A surprising new study finds that when an economy collapses, better health may be a byproduct
By Gary Drevitch
Originally Posted On May 19, 2013
Gary Drevitch is senior Web editor for Next Avenue's Caregiving and Health & Well-Being channels. Follow Gary on Twitter @GaryDrevitch.
One of the most common reactions to earnest recommendations that we overhaul our eating habits, from a diet based largely on red meat and highly processed foods to one more focused on vegetables, fruit and whole foods, is that we can never really be sure what's good for us. "Just wait," someone inevitably jokes. "Tomorrow they'll tell us that broccoli will kill us."
The subjects of the study were the people of Cuba, who unknowingly took part in a large-scale study on the effect of lifestyle change during their country's extended economic downturn in the 1990s.
The economy began to collapse after the government of its state sponsor, the Soviet Union, fell in 1989. The Russian republic that emerged from the former regime soon ended its subsidies of cheap oil for Cuba. As Richard Schiffman reports in a fascinating new article in The Atlantic, the shift sent Cuba "into an economic tailspin from which it would not recover for over half a decade."
The effects were widespread. Most motorized agriculture and food distribution systems halted. The ongoing U.S. trade embargo, strengthened by Congress in 1996, further prevented the import of many drugs, manufactured goods and food products. "Cubans survived drinking sugared water and eating anything they could get their hands on," Schiffman writes, "including domestic pets and the animals in the Havana Zoo."
And yet the population's health actually improved, in some ways dramatically, according to a study recently released by researchers working in Cuba, Spain and the United States and published by the medical journal BMJ.
Researchers tracking the health of about 6,000 residents and analyzing national data compiled by the Cuban Ministry of Public Health found that mortality in the island country dropped during the depression. Death from cardiovascular disease fell by a third, and from adult-onset Type 2 diabetes by half. The rate of strokes was reduced, too.
Despite its economic struggles, Cuba maintained an effective health-care system. But the study found that it was not the doctors that kept citizens healthy but the lifestyle changes poverty forced on them.
Cuba had gone green, even if unintentionally. With limited access to agro-chemicals, "farmers returned to the machetes and oxen-drawn plows of their ancestors," Schiffman notes. Community gardens flourished in major cities.
Cuba's state-controlled economy regained some of its footing in the late 1990s, due in large part to the support of oil-rich Venezuela. And as soon as cheap access to oil was restored, Cubans began exercising less and eating more. By 2011, the researchers found, the nation's obesity rate had almost tripled from its 1995 low. Diabetes and cardiovascular disease rates rose in lockstep with obesity and the national mortality rate returned to pre-downturn levels.
In an editorial accompanying the study in BMJ, Professor Walter Willett of the Harvard School of Public Health wrote: "Although the hardships experienced by Cubans in the 1990s were unfortunate, the present findings add powerful evidence that major population-wide benefits will be obtained rapidly by reducing overweight and obesity. To achieve this is perhaps the major public health and societal challenge of this century."
Schiffman joins Willett in wondering what the United States can learn from the Cuban experience as our own health care system struggles to manage soaring rates of Type 2 diabetes. The American Diabetes Association's chief medical officer, Dr. Robert Rattner, says 1 in 3 American adults could have the condition by 2050. Meanwhile, heart disease, which like diabetes is closely linked to a sedentary lifestyle and unhealthy diet, remains the leading cause of death in the United States.
In the absence of national initiative, it's up to each of us to do what we can to improve our own health. What can you do? Here are some fundamental steps that could boost your health and prolong your life. If enough of us adopt them, we may see a reduction in our national rates of diabetes and heart disease, and we'll ward off more cases of dementia, too: