A Culture of Non-Essential Health

This is the second in a three-part series "What’s the True ‘Root Rot’ of American & Global Health? " examining what the Covid-19 pandemic is revealing about the overall state of American and global health.  

During the Covid-19 pandemic, fitness centers have been forced to shut down, while fast food restaurants, liquor stores and marijuana businesses remain open.  

If there’s one sentence that perfectly summarizes the decay of our nation’s health, it’s that one. To add insult to injury, take a look at this snippet from the April 8 Executive Order from my home state of Minnesota defining “essential healthcare workers” allowed to work during Covid-19: 

“Healthcare providers and caregivers including physicians, dentists, psychologists, mid-level practitioners, nurses and assistants, infection control and quality assurance personnel, pharmacists, physical and occupational therapists and assistants, social workers, optometrists, speech pathologists, chiropractors, and diagnostic and therapeutic technicians and technologists.” 

Notice what’s missing: certified personal trainers, health coaches and qualified fitness professionals. Even in a relatively healthy state like Minnesota, the people who work on the front lines of getting people to exercise, improve and solve their chronic illnesses, and boost their immune systems are literally seen as “non-essential.” 

You might think my perspective is biased based on my position as the co-founder and CEO of the world’s largest fitness chain, but that actually makes it more evidence-based. Because while we watch vaccine developments with bated breath and place our hopes in drugs like remdesivir, the truth is that we already know our greatest weapon against Covid-19—and it’s completely within our control: our personal health.  

The evidence to support this fact keeps piling up around us, yet we keep ignoring it. A recent UK study of nearly 17,000 Covid-19 patients found that those who were obese (BMI greater than 30) had a 33% greater risk of dying than those who weren’t. A separate UK study found a doubling of Covid-19 mortality risks among the obese. Taking heart disease, type 2 diabetes and other obesity-related health conditions into account, researchers in the second study said the Covid-19 mortality risks of obesity are even higher.  

If word broke of an affordable, readily available drug that lowered Covid-19 mortality rates by at least 33-50%, can you imagine the headlines? The excitement? The euphoria? The economy would probably re-open overnight and send the stock market to all-time highs.  

But despite all evidence, we still resist the idea of “exercise as medicine.” The coronavirus takes full advantage of that, because we know that being overweight or obese produces three strikes when it comes to Covid-19: 

1. Obesity can literally open the door for the virus to enter your body. The coronavirus enters through an enzyme called ACE2, and higher levels of that molecule are thought to be found in adipose (fatty) tissue. This could explain why obese people have a higher risk of catching the disease and becoming seriously ill.  
2. Once you have the virus, obesity lowers your lung capacity and makes it harder to get oxygen around your body, thus leaving you at greater risk to organ failure. 
3. Obesity compromises the immune system in ways that can lead to the dreaded “cytokine storm”: an over-reaction of the immune system that can cause serious bodily harm or even death. 

Political leaders and health experts tell us to stay at home, but home environments are rarely healthy. Not surprisingly, we’re finding out that despite the ubiquity of digital fitness offerings today, physical activity has decreased over the last eight weeks, while processed food purchases have gone up. 

As a business leader, it’s my responsibility to design a corporate culture that steers our employees’ behavior in the right direction. Values matter. Language matters. What we reward matters, as does what we punish. My company has successfully built a culture of health over the years, and that’s not just because we’re in the fitness industry. It’s simply the right thing to do.  

So especially at a time when one’s personal health is a matter of life and death in the immediate term, why aren’t political leaders calling on us to build a culture of health and wellness in this country? 

In the spirit of open dialogue, I’m asking your opinions on these important policy questions—some general, some specific: 

How can our political leaders and health care experts most effectively design a culture of health, both now and on the other side of the Covid-19 pandemic? 

Should doctors be able to prescribe certified health coaching or personal training as reimbursable treatments?   

Should we have a National Personal Health Campaign that’s actually measurable instead of just rhetoric? 

Should we create healthy opportunity zones to subsidize nutrