Dynamic Dialogue with Danny Matranga - 351: 8 Things I Would Do as Public Health Minister
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Welcome in everybody to another episode of the dynamic dialogue podcast. As always, I'm your host, Danny Matranga. And today's episode is inspired in many ways by the previous episode, episode 350, in which I talked about some non specific topics on fitness non-fitness specific topics. And it's also
inspired by several memes of overweight public health ministers from various countries. So many
of us in the health and fitness adjunct space are critical of the way public health authorities
look. And it is certainly strange to see a public health authority who is
obese or overweight or does not look healthy by conventional standards. But I have to say,
one of the things that has really jumped off the page to me in the last several years, especially
post-pandemic, is the need for a thoughtful public health policy, not just in the response to a
once-in-a-generation pandemic or an infectious disease, but quite frankly, just better public
health policy in democracies, autocracies, wherever it is that you may be listening to this.
democracies, autocracies, wherever it is that you may be listening to this.
Hopefully, it's in a democracy, but it's very challenging for institutions and governments to regulate policy and public health in the time of crisis.
I would imagine that doing better when we're not in crisis and making more of a
concerted effort overall to improve the health and wellbeing of our population could make a huge
difference. And so, you know, in response to some of these memes, which are mildly funny and oftentimes, let's say, ill-intentioned,
I thought to myself, you know, I appear to be fit. People might be more receptive to some of my
public health policy positions. And if I were just given a complete, entire, and kind of unabashed opportunity to
shift America's public health policy, what is it that I would do? And I came up with eight things
that I think would be foundational to changing America's public health for the better.
And so today's episode, I will be discussing what I believe to be eight policy-based changes that would make huge, huge adjustments to how Americans
live, reduce what I believe to be some of the primary drivers of disease, of mental health,
negative mental health, I should say, and more. So it should be a fun episode.
There will be a little bit of a policy spin here. So there might be some semantics or some verbiage
that isn't particularly up your alley, but that's totally okay. If any of it flies over your head,
feel free to email me or DM me with questions. If you have critiques, please do the same.
But here are eight things I would do if I were to take over as America's public health minister,
which just so you know, is not an actual position, but it is a position that exists in many countries. Enjoy. This podcast has some awesome partners. And one of my favorite,
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supporting the show. Okay, so the first thing that I would do if I were a public health minister or
if I were creating policy with the goal of helping drive better outcomes in public health, in obesity, in mental
health, in happiness, et cetera, would absolutely be an educational component. I am thoroughly of
the opinion that the best opportunity to adjust behavior is to start
adjusting it early. And I think a lot of our health and fitness knowledge is unlearning,
or I should say, I think a lot of what we need to learn with regards to improving our health and
fitness, you know, we do need to do a lot of unlearning first. There is a lot of misinformation,
a lot of old wives' tales, a lot of just particularly pervasive junk knowledge in the
space. And I think what a lot of people hold to be true and near and dear about health,
about nutrition, about exercise, a lot of it just frankly is completely not rooted in fact.
And people do not know how to think critically about their health, about their well-being.
And they believe a lot of garbage.
And one of the ways I think that we could quickly reduce this is by teaching children
how to think more critically about health, about wellness, about science.
how to think more critically about health, about wellness, about science.
And if you just look at our funding for public education relative to many other countries in the developed world, it's lower than a lot of people would assume, especially when you
contextualize like, hey, do you know what we spend on our military? Do you know what we spend on
a lot of these other programs? So I would say, certainly, we should look to spend a little bit more on early
childhood education in the sciences and the health sciences in critical thinking and reasoning.
I think when people are intelligent and well-equipped, they can make substantially
better decisions about their health
than when they aren't. But even if we weren't to spend another dime on public education,
one of the things that's always baffled me is how we oftentimes require that children take chemistry
and biology in elementary school and in high school. But very rarely in any of that coursework
do we teach them about nutrition. And nutrition is a uniquely biological and chemical. Every macro
is biological. Every vitamin, every subcomponent of every macro, every micro is chemical.
