In the quest to create more social justice and equity, a lot of economic common sense leaves the discussion first. If I become a politician by promising you that you'll get your own personal doctor, for example, you aren't getting a real doctor - you are getting someone handed a doctor title but is really a naturopath, homeopath or whatever else that can be found cheap.

It's a great sales pitch and plenty of people will carry water for it and hope for the best, but it is unworkable in the real world, the health care equivalent of a “chicken in every pot”. We have seen this in the quest to create more health care equality. To help the million people who once couldn't get insurance, we raised costs of many who had it by 300 percent. Since you had to buy it or face government penalties, they reduced supply while mandating demand. The people who had it but were getting it more affordable ended up with even less access because doctors couldn't take on unlimited patients.


Social justice takes many forms. Credit: Case Western Reserve University

A smarter approach than more regulations or political promises is lifestyle changes that lower risk of diseases in the first place. (1) It won't get anyone in the New York Times, but it may be far more helpful. We have made a lot of strides in the quest to go beyond symptom-based medicine of the past and while some are still more woo than science - epigenetics and the microbiome and buying fancy yogurt - we now know two are real contributors to disease risk; mental health and dental care.

With mental health, not a lot of progress is being made due to so many co-factors, but where once bad oral health was dismissed as genetics, studies have since shown that lifestyle was far more important. Trips to the dentist, better brushing discipline, and things like lowering sugar directly on the teeth (i.e. sugarless chewing gum) all made a huge impact, and it was later found better oral health contributed to lowering other disease risk also. (2)

The COVID-19 pandemic led to a huge resurgence in desire for affordable ways to create lower health and mental health risk. In January of this year, fellow USA Today opinion columnist Alysha Tagert outlined a "coping tool box" for stress during the pandemic. It had things like a fidget spinner, something that smells calming, a distraction, like a puzzle book, and gum for "sham" eating. These are all things that have no real financial barrier to entry but may do tremendous good. If we care about social justice and the lingering effects of the pandemic, let's do the analysis now and see what works, not create another government program and a website no one reads. People don't need top-down centralized guidance, maybe instead of special government ATM cards that can only be used at organic industry farmer's markets, health insurers could give out packs of gum and stress balls. Helping people outside public relations campaigns is real social justice.

Not all of those will work for every person, fidget spinners didn't exist until recently so there is no weight of evidence yet, but distraction and sham eating have been done for thousands of years. People like to chew on things because it can be calming. People under stress also benefit from forgetting about it.

Biopsychosocial wellness doesn't really roll off the tongue, and it isn't part of the popular lexicon yet, but until recently neither were Anthropocene or Mansplaining. That doesn't mean they weren't important and the same goes for oral health and ways to make sure it is available for everyone. 

NOTES:

(1) If the US Centers for Disease Control and Prevention had been concerned about preventing disease this century, they could have instituted a numbers of interventions. Instead, they manufactured new epidemics which they then told Congress only they could solve - if they got more money for their union employees. When a real pandemic hit, they were not only logistically unprepared, they were culturally so invested in their own fiefdoms they forgot the public.

They even refused to send coronavirus testing kits to hospitals early in the COVID-19 pandemic unless the hospital first proved patients had the disease.

Anyone who knows CDC culture knows why; it is not a pandemic unless they say it is. But disease does not work that way. The White House finally forced them to send testing kits but they had faulty reagents, making them useless. It was up to FDA to use its emergency authorization power to bypass CDC obstructionism and get tests where they were needed.

Meanwhile, CDC was continuing to pay for highway billboards manufacturing a vaping epidemic and lumping in cancer patients in pain with recreational opioid junkies and make getting access to painkillers difficult.

(2) Kane, S. F. (2017). The effects of oral health on systemic health. General dentistry, 65(6), 30-34.