Something for Nothing: The Mindset of American Health?

Schweinfurt

In 1933 Fiorella La Guardia was elected mayor of New York, declaring “È finita la cuccagna!” Loosely translated as “no more free lunch,” La Guardia may have been referring specifically to the corruption plaguing the Big Apple. Yet, this was apparently the first recorded usage of the term that can be used to describe the comment that is now more present in our society: “you can’t get something for nothing.”

I was reminded of the phrase a few years back when I was touring with a researcher and friend from Schweinfurt, a small town in the lower Franconian region of Bavaria, Germany. The town, founded well over a thousand years ago in 791, is a lovely Medieval city with solidly built homes and small shops that have withstood the test of time and a town square where one can walk or ride a bike to work, stop at the butcher on the way home, and socialize with neighbors. In fact, the pedal bike was invented in Schweinfurt in 1853 and the human imprint on the town forged by years of hard work is palpable as one traverses the cobblestone walkways and narrow streets surrounded by historic and beautiful buildings. We passed through these narrow channels as we rode bikes to the local cancer center where I was visiting, and walked around town in the evenings. The town, though tiny in stature, was spewing community, a vibrant social life, and an active population most often on their feet. One couldn’t help but feel part of something larger when strolling through town – a sense of belonging was everywhere. One thing was apparent – this town took considerable effort to build out of stone and continues to take considerable effort to maintain. This effort gave the town life, it made it feel alive. This town was built by people, for people.

Years later, when he visited the US to speak at an academic conference, it was my turn to return the favor and provide a tour of the area. As we strolled through the towns of America (by strolled, I mean drive around in a car, of course, and by towns, I of course mean suburbs) the contrast between my prior time at Schweinfurt made an unfortunate truth stick out like a sore thumb: every “home” was a square box of inexpensively constructed wood frame with plastic vinyl siding hanging on the stick frame like a picture on the wall used to cover up a blemish. The blemish, in this case, was the house itself. In fact, the entire neighborhood was a linear row of nearly similar blemishes arranged on each side of a massively over-widened road with sidewalks adorning each end. Each equally massive home was also far from the street, with a large double garage in the front, serving as a strange sort of welcome sign for the home: “welcome, cars.” Contrasting Schweinfurt’s cobblestone sidewalks adorned with beautiful stone buildings on each side, providing passersby the sensation of being safely nestled within, these suburban sidewalks, exposed in the open and adorned by few trees, went to nowhere. There was no bike riding or walking, as there was no motivation to even exit our vehicle, so we completed the tour within our car. Worse yet, these eyesore neighborhoods were not even part of the tour, but as they stretch for miles and have consumed the countryside, we had no choice but to negotiate them to get to our final destination.

Getting Something for Nothing

I explained the ins and outs of these communities. From their construction, which includes fake window eaves, phony wood trim, hollow columns without a structural purpose, plastic shingles meant to resemble wood when seen from a distance, and an array of other imitation design elements that attempt to resemble actual building materials at a fraction of the cost. These communities, coined “maintenance-free,” are also constructed to minimize any semblance of work for the inhabitants and come with HOA fees that fund truckloads of weekly workers to cut the various patches of grass in the neighborhood, trim the hedges, and shovel walkways. These “maintenance-free” communities are built with the ultimate goal of getting something for nothing. To add insult to injury, the houses are set off the roads and sidewalks, further inhibiting conversations with neighbors. Large garages house the inhabitant’s large cars, allowing them to avoid the annoying necessity of walking as they transport themselves from point A to point B during the daily ant march to and from work, the grocery store, and the big box stores that ship in cheaply and unethically-made goods from other countries, that we’ve dismissively labeled “developing” but are in total reliance of to satiate these inhabitants’ consumer needs. In other words, these communities, built for cars, are a mirage of real communities like Schweinfurt, which was built for people.