The way in which the things we eat
interact with our body are uniquely biological and chemical. And it's always blown my mind
that we teach kids in the United States for 12 years of compulsory education from first
year all the way up to being a senior in high school. And the opportunity for them to learn about nutrition is limited. And nutrition is almost never woven into the biological or chemistry
coursework that they take. There are some classes where maybe anatomy is available or some schools
where anatomy might be available. And maybe there's some nutritional coursework there. Maybe
there's even a nutrition class available in some of these schools. But it's just always baffled me that we do not include fundamental nutritional coursework in
chemistry and in biology, which are classes that kids take in, you know, seventh grade, eighth
grade, all through high school. Those are the years in which children are the most impressionable.
They are the years where they begin to start to think about their body, their body image, the way in which their body,
you know, presents to the world around them and giving them the tools. And quite frankly,
the facts about how it is that macronutrients, micronutrients, and calories influence their body,
whether it's from the chemistry side of like, Hey, this is how energy balance and thermodynamics work, or it's from the biological side of like, hey, this is how the different stuff
you eat actually take shape and form on your body. By not doing that, I think we leave the door open
for kids and then, of course, therefore adults to become misinformed, to have ill equipment in terms
of having the ability to make good health decisions long-term, I think that
is a huge miss for the American public education system, not working the foundational concepts of
nutrition into the biology and the chemistry classes that we make kids take in compulsory
education. I think that kids would have a better understanding of chemistry and biology if we use something that many of them interact with every day, food, as a medium to connect the dots. So I think that's a huge sciences and health sciences. But if nothing else, I would rework coursework in biology and chemistry as hopefully at the state by state level. But if not like
trying to have some type of, um, you know, federal funding for schools that, and this is the hard
part is like, how do you determine who deserves the money from, you know, state funding, or you've
probably all taken those standardized tests where it's like, Hey, the better you score, the more money you get from the state. Well, that's crazy,
right? Like shouldn't the kids that have a harder time scoring higher, get a little more funding.
It's so ass backwards, but I would do all that, which I could to include more discussion around
nutrition in these classes that kids are already taking to help connect the dots.
Another area where I would look to increase funding is in physical education. And again,
this means providing more money for education, which I think a lot of people would hear and
interpret as like, oh, that means more taxes. And it doesn't always mean more taxes. Sometimes it just means a reallocation of resources.
But the amount of PE happening in schools right now is lower than it's ever been.
There is substantially less physical education opportunity available for kids now.
And it's really sad because it definitely, in my opinion, is a component of why childhood obesity
is higher than it's ever been. And it appears to be something that is totally and wildly out of
control. You know, we have seen more physical education cuts in schools in the last like 10
to 15 years than I've ever seen. And we've seen even more cuts on that, you know, post-pandemic as
things have changed, as remote learning has become more acceptable or a bigger part of,
you know, what we would consider the normative educational experience. It's certainly
not as bad as it was in the middle of the pandemic, but, you know, just citing some
data from the last decade, the average number of
days that adolescents participate in physical education each week varies county to county.
This is from California, the state where I live. It can be as low as 1.8 days to as high as 3.8
days. The average number of days that teens engage in 60 minutes of physical activity ranges from 3.1 to 4.7 days. Um, you know, so we're seeing
as low as 1.8 days, all the way up to 4.7 days. And I would argue that even 4.7 days of an hour
of activity is probably not enough. Like kids are growing, they are developing, they need movement
to reach their academic potential, to reach their physical potential. It is good for kids to move
their body. It is good for the development of their brain. It's good for the development of
their coordination. If you really zoom out and you think about public health, it sets them up
substantially better for the fight against diabetes, for the fight against obesity.
It would clearly strengthen America's militaristic standing to have a fit and capable young,
especially male population.
We do not have that the way we used to.
And it's just nerve wracking to me how many children do not engage with even a small amount
of physical activity on a semi-regular basis.
I think that that is concerning because it sets these kids up for a
lifetime of battling largely preventable chronic health conditions. And there was a time in this
country where physical education was a five-day-a-week, hour-a-day thing. And I don't think
that would be bad whatsoever. I think it would actually be quite good for the development of
a population
who is spending more time on screens and less time moving than they ever have. And this, in my
opinion, is a huge driver of why so many teens are struggling with their mood, with their well-being.
And of course, this extends to adolescents as well. But we need to encourage kids to move more.
And we are not doing enough. We are not doing as much as we used to. We are
seeing a direct negative effect from this. The facts are startling when you look at childhood
obesity and you talk about regular exercise as a child being correlated with reduced anxiety,
reduced depression, and a reduction in the development of long-term conditions like heart
disease, cancer, type 2 diabetes, high blood pressure, osteoporosis, and obesity.
