As time passes, we assume that innovative thought has enabled individuals to create happier, healthier and more fulfilling lives. But, if this assumption were true, then why do we have the unhappiest, unhealthiest, and most confused population in human history? Either the original assumption is inherently incorrect, or the conclusion is.

Currently, the United States has the most per population chronic diseases ever recorded, alongside having the most suicides, Adderall and SSRI prescriptions, and Semaglutide users. Without a doubt, we can consider this current population to be the unhealthiest in modern history. But it is not too late. As these phenomena have only formed within the past few decades, reversal is still possible. In order to understand what changes need to be implemented, it is vital to locate the poor governance that took place and understand why no reform is occurring.

Starting with the most obvious, we have obesity. By the end of WW2, around 13% of Americans were classified as obese, with fewer than 1% having diabetes. It wasn’t until the 1970s when obesity and its comorbidities started surging. It was around this same time that we saw their food culture move from prioritising naturality to circulating around inexpensive, empty calories. As a result, by the 1990s, obesity and diabetes had become mainstream health conditions with prevalence exceeding 30%.

Next, we have mental health conditions such as depression, anxiety, and ADHD. Weirdly enough, these conditions followed suit to obesity with the biggest surges occurring in the 80s and 90s. However, a huge difference with something like depression compared to obesity is the abundance of treatments. For example, the proportion of US population receiving outpatient treatment for depression increased over 300% between 1987 and 1997 after Prozac (introduced in 1987) hit the market. ADHD is slightly more difficult due to the ever-expanding diagnosis criteria. Yet, it is difficult to attribute an 80% increase in diagnoses from 1997 to 2016 on enhanced diagnostic tools alone.

By no means as mainstream, but definitely as interesting, we have allergies. Since the 1980s, allergies of all kinds have more than doubled. Similarly, but quite bewildering to the naked eye, this surge has also been seen in autoimmune conditions like coeliac, suggesting a serious environmental problem taking place.

Now, whilst it is almost impossible to pinpoint exact changes that have taken place to cause huge epidemics to occur, we can correlate time stamps and relevance to search for possible culprits. In the end, locating the possible culprits could enhance our vision of causation, and by taking a reversal approach, potentially find solutions. Or, at the very least, we can start.

One of the major political decisions that seemed to shift obesity rate came in the early 1970s under President Nixon’s Agricultural Secretary, Earl Butz. Labelled the 1973 Farm Bill, this policy aimed at controlling the price of corn by supporting farmers and maximising production. By abolishing previous policies and encouraging farmers to plant “fencerow to fencerow” an abundance on corn was created, drastically reducing prices. However, this policy did not account for just how much corn was going to be created. By the mid-1970s, the United States had so much corn that it was diverted into cattle feed, producing fattier meat, and into a new product called High-Fructose Corn Syrup (HFCS), which since its creation, has become a staple of the American Diet. Unlike in Europe where we use cane or beet sugar, Americans mainly consume HFCS due to its affordability and abundance, but unfortunately to them, it has been linked to with mercury contamination, leaky gut syndrome and a much bigger diabetes risk compared to natural sugars.

Following from the same policy, we have the increase in soybeans. Alongside corn, soybean plantations grew by almost 30 million acres over the space of 10 years, with a rate increase of 52%. As a result, per capita soybean oil doubled due to its oversupply. Furthermore, subsidy structures post-1973 further pushed down the price of soybeans, enabling them to be put into everything from animal feed to children’s school lunches. This policy also paved the way for many other vegetable oils and syrups, such as HFCS, to become to the building block of countless ultra-processed foods. But it doesn’t stop there. By the late 1970s saturated animal fats fell out of favour due to manipulated studies and dietary guidelines. Instead, there was a push for including “heart healthy” vegetable oils into everything. Industrially produced trans fats were all billed as heart healthy compared to natural alternatives, increasing the reputation of these food factories, and therefore their sales, but in the meantime, wreaking havoc on the US population.

By 2010, the United States became the world leader in ultra-processed food consumption which have been completely filled with vegetable oils and sugar alternatives. Some suggest that it is not the substances in the food, but the calories themselves. But even though American caloric intake has increased by roughly 15% since 1970 (300-500 extra daily), this has been completely outpaced by the rise in obesity, suggesting other factors in play. Moreover, the addictiveness of these chemicals cannot be underestimated, further suggesting a need for ingredient swaps.

Next, we have the reduced food assistance programmes from the 1980s where Raegen’s federal budget cuts reduced the quality of school meals. Epitomised with the classification of ketchup as a vegetable, the quality of school meals swapped from fresh ingredients to cheaper, processed substitutes, and also the reduction of subsidised meals. It wasn’t until 2010 that this was changed, but even though it has been 15 years, not many positives have been brought to light.

