William Vaughan’s assertion that illnesses are caused by personal behaviors oversimplifies a complex problem. Our decisions impact our health, but so does our environment.

The social determinants of health are increasingly recognized as having a profound impact on a person’s well-being. According to the Kaiser Family Foundation, social determinants are factors such as “the conditions in which people are born, grow, live, work and age.”

Whether a person has a steady income, lives in a safe neighborhood, has access to high quality food, social support networks, safe places to walk, access to health care etc. all play an important role in an individual’s level of health.

Vaughan highlights the obesity epidemic as another self-imposed condition without considering the plethora of high calorie, low quality food in our environment. Food manufacturers have spent years manipulating formulas for everything from spaghetti sauce to soda to achieve what they refer to as the “bliss point” or the “greatest amount of crave.” Billions are spent annually marketing foods that are high in fat, sugar and salt, and food manufacturers have fought efforts to tax sodas.

No, Mr. Vaughan, individuals are not solely responsible for their health status. If it were only that simple.

Mary Ann Larson


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