So we are a country where people pay into entitlement programs. Many people call them
entitlement programs, but we pay into programs like Medicare, which are supposed to be available
to take care of us in our adult age. And the burden on those systems is so great.
And it projects to be substantially greater than what the pay-ins can cover. And a large part of
this is because the demand on the system from chronic, largely avoidable health conditions
is so big. It's huge. And we are not doing ourselves any favors. And as people who pay taxes,
you know, we stand to pay into a system that can't support us because it's completely and
wildly overburdened by, in my opinion, things that could be completely eliminated through good
choices and through regular physical activity. And kids are not going to make those good choices
and are not going to engage in the regular physical activity that they used to unless we make it compulsory,
because you know what? And I don't blame kids for this. They are more drawn to things like video
games, to screens, and to all of these other things than they are to things like exercise,
than they are to things like exercise. Because quite frankly, exercise is substantially more boring than Fortnite for most kids. And a lot of these games and technologies are designed to be
particularly appealing to children's brains. Okay, the third thing I would look to do,
and this would be really tough, and this would absolutely, without a doubt, be something that people completely took advantage of. It would, who maintain a healthy weight, who maintain a
high level of muscularity. Again, this would be extremely difficult to do because if you have
muscle, you kind of break BMI as a system. Like people who have muscle are substantially more
likely to show up as obese than people who are over fat and under muscled. But it's one of these
things where if we could come up with a proxy or a calculation or some series of, you know,
Hey, like I got a checkup from my doctor, uh, annually, and there is a particular form that
my doctor will fill out that takes percentage body fat using a semi-accurate proxy.
Maybe that's, you know, calipers, even something that's pretty variable like bioelectrical
impedance. They took my height, they took my weight, they took my age. And then I was, you
know, given a cardiac stress test and a high blood pressure test. And if I reach a certain threshold
on all of these tests, I can submit this form to the government when I file my individual taxes
and I can receive a tax credit for maintaining regular physical fitness. I think that would
encourage people to stay in better shape if they were able to deduct
$2,000 to $3,000. You could go even higher than that if you want of income for maintaining a
certain level of fitness. I don't know if financial incentives alone or tax incentives alone are
enough to get people to actually make these changes, but it's something that I've thought
about for quite some time, which is a way of rewarding people who are in a position to do something about their health.
I think this would be a little bit challenging because there are people who are, you know,
not in a position there.
Maybe they're disabled.
Maybe they have an injury and, you know, maybe they are not able to access these particular
tax incentives.
That's that's kind of tricky.
But it's like you have tax incentives for people
who have children and there's people who can't have children. So it's not particularly fair to
them, but they don't get access to those tax incentives. There's something there. I've always
thought it would be interesting. Not sure what that would look like, but looking at a tax credit
for maintaining certain health metrics at certain levels for years, you know, year after year. Taking a break from this episode to tell you a little bit about my coaching company,
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my app-based training community. Back to the show.
Another thing that I would do for sure 100% is make any fitness club, any boot camp, any
personal training 100% tax deductible.
I think that, you know, I'm not saying that they're free.
I'm not saying that they're government subsidized, but I'm saying that the cost of engaging in regular physical fitness, in my opinion,
should be 100% tax deductible because the likelihood of that engagement decreasing
the burden on entitlement programs down the road is probably really high. The more people who
engage in regular exercise probably means the longer the money in Medicare and social security
lasts. Quite frankly, that's my opinion. I might be wrong. I might not have all the data in front
of me, but I believe if people could write off the cost of personal training, the cost of going
to the gym, the cost of going to F45, uh, orange theory, et cetera, they would be more likely to
stick with fitness and health programs longer. There would
be less of the resolution kind of fizzling out. There would be less of a price burden on
individuals who engage with these things. You are not making it free. If you made it free,
I think people would just completely not use it. It would just become like devalued.
That's not true. That's a little bit of a, a jump. I'm definitely making a strong
assumption there that if it was free, people wouldn't use it or take advantage of it. But,
um, I think that if you were to give people the ability to deduct 100% of the costs or 50% of the
costs of a gym membership of fitness training of a bootcamp class, it would make a really big
difference. Um, and again, a lot of people think
that that's probably crazy. Um, another thing that I would do if I were the public health minister
that would probably piss people off royally. Um, but I think it would make a fantastic, uh,
progress in terms of, you know, increasing public health writ large would be to just increase the
taxes on alcohol. Uh, if you go buy cannabis in California at a dispensary,
the taxes on the cannabis are substantial. They're noticeable. If you buy alcohol,
that's not so much the case. And I think if you tax the shit out of alcohol, the way they do
more innocuous compounds like cannabis, you might see a reduction in drinking. You might not,
but you might. and I don't know
how you influence people to drink less. It's probably not through taxation. Um, but if you
look at the people who are the most affected by chronic drinking, it tends to be people who are
lower on the socioeconomic bracket. And I think if you put a little barrier in between people and
their drinking habits, you might improve public health. Cause I don't think there's a single drug
that puts a greater toll on the public health, uh, you know, on might improve public health because I don't think there's a single drug that puts a greater toll on the public health, you know, on America's public health than drinking,
specifically chronic drinking. I mean, you're talking about increasing the risk of cancers,
heart disease, stroke, diabetes, depression, suicide, domestic violence. All of these things
are correlated very tightly with alcohol consumption. And if you put a
barrier or put greater friction between people and their ability to consume alcohol, I think we would
all benefit. The only people who wouldn't benefit directly are the people who love to drink
chronically, which is a lot of people. And I understand that, but they tax sugary drinks out
the wazoo in certain States. They tax cannabis out the wazoo in certain states,
and it probably decreases consumption in some capacity. And I'm wondering if doing that with
alcohol wouldn't be worth it given the known negative health effects of chronic alcohol
consumption compared to other things. So that's just something that I would look at that I would
consider. I don't think you need to like make it a huge tax, but I think if you increased the amount that you tax alcohol products at,
you know, maybe it's federal. Uh, I'm sure it would have to be state by state because, you know,
some States don't even have sales tax, but maybe if you, I don't know, I don't know. I think there
might be something there. Call me crazy. Um, number five, I would,
well, that was number five. I would also extend that like New York state sugary drink tax. Um,
but number six would be, I would make an attempt to ban advertising junk food to children. I know
that a lot of people would be like, Oh, that's massive government overreach. But I would definitely make an effort to reduce the amount of advertisements children
see specifically for junk food and for hyper processed, ultra processed foods. I think a lot
of people are super sensitive to the amount of advertisement they see for pharmaceutical
companies when they watch the news. Um, you know,
if you look at like cable news specifically, like every other commercial, it's like alcohol,
pharmaceuticals, alcohol, pharmaceuticals, alcohol, pharmaceuticals. And people are like, yo,
like, that's crazy. That's obnoxious. Like no wonder people are overloaded with, you know,
polypharmacy and alcoholism. It's all you see on TV. But if you watch cartoons,
I don't watch them very often, but it's like toys, junk food, toys, junk food, toys, junk food.
And you wonder why children are drawn to eat so much shit. And I think that when you put all the
junk food lower on the grocery store shelves and you bombard children with advertisements for ultra-processed, hyper-processed
foods, you will probably create a population of children who are drawn to these foods.
And we already live in an obesogenic enough environment and those foods already cost less
than many healthy foods. So you're going to see households and household decision-making around
what to feed their kids generally skew more towards ultra-processed, hyper-processed foods that are low in nutrient density, that are low in protein,
that are low in fiber. And I think if I wanted to make a population of doughy, fat kids who are
more likely to develop diabetes, who are more likely to develop obesity, I would advertise
junk food everywhere and put it low on shelves where kids can see it. So, you know, if I were a public health minister, that's certainly something
that I would change. And I know that that would be like a deeply unpopular thing to do.
But it's something that I think would really make a big difference. Number six, this is something
that we're seeing in California and it's the conversion of unused commercial space to like
housing because we have such a housing issue. We have a homelessness issue, as I'm sure many of you are aware.
I think a lot of people who live in non, who don't live in California talk about it more than
the people who do, because it's like always fun to like take the air out of California sales,
so to speak. But it's one of those things that I think it would absolutely make a huge difference
if we found a way to convert unused commercial space space that's just going to waste into, uh, or maybe this is, you know, public parks. Maybe we can add to our existing parks and regional parks. Um, you know, fitness equipment. I see all the time in different cities that I travel to outdoor, you know, human powered ellipticals or like
different workout things that are like really creative and are architecturally kind of unique.
