Doctors in Boston can now prescribe biking to fight obesity
— By Tyler Falk on April 7, 2014, 3:07 PM PST
This is another one of those silly "if you give it to them, they will come" stories. Dana Blankenhorn used to post these all the time for "Reinventing Healthcare". My favorite was the one where it was suggested that if we only spent enough money to make sure that every neighborhood had sidewalks, then everyone would be walking and obesity would disappear. Strangely enough, my neighborhood has no sidewalks, and yet every evening hundreds of people (myself included) can be seen walking the streets before sundown. On the other hand, I know plenty of less-affluent neighborhoods where all streets have sidewalks, and yet there are few pedestrians. What gives?
The reality is that the "obesity crisis" has more to do with culture and values than it does availability of bicycles and sidewalks. This seems more like a scheme to help prop up the city's bike sharing program.
Will the physicians receive immunity from legal action when one of the participants is injured or killed while engaged in the "doctor prescribed" program? With all of the trial attorneys running the government and just about everything else, I think not. What a sad indictment on our society running amok.
"Obesity is a significant and growing health concern for our city, particularly among low-income Boston residents," said Kate Walsh, chief executive of Boston Medical Center, in the statement. "Regular exercise is key to combating this trend"
Although a welcome move, "eating less and exercising more" is not "experts reveal staggering news" new rocket science.
...why not just give people a dicount voucher for a personal bike, or perhaps a familiy set of bikes to encourage wider use - they can cash in at Walmart, Decathlon, Tesco, Target, Sports Direct, Halfords etc....as opposed to a bike-share programme, of little use to people where it does not exist. Indeed, it seems self-serving of the City to be subsidizing it's own scheme.
"To qualify for the prescription, participants must be 16 years or older and be enrolled in some form of public assistance, or have a household income of no more than four times the poverty level, according to the statement.".....
......... aahhh, you missed the small-print - only open the 'deserving poor', and no fat kids allowed, and for the rest of the population it's "on yer bike".
For the reality of the Obesity crisis, don't forget the food growers, manufacturers and retailers secondary culpability, with their industrialised food, High Fructose Corn Syrup, the lies of 'low fat' and diet foods, the dependency culture of gyms and weight loss comanies and supersized portions which has invaded and corrupted the 'culture' you mention.
Primary culpability remains with people shoving the stuff in their mouths, and living a sedantary lifestyle.
@Neil Postlethwaite It's definitely not a perfect program. I'm not sure about Boston, but if this program were in DC, where I live, it would have one major flaw: bikeshare density is not high in the parts of the city where the concentration of poverty is highest.
Take a look:
That would make the program worthless in DC if the goal is to try to encourage people living in poverty to bike more. In that case, I like the idea of a voucher for a bike. But I would give patients the option of choosing a bike voucher or bikeshare membership, since there are advantages of that system -- patients wouldn't have to maintain the bikes or store them.
@Neil Postlethwaite Recently I attended a "grandparents and relatives" event at my niece's and nephew's private school. About half way though the day's activities, it occurred to me that out of the hundreds of children that crossed my path, I saw absolutely zero that I would have classified as "obese" and almost none that I'd even call "overweight". Then I started looking at the adults, (parents & relatives of these children) and although they weren't as universally fit as the children, there were far fewer overweight people than the population at large.
There's no question that much of this could be written off to the fact that as most of these people are far more affluent than average and are on better diets. However, that doesn't explain all of it. I also know how my nieces and nephews eat. They are hardly on a Michelle Obama approved diet.
I think that it has more to do with a far less sedentary lifestyle and the absence of the "latchkey syndrome", amonst other factors.
@Tyler Falk @Neil Postlethwaite
Thanks for the reply, with some comparative context elsewhere.
Pretty much why I said just give people a voucher/coupon to give a discount on a bike, they can own, keep and use all the time. You can buy a respectable entry level bike (adult and child) for < $100, and 75% off would tip many people into getting one. Maintenance on a bike is hardly that troublesome, though perhaps a community drop-in in partnership with a few bike retailers in a coupon scheme, to help with this too.
@Neil Postlethwaite It's just another argument for the demonopolization of schools in the US.
@JohnMcGrew @Neil Postlethwaite
However, don't forget most private schools have excellent and extensive sports facilities, and chasing aspirational achievement and competitive competition is strongly encouraged - "building tomorrow's leaders". See the GB team's Olympic medal's at London 2012 for example, where half the medal haul came from kids privately educated - a reported 7% of the general population.
A number of these sport heavy schools also suck up poorer kids who are sporting leaders - the UK's Tom Daly diver for example had a scholarship to a private school, although after some well publicized issues.
More wealthy parents, also are more likely to have Gym or Country Club memberships too. You can add other activities commonly dominated by more children or more affluent parents swimming, gymnastics, winter sports, Irish Dancing
Discount no, prescription yes. With a prescription in hand, a store cannot charge sales tax on the purchase of a bike or trike. The way our current idiotic regulations work, you can buy a stationary Exercycle (assuming you can cough up $3,500) tax free, but buy a bike for outdoors for $100 with or without a prescription and you are screwed, and no, putting an outdoor bike on a dynomometer won't get around the restrictions. Get rid of the restriction for Medicare, have doctors prescribe bikes and trikes and have the private insurance companies pony up their share.