Controversially, I would like to add the lack of universal healthcare as a factor for these epidemics. Whilst countries like the United Kingdom, which have the NHS, are a completely mockery, the opposite system within the United States has not worked at all. Taking a middle ground, like The Netherlands, may have prevented many of these issues from worsening. For example, the regulated insurance healthcare, similar to the US but with lots of red tape, have helped the Dutch to become one of the healthiest nations in the world. But, instead of that, the US have 18% of uninsured citizens, neglect in preventative care, poor symptom management, and the huge fear of healthcare bills (even with insurance). As a result of this privatised, unregulated healthcare system, the US has become more focused on treatment over prevention (obviously). This is because prevention doesn’t rake in profit. In fact, it does the opposite.

A lesser thought of factor, but still of vital importance is the 1997 FDA relaxation on direct-to-customer advertising of prescription drugs. The United States became one of the few nations to permit advertisements telling people to “ask your doctor” in relation to prescription medication. This included antidepressants, anxiolytics, and later on, Adderall. As a result, the stigma behind mental health medication swiftly disappeared, whilst the numbers of people on prescriptions skyrocketed. Instead of becoming a treatment and prevention focused nation, the United States furthered into commercialisation and normalisation of pharmaceuticals.

As time went on, the standards for prescribing medications relaxed with many conditions, like ADHD, having drug treatment now as their first line of defence, instead of alternative therapies like counselling and education. These shifts meant that by the 2000s, more Americans were on long-term pharmacotherapy for chronic conditions than ever before, and the numbers are still surging.

Another vital factor is the No Child Left Behind (NCLB) Act of 2001. Originally created as a means to increase standardised testing scores across the nation, this policy reauthorised the Elementary and Secondary School Act, and encouraged a complete shift in funding. Instead of government resources for schools going towards lunch time meals, nutritional education, and physical education, the main focus became standardised testing. Looking at this blindly, it seems like an adequate bill. For instance, increasing the education across the nation can only benefit future civilisation. However, the drastic shift in funding caused 44% government funded schools to reduce PE and recess time, correlating to a rapid increase in childhood obesity. As a result, kids were burning less calories, building fewer physical skills but consuming more calories from ultra-processed lunches.

Outside of PE, broader youth fitness initiatives lost momentum. After the terms of President Eisenhower and Kennedy the Presidential Fitness Test almost but disappeared due to its overly competitive nature, and instilling a stigma on competitive sports.

Furthermore, the ever-increasing population caused a need for new community-built schools. But, due to this increase being so rapid, locations for the schools could not keep up with the growth of the urban areas. As a result, new schools had to be built on town outskirts to accommodate larger campuses, making it difficult to walk or cycle to school. For example, in 1969, 48% of American children walked or biked to school, but by 2009, this number became only 13%.

Unfortunately, it doesn’t stop there. Previous Raegen-era federal school funding cuts forced many schools in the 1980s to increase their finances by other means. But due to tight regulations, most turned towards making deals with vending machine companies and fast-food vendors. Not only did this enable ultra-processed foods and drinks to be accessible during all school hours, but it encouraged a culture of poor nutritional choices in children as young as 5.

The impact from educational institutions cannot be underestimated. A child’s culture is built during this vital period of their life. If they are unable to learn about nutrition, cooking and physical education, they are more likely to go through their lives eating ultra-processed foods, not exercising, and being part of the obese community. Therefore, it is vital to make nutrition and exercise a habitual part of a child’s life to allow them to make adequate decisions as they become more independent.  

Finally, we have America’s extreme car reliant culture. Post-WW2, the United States was seeing a surge in economic growth, causing a need for rapid suburban expansion. This encouraged the creation of the Federal-Aid Highway Act of 1956. The unintended consequence of this act separated residential areas from commercial, resulting in a car-dependent lifestyle for most Americans. As a result, work-related physical activity plummeted. This decline in physical exertion is estimated to have resulted in 100+ fewer calories burned per day in sedentary work, or 36,500 calories a year which equates to just above 18 full days of eating.

Furthermore, most post-war suburban areas were built without pavements, parks and bike lanes due to the heavily favoured federal interest in highways over mass transit or pedestrian projects. For instance, funding for public transport stagnated around this period, resulting in rail lines across many cities to be dismantled Consequentially, daily incidental exercise, such as walking to the bus, almost disappeared. The political aim of convenience has caused a reduced walkability and led to the long-standing pattern of “drive or stay home”.

The staggering rise in chronic illnesses, obesity, mental health disorders and pharmaceutical reliance in the United States should not be dismissed as coincidence or a mere byproduct of modern living. These epidemics are a direct result of deliberate and illiterate political decisions spanning across agriculture, healthcare, education, urban planning and pharmaceutical regulation. What began in 1970s as a means to consumerise nutrition and education, has over decades, culminated a society that thrives off of poor health. From corn subsidies to trans fat loopholes to vending machines in schools and car-dependent neighbourhoods, these systemic choices have eroded national autonomy and personal wellbeing.

But what has been inadequately engineered can be undone. Reversing this crisis will take nothing less than appropriate political figures, coordinated community uproar and unwinding the incentive to prioritise profit over prevention. That means removing harmful subsidies, restricting ultra-processed food and pharmaceutical marketing, reforming the medical establishment to favour preventative care, rebuilding environments where movement can rebecome the norm, not the exception, and flipping the educational philosophy upside down. This is not about returning to the past but about reclaiming the autonomy the past used to encourage.