There are many reasons these communities as a major issue in the US. Writers, like James Howard Kunstler in the must-read The Geography of Nowhere, were warning us several decades ago about the issues with promoting unsustainable growth, destroying our farmlands and local businesses, and creating an utter reliance on cars for all daily activities and to travel to distant places for our food. Yet, few of us consider the devastating effects on our health. Like Schweinfurt, actual communities take effort and are lived in and nurtured, and the inhabitants of those communities are rewarded with a sense of belonging and tangible health. Communities are not maintenance-free, but rather, the total opposite. How will living in prefab houses made of imitation materials requiring little to no upkeep and outsourcing all activity-requiring labor impact us? Additionally, when (not will) does the health of these inhabitants fail when they spend the majority of their time sitting in their car or on their couch?

Schweinfurt City Square

I could quote the statistics, however, a simple glance at pictures of Schweinfurt and typical US neighborhoods tells us enough.

Countering real communities made by people for people, are our new “communities” which are setting our health up for miserable failure from the start, and failing we are. And when our health fails, which it likely will for many of us, our friends, and our family members, we are told we can fix it for nothing. Like our phony suburban communities, we can magically get something for nothing utilizing a bunch of fake, hollow, and cheap materials. Nearly 50% of us are already obese, and the number keeps rising. The population that is severely obese doubled to 10% in 2018 and continues to rise as well. Add on 10% of us with diabetes and a third with prediabetes, and you start to get the picture. Our health is spiraling downwards, and this cannot be fixed by magician physicians, phone apps, social media, or whatever latest technological wonder is being touted as the fix to our future, though we continue to tell this message to the public. A simple internet search reveals all the ways in which apps and other digital saviors are waiting to repair our mental and physical health after years of battering. Many doctors will work their magic as well. Bad knees from excess weight crushing down upon them for the last 40 years of your life? We can instantly fix that for you with a new set of knees. Bad back from the same reasons? We can fix that for you too.

Suburban Wasteland

Lots of cars, vinyl (i.e. plastic) siding, the same house repeated for several miles, few usable spaces, nowhere to walk: this typical neighborhood is a wasteland for the soul

Yet, when my grandfather, whose parents left a small town not far from Schweinfurt and emigrated to the US, his generation told me repeatedly that I could not get something for nothing three decades ago, he had a point. That magical knee replacement is only a temporary fix. Back operations rarely work and are even more abysmal, with success rates quoted as all over the map (many surgeons compare it to a coin flip). Those diabetes meds are difficult to manage, expensive, and still leave you with a slew of diabetic-related complications. Furthermore, younger individuals with Type 2 diabetes have a 2-3 times increased risk of death.1 In other words, we may be delaying the inevitable, but it is waiting for us with a vengeance just around the corner. Any physician that is your friend will tell you this, even those surgeons whose paychecks rely on the above operations.

In other words, we are all constantly gambling with our health and relying on our physicians to fix our years of neglect, abuse, and misuse. We are not maintenance-free, and in reality, neither are our homes or communities. We are attempting to get something for nothing. This strategy is guaranteed to fail for the majority of us, and it is failing on a massive scale. Just as Schweinfurt required thousands of years of hard work to become and remain the beautiful community that it is, so does our health. Yet, when surrounded by imposters and constant attempts to get something for nothing, the sobering statistics on our health should hardly be surprising. Just as the ugly fake materials adorning our maintenance-free communities fade, fall apart, and are leaving a desert wasteland of eyesore scattered throughout the US, the health of the people that live in these houses is closely following.

We can pretend life is a slot machine, where as long as we pull the lever enough times while sitting there enjoying our free drinks, we will strike it rich. But much like in the casino, the odds are sharply against us. We need to set up our communities for people, much like our ancestors did over the past several thousand years, visualized in Schweinfurt and far beyond. Just as our real communities take time to build and time to maintain, we must view our bodies and our health in the same way. We must carefully and routinely work at it. The beautification and maintenance of a place requires a methodical approach and our well-being requires the same. We need to remind our neighbors and ourselves that a healthy life is the best life, and it takes a little work. Most importantly, echoing Fiorella La Guardia almost a century later, we have to remind ourselves that you can never get something for nothing, especially when it comes to our health.





References:

  1. Tancredi, M. et al. Excess Mortality among Persons with Type 2 Diabetes. N. Engl. J. Med. 373, 1720–1732 (2015).

© 2021 CDR Health and Nutrition, LLC. All Rights Reserved.

Leave a Reply