People have real reason to be unsatisfied with public health in America. After decades of public health campaigns, most well meaning, the effective useful lifespan of the average American is stuck at 66 years old. Beyond that age, the average American is in poor health and unable to live a full life due to a serious health issue such as diabetes, heart attack, gout, breathing difficulties etc. Not all Americans but averaged together, beyond 66 years of age more Americans are severely crippled then not. And that’s a big failure of public health.

While it’s true that on paper American lifespans are longer than 50 years ago, much of that lifespan is not in good health. We’ve been warned for decades about the dangers of smoking and chemicals, when it’s really the sugars, fats, salts, and lack of exercise in every day life that’s killing Americans. Public health has failed to make a difference where it really matters.

Will bringing back cigarette smoking to office buildings and beef fat drenched French fries make Americans more healthy? Probably not. One unhealthy behavior doesn’t cancel out another. But the promises of banning such things has been a clear failure because it’s occurred at a time when cities only became more car dependent and people are eating more processed foods and walking less. Javon’s paradox!

It’s not like seatbelts in cars – it’s well established fact that drivers who use seatbelts are more reckless – though there are clear benefits to be buckled up during a crash. But it still makes for drivers who drive more recklessly and are more likely to get in an accident in the first place, as they know the risk of dying is lower in a crash then operating without safety equipment! There is an net benefit, but it’s not at a cost of more crashes.