Issues at lunch

The stockbroker ordered a salad and the rest of us thought he’d lost his mind, or that the waitress had laced our iced tea with L.S.D.

“Starting the new year right,” he growled, his frown suggesting that he had chatted recently with his physician, likely after a physical, the concerned doctor waving the results of his patient’s lab work. Stockbroker, you see, is Arkansas’s leading advocate of the chilidog, or chiliburger, as the key to a long and happy and healthy life, especially when accompanied by a heaping order of French fries, spuds sleeted with sodium.

Our buddy the broker is not obese, by his insistence and perhaps even by the accepted clinical definition. But he has always been willing to acknowledge, and at times volunteer, that he is “heavy.” He could “do with a few less pounds.” His belt, he once cheerfully observed, was both genuine alligator and in need of another hole.

Starting his new year right started the conversation for our little lunch bunch, our first feast of the new year, and darned if his example didn’t prompt the guy we know as Big D Democrat to amend his order: Instead of his customary BLT — bacon and mayonnaise, true, but hardly the cardiac bomb that is a chili-slathered cheeseburger — he went for a chef’s salad. Oil and vinegar, thanks, and hold the bacon bits, light on the cheese. Little D, closer to the political center than Big D, weighed the day’s soup options: vegetable, vegetable beef, chicken tortilla. Chastened, maybe by the salads with which some of us were starting the new year, right or not, he chose the comparatively benign vegetable. (Your columnist: a Cobb, with a vinegarette, but he forgot to forego the bacon bits and blue cheese crumbles.)

Food — salads, sweets, vegetables, fat, fruit, protein, carbohydrates, calories — food fairly quickly segued us to politics, and the legislative session and a new governor. The agendas, the legislature’s and the administration’s: what was proposed thus far; what was pending, perhaps weeks distant. And what had not been proposed, likely would not be.

Food: Our posse’s second broker, the one who deals in insurance instead of securities, was prompted to share the particulars of an article he had read the night before, an update on the current chaos afflicting Britain’s vaunted National Health Service (NHS). A shortage of physicians. Nurses, too, who have twice gone on strike; overworked and underpaid, their complaint. Ambulance crews are threatening another walkout unless their wages are raised. That the NHS has been chronically underfunded is as commonly known as is the British public’s insistence that the service be continued. But another factor was in play, too, as our insurance broker explained.

Merry Old England has become fat. Overweight, significantly. British officials estimate that obesity drains the NHS of almost $72 billion dollars (U.S.) and is on a steep upward curve. The cost to Britain’s private sector, and to other government agencies in lost productivity, is easily in the billions. Making matters worse, surveys of English elementary students are recording depressingly high rates of early-stage obesity. The author of the article, a physician, asserted that government intervention was indicated, that there was basically no difference between epidemic obesity and smoking, drunken driving or illegal drug use.

So, our pal asked, where’s the plan, the commitment, to do something about obesity in Arkansas, in either adults or kids? (Both, preferably.) For decades the leaders of every public health agency of state government and private medicine have urged a consistent, comprehensive attack on obesity, a category of social and clinical ill in which our state invariably ranks in the top ten, often the top five. Cardiovascular disease, kidney failure, stroke, diabetes — the maladies brought about by obesity cost the Arkansas Medicaid program hundreds of millions of dollars annually, and siphon like sums from private enterprise while helping drive up health insurance premiums.

Big D wondered how many of us remembered the uproar, exactly two decades ago, when Arkansas officials sought to address early-stage obesity by measuring the Body Mass Index of public school students. The backlash was immediate, and singed policymakers from school boards to the State Capitol. For a few weeks it was the drag queen ban of its time.

“Tell you another one,” one of us said, meaning an issue unaddressed: adolescent and teen pregnancy. Arkansas never truly put its shoulder behind the wheel, he said, and as a consequence the state was continuing to essentially manufacture poverty; the data was definitive.

So there we sat, our group, most of us doing what we could for our state at that moment. Salad.