The Trump administration's recently released "skinny budget" delivers on its name, save for one key area. Described as a "hard power budget," it cuts many social programs
while allocating an additional $54 billion for defense spending. The
central idea behind this budget seems to be that we can create a safer
country by heavily investing in defense, while ignoring spending on all
else. But can we?
There is no question that we prize national security. This is evident in everything from our defense budget, to the rhetoric of our politicians, to the dimensions of our foreign policy. While Trump's budget is unlikely to be approved by Congress
in its present form, it nevertheless reflects a key truth – in the
U.S., we frequently view national security from a combative, military
perspective. However, when we prioritize defense at the expense of
programs that keep us healthy, we, in fact, undercut our security,
making our nation less safe.
True security comes from living in a society
that is not vulnerable to preventable hazard and disease, or divided by
health gaps that undermine equity and well-being. Public health has
cultivated this security by addressing the cultural, economic and
environmental conditions that shape health and contribute to social
cohesion. Fundamentally, national security deals with threats to these
conditions, which challenge the stability of a given country or region.
This means distinguishing between threats that are tangential to the
overall stability of a country, and those that undermine its ability to
remain functional and its people healthy, over the long term. A
longstanding example of such a threat is the problem of HIV/AIDS in
Africa, which has strained the stability of several regions, particularly sub-Saharan Africa.
What health risks pose a security threat to the
U.S.? In this country, we have seen obesity evolve into a clear security
threat, straining our health system, our economy and our capacity to
live active, healthy lives. Rising obesity rates cost the U.S. an estimated $147 to $210 billion per year in health care spending. In 2015, obesity rates among adults exceeded 35 percent in four states, increasing the burden of associated conditions like heart disease, diabetes and infant mortality. Obesity also exacerbates health divides that exist between vulnerable minority groups, and between the rich and the poor, deepening the growing inequality in the U.S. Between 2011 and 2012,
the overall obesity rate was 34.9 percent. Obesity rates among adults
during that time were highest in the black community, at 47.8 percent,
and the Latino community, at 42.5 percent, compared to 32.6 percent
obesity for whites.
RELATED CONTENT
Trump's Ridiculously Skinny Budget
Another population, whose struggle with obesity
is not incidental to our national security, is the U.S. military. The
percentage of military personnel classified as overweight has increased significantly
since 2001. Close to 8 percent of the military's active-duty force is
now classified as clinically overweight, compared to 1.6 percent in
2001. It is hard not to see rising military obesity rates as part of the
larger picture of obesity in the U.S., with 20 percent of male military
recruits and 40 percent of female recruits classified as initially too overweight to join the ranks. While many in the media
have begun calling military obesity a national security threat due to
its potential to undermine the combat readiness of our troops, obesity
among the armed forces is actually symptomatic of the true security
threat posed by obesity – its broader role in making Americans less
healthy at all levels of society.
The gulf between the view that national security
is embodied by our capacity to project power militarily and the view
that national security "begins at home" through the production of a
healthier society is well illustrated by President Donald Trump's
budget. Characterized by deep funding cuts for many of the agencies that
safeguard America's health – such as the Environmental Protection Agency, the National Institutes of Health and the Department of Housing and Urban Development
– the budget has opened the door for a debate over how we,
collectively, define national security. Unless we invest in the fight
against health gaps, chronic disease, opioid abuse and
other threats that undermine the health of populations, we can never be
fully secure, no matter how powerful our military might. Our public
health spending should be commensurate with our investment in other
projects that contribute to our country's safety. It would be a shame
if, in the name of national security, we cast aside the programs that,
by keeping us healthy, truly keep us secure.
No comments:
Post a Comment