Customer Reviews

Prescription for a Healthy Nation: A New Approach to Improving Our Lives by Fixing Our Everyday World

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There have been a number of recent books about health habits and the environment, but this is by far the most enjoyable read. The writing is outstanding and not the clunky prose you often encounter in books written by academics - I wish I could write like them. Although written for a general audience, with (good) human interest anecdotes, the book nevertheless covers some deeper ideas, such as "curve shifting". The idea is that how often we encounter extreme outcomes, whether severe obesity, alcoholism, HIV, depends on "normal" or average behavior in the population. The early chapters that elaborate on those ideas alone are worth reading the book. I don't care too much about "passionate advocacy" and while the authors do fall into the advocacy camp, there is very little of the whining or scolding that has turned me off in other related books. Instead, arguments are generally well balanced even if you know on which side the authors are going to come down. It made a great read for a long flight.

In reading Prescription for a Healthy Nation by Tom Farley, M.D., Deborah A. Cohen M.D. this week, I pondered our health care system. It really does seem like we're looking at the wrong factors. With rising rates of diabetes, hypertension, obesity, we wonder how can we reduce the costs of medication, healthcare and fix health insurance in general, while our population is becoming more unhealthy with each passing minute. It's true, something needs to change.

I am in the business of health care. I care about health. I want to live a healthy lifestyle, unencumbered by disease or injury myself. I'd also like to see that for the rest of our society. But we live in a world where it seems that fitness and health are not priorities, rather, they are additional responsiblities on people's already too busy lifestyles. Which is why this book was actually quite interesting, discussing things like shelf space devoted to food products, pricing as related to people's consumption/purchasing tendencies, children walking to school now vs 20 years ago-- generally questioning our assumptions on what's broken with healthcare and society and how it could be changed. (Cutting healthcare costs and improving medicine vs changing lifestyles and cityscapes.)

It's not just the system that's broken, it's also the people who are using it. Just looking around, it's obvious that most people are not healthy, fit or at a comfortable weight. In my office alone, a non-scientific survey says more than 50% (and likely nearer 75%) would like to lose weight, but what are they doing about it? Most talk about it, but do not act on it.

The suggestion of this book is to work on changing society to create an environment which encourges healthy choices, whether it's by walking and biking, planting a garden, handing out free condoms, or installing safety bars so children don't fall off balconies. It is less about education (most education does not affect the rates of smoking, condom use, weight loss, and so on) and guilting people into improving behaviours than it is about making healhy choices accessible and easy.

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This book clearly and concisely lays out what must be done to reign in the major killers of our time, such as heart disease, diabetes, obesity, and injuries. Right off the bat, the authors present formidable evidence showing that access to health care is not the answer to ending these problems. From there, a strategy is laid out showing just EXACTLY what we can do as a nation to curb the modern epidemics. The authors base their strategy on the groundbreaking work done by epidemiologist Geoffrey Rose Rose's Strategy of Preventive Medicine, as well as classic public health experts like Edwin Chadwick and John Snow. The book is convincing, logical, and backed up by a huge amount of new and old evidence. This is cutting edge public health and it is what students of medicine and public health are being taught in the classroom.

This book is awesome, one of the best public health books not written for public health professionals in awhile. Very easy to understand concepts. I normally read pretty slowly but I'm racing through this book! LOVE IT!!!

This book was in great condition and it arrived a day early. I had it just in time for school. I would recommend this seller to everyone!

The title says it all - this is quite simply one of the most important books in public health to date. The authors, Farley and Cohen, make a convincing case against the "education" model of public health that has failed, so far, to prevent or remedy the societal ills of smoking, obesity, heart disease and violence. We have normalized bad health and bad habits in our society - being overweight is not unusual, nor is heart disease or even violence. The focus of public health intervention has followed one of two typical paths - either interfere directly with the extreme cases, such as chronic alcoholics or morbidly obese individuals, or to publish a pamphlet and trust in people to make the right decision on their own. While this is a gross oversimplification it brings up two important points.

We know that education is ineffective - look at D.A.R.E., which is well funded and well supported but has ultimately had no effect on drug consumption among its graduates. Anti-obesity education by public health officials cannot compete with an environment that fosters overconsumption. Billions of dollars are spent on advertising "junk food", high calorie colas, sugary cereal and snacks (particularly to children). Through sixty years of marketing research everything from an advertising campaign to the placment of an item on a grocery store shelf is calculated to get the most yield - consumption - per dollar spent. A few million a year on a public health campaign cannot compete with that.

Medicine has always focused on the "bad apples", those that are sick and need attention. We are infatuated with dramatic interventions such as massive weightloss in formerly obese patients, or liver transplantation in chronic alcoholics. These extreme cases represent only a very tiny portion of the overall population and a fraction of overall costs related to a particular behavior. Small measures that will in all liklihood not affect the extremes of unhealthy behavior. If everyone in the country who was only slightly overweight dropped five pounds then as a nation we are much healthier and have done more to save on healthcare costs than would be seen in 10,000 gastric bypasses.

Lastly there is the radical notion of "healthscaping" - changing our environment to make us healthier. Things like designing more walkable and bikable neighborhoods will encourage exercise, or discouraging spur-of-the-moment drinking by barring the sale of prechilled beer, are small things that can be done to make us a healthier society. It's not a new concept - we made our environment healthier by installing sanitary sewers and making access to clean drinkable water almost universal, saving more lives at a stroke than interventional medicine has in its entire history.

This is a very powerful book and should be required reading for anyone hoping to be involved in medicine, public health, health law, health policy or breathing.

This book does outline American's health issues quite well. I also believe it does give a nice balance of each issue. Where it loses its objectivity is how to solve the issues. There is nothing new there. Ban vending machines from school, Twinkie tax, etc. The only "new" solutions to me is to tax R rated movies, and prevent fast food restaurants from opening up on every street corner. For some reason they believe taxing us to death is a good idea. Despite what the authors say, they are trying to create a nanny state.