was also before the Surgeon General reported that tobacco and smoking led to heart disease and cancer, and it was not until 1960 that the general medical opinion believed that exercise would benefit the common man (Goldstein 83). This made Americans even more susceptible to the effects of heart disease and cancer.

Starting in the 1960’s Americans were aware of the benefits of exercise which included a reduced risk of premature mortality, lower cases of heart disease, hypertension, lack of depression, improved overall mood, and a greater ability to perform daily tasks. The Surgeon General also first reported the harmful effects of tobacco use in 1964 (Surgeon General). In the working environment, occupational health departments started stressing a move away from the "reactive department" to a more "preventive position." Instead of waiting for sickness and disease to occur, experts began trying to treat causes instead of effects (Cooper, C 54).

The current status of the health movement shows young adults, women, and those with a college education are most active in the health movement (Goldstein 121). Despite a great deal of scientific evidence showing the benefits of exercise and maintaining physical health, only a minority of Americans exercise frequently. In the 1996 Surgeon General’s report, it states more than sixty percent of American adults are not regularly active, and twenty-five percent of the adult population are not active at all. The problem in the 1990’s is how to help people aim for individual physical health goals which are achievable(Surgeon General).

Possible human causes of poor physical health include our demand for instant gratification, lack of discipline, and work stress (Quick 54). Instant gratification has been said to be the dominant value in American society (Goldstein 34). If people have to wait for something, they often do not wish to do it for long periods of time and simply give up on their goals. When people are questioned about why they do not exercise, lack of time and discipline are the two major reasons given(Goldstein 92). The psychologist William James writes, "Never suffer an exception to occur till the new habit is securely rooted in your life." Perhaps Americans have a great difficulty in changing their daily habits. Studies have shown failure rate between eighty and ninety percent for diets, and the Surgeon General has stated that most people do not sustain participation in exercise programs (Surgeon General). A person’s working environment can also contribute to a decline in his or her health. Work stress is caused by jobs which lack variety, do not incorporate creativity, and demand too much from an employee (Quick 54). An employee who is under a great deal of stress has a far greater chance of encountering health problems compared to the average man or woman. In all facets of wellness, the goal of health is defined as something positive, but often Americans encounter difficulties along the way which turn health and fitness into a negative thought (Goldstein 18).

Nutrition has also caused a decline in the health of many Americans. Proper nutrition can be expected to help prevent disease and promote a healthy lifestyle. Poor dietary habits can contribute to the development of heart disease, stroke, and certain types of cancer. Nutrition practices and a non-active lifestyle account for at least three-hundred thousand deaths each year according to the American Medical Association (Johnson). Diet is considered a major factor that can be changed to slow the development of cardiovascular diseases, such as a heart attack or stroke. A worker who has a stroke or heart attack is especially costly to his or her employer. Most people who suffer a stroke or heart attack survive, but spend the rest of their lives severely disabled which can be especially costly (Johnson). The saying, "You are what you eat," is often very true and should be heeded by Americans who practice poor nutritional habits (Goldstein 41).

In past centuries many groups have preached the benefits of daily health habits. Many people did not listen to them because they lacked the evidence needed to prove their point. Now in the twentieth century and beyond, with sufficient technology to provide preventive care and diagnostic tools, experts are able to tell Americans what they should and should not do. Society can not force itself on the individual, though. The individual or organization will decide what he, she, or it wishes to do with their life or business. Personal misbehavior and environmental conditions under our control cause sickness and eventually lead to our deaths. Health demands personal responsibility, and it is our choice whether or not to be accountable for our well-being (Goldstein 19).

The next chapter of The Health Connection will solve the problems described in "Regulations and Fads" and the previous section in a realistic workplace setting.

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