Like I went to, I was in Florida not that long ago and there was a park where you could do like
all these different movements on these machines where your weight, if you've ever been in a
commercial gym that has hoist equipment, they use like your body as a component of the weight.
Like there was a park where you could do a chest press and lift your own weight and do a pull down and lift your own weight.
And it was like a completely free public park where you could go and do like a legit resistance
training workout. Obviously the equipment isn't as nice, um, as some of the stuff you might find
in a gym, but it's certainly durable and it's outside. And, you know, putting more of those
out there or converting a lot of this unused junk space to places where the community can go and access movement. Like, oh my God,
I would go crazy for that. I think that would, that would be awesome. It would encourage movement,
specifically resistance training. Um, I would be so, so huge on that. Um, that would be a,
a really easy to do thing. Um, do thing. And you look at some of the infrastructure
programs that have been passed recently, or some of the climate credit stuff that's been passed
recently, or where we allocate funds. I don't think it would cost all that much money, relatively
speaking, to get a body weight powered, if you will, resistance training, uh, apparatus outfitted in
multiple different towns and multiple different cities and multiple different states in the
country. I think we could make that a every town kind of thing. And you know what? Not everybody's
going to use it, but there are probably people everywhere who would make a trip to the park
to do a little bit
of working out on some of these human powered machines. And I think it could be a really cool
way to encourage people. And I think about how I got started. Like I got started doing pushups and
pull-ups and sit-ups and body weight workouts, and I didn't have a gym membership and that might be
your entry, uh, your point of entry. So that would be really encouraging or exciting to me.
The seventh thing I would do is I would extend maternity leave and paid maternity leave to be
as long as reasonably possible, because I think the more time that a mother can spend with her
child in that kind of foundational period of their development, the better the health outcomes for
the child mentally, socially, physically, et cetera. And I think it's crazy that like some people get like two weeks
or four weeks or six weeks. Uh, I don't know what the lowest rate of maternity leave is in this
country, but I know it's substantially lower than it is in other countries. And I think it's good
for kids to have their mom around. I think it's good to have your dad around too. I would even
encourage the discussion of like at least three months of paternity leave and at least six months of maternity leave.
I think it's good to have the family around.
And yes, I know that would cost money, but I think keeping the family unit together and around during that particular time in a child's development would be wildly beneficial for their health.
And the last thing I would do that I think would really make a difference is, and again, this is a spending thing. That's why this is hard because it's, you know, there's a tremendous argument for making
cuts across our budget. You know, increasing spending is like definitely a touchy subject,
but I wonder if increasing spending in certain areas might save us tons of money in other areas.
You know, the old a pound of prevention is worth a hundred pounds of a problem,
whatever it is that they say. But that would be to create some real addiction treatment services
specifically for smoking opiates and alcohol. These are things that put a huge, huge toll
on public health, on community health, on social health. Alcohol and opiates are super, super damaging to families.
They're super, super damaging to communities. They are very difficult for hospitals to navigate
and to manage. And these are things that I think if we could do a better job of helping people
manage addiction, and it would also like indirectly help with our homelessness problem,
it would indirectly help with our mental health problem. And I don't think anybody deserves to be addicted. I think addiction is an extremely
complicated situation. And of course requires desire and willpower and a want to change your
situation. But I don't think anybody should be chained to an addiction if we could, you know,
engage in increasing access to addiction services and help people fight back
against some of the most powerful addictive substances
that have ever been created
that have made corporations wildly wealthy
by maybe taxing their profits.
Like, hey, we're gonna fund addiction services
by taxing the fuck out of the opiate manufacturers
and the alcohol manufacturers.
I don't hate that idea.
I think some people might,
but those are just some things that I would do if I was America's public health minister.
I know that this is a little bit of a different discussion, but I hope you guys enjoyed it.
If you did leave me a five-star rating and review on Spotify or Apple podcasts,
I'd love to get a message from you about what you enjoyed. Share this to your story. So more
people can hear it. So we can just expand the public discussion in this space. I think we are responsible for our health and the government will never be able to do
as good of a job as we can. But if we are, you know, voting for electing people who actually
give a shit about our well-being, we stand a fighting chance. All right, folks, thanks so
much for tuning in and I'll catch you on the next one. one