So I listened to Vox’s The Weeds podcast on the relationship between public policy, public health, and eating yesterday. They are particularly interested in the use of nudges and nags to improve healthy eating and healthy outcomes. It made me think of a few things. There’s no grand point here, just some impressions.
1. Maybe two years ago, I was holed up in a coffee shop that I used to go to regularly, sweating through my dissertation prospectus. I was chatting with the owner’s son who was working the register. I had noticed that an awful lot of people came into the shop and just got Cokes — big, 24 ounce Cokes. He told me that there was a big contingent of people, as many as a couple dozen, that came in before work in the morning and then again during their lunch breaks, like clockwork, to buy 24 ounce Cokes. Some offices, he said, made soda runs three times a day. These weren’t big sales, obviously, but because soda is so cheap on their end, it was a nice, consistent profit for them. Day in, and day out. I immediately felt a sense of revulsion. That much soda, every day?
I then felt guilty for feeling revulsion. After all, there I was, sucking down probably my fourth coffee of the day, in typical grad student fashion. I had my own addiction, after all. And clearly, there is a class element to that feeling. Coffee has, in the past couple decades, become coded as a bourgie good, even though it’s such a widely-consumed beverage. From my perspective, coffee’s traded its cup-of-Joe-at-the-diner symbolism, in the public consciousness, for someone at a fancy coffee shop paying $4 for beans grown on some mountain somewhere. Soda, meanwhile, has become more and more seen as a public health scourge, and as eating well has become a more-and-more class-marked practice, soda seems to me to have taken on a lower-class element to me. So my feeling of revulsion strikes me as classist in a really objectionable way.
(It’s important to note that, despite what people sometimes assume, there’s no clear relationship between socioeconomic class and obesity.)
However: I couldn’t deny then, and can’t deny now, that drinking that much soda every day is probably terrible for you, and despite the endless back and forth about the effect of caffeine, drinking a lot of coffee probably isn’t. A coffee addiction is simply much healthier than a soda addiction, especially if, like me, you take your coffee without milk or sugar. And so as much as I distrust the motivations of my feeling of disgust at drinking that much soda, and as sure as I am that there is an ugly class element to that disgust, that disgust is good for me, and it would probably be better for other people if they felt similar internal emotional pressure to avoid soda.
2. There’s a McDonald’s on the walk home from my office on campus to my current apartment. This is a problem for me. After teaching and office hours and tutoring, I’m pretty tired, and the urge to just get dinner on the way home is powerful. McDonald’s has the virtue not only of being fast and (I admit) gross-but-delicious, it’s also cheap. Two dollar menu McDoubles will fill me up for the evening, whereas $20 worth of sushi leaves me hungry later on. So it’s tempting.
Luckily for my health, I usually avoid that temptation. I’m an active, mostly-fit adult. I’ve found that it’s been much easier as I’ve gotten older (I’m in my mid-30s now, eep) to keep exercising than it is to eat well. The goalposts seem to move all the time. What once seemed like a healthy diet to me now seems like slacking. Part of the trouble is the difficulty of eating well on campus, and of feeling like it’s not worth it to cook for myself when I live alone. But I am able to avoid that McDonald’s, with an exception maybe once or twice a month. Again, there’s an element of shame there: I actually feel, at this point, actively embarrassed to be walking into McDonald’s. Here again I’m troubled by the relationship between what’s healthy for me and the class dimensions of my aversion to this food. If you said to me that people should feel ashamed to walk into a McDonald’s, I’d tell you that there’s some really gross class connotations there. But I also can’t deny that the shame I feel is a more powerful disincentive to eating food that’s really bad for me, and I can’t deny that it would be healthier for other people, including poorer people, if they felt the same. It’s tricky.
The solution, it seems to me, has to be to use government proactively to provide real economic incentives to make it easier and cheaper for people to eat healthy food. This stuff should pay for itself, given the immense costs of obesity and attendant health problems. Of course, devising and implementing a workable system’s easier said than done.
3. There’s also a liquor store on my way home from campus. I have a family history of alcoholism, on both my mother and father’s side, and I feel lucky not to suffer from that affliction myself. I’ve never had any of the problems associated with heavy drinking. I don’t drive drunk and have never gotten a DUI. I don’t start fights or get aggressive with women when drinking. I don’t black out. I don’t lose control. And it’s very easy for me to go weeks without alcohol if I feel like I should lower my consumption, want to save money, or just don’t feel like drinking.
But that doesn’t mean that my relationship to alcohol is 100% healthy, either. See, it’s really easy for me to get into the habit of picking up a six pack of beer and drinking it every evening. I can do this without ever getting even tipsy; I just have a beer with dinner around 6 and drinking slowly and steadily until I go to bed around midnight. I never become drunk, and so in my mind, it’s never a problem. I really like beer; it’s relaxing and it tastes good and it’s nice to sip while I’m writing, grading, or researching. But beer has a lot of calories, and if I’m drinking a six pack of the kind of craft beers that I like, we’re talking anywhere between 600 and 900 calories in an evening! I wouldn’t eat a large McDonald’s fries after eating dinner, but by drinking a six pack in a leisurely evening, I’m doing worse, calories-wise. (I can’t be doing my liver any favors, either.)
So I’ve been careful not to fall into that habit again, which I developed while writing my dissertation. I’ve been much more aggressive about measuring the impact of beer on my overall diet since then. What’s interesting to me, though, and pretty unfair, is that my impression of the way we think about alcohol as a society is that its dangers come from the fact that it produces drunkeness, not from its calories and nutritional value. Yet the ambient shame of soda drinking depends on just that, while beer can be as bad or worse. During the fight over the Bloomberg-era big soda ban in New York City, some smart people pointed out that many of the soda ban’s supporters are the type who drink a bottle of red wine a night without thinking of it — and red wine’s worse for you than soda. I guess the point is just that, though shame and stigma have to play a role in how we get to more healthy diets and a more healthy society, we are very selective and inconsistent in how we apply such stigma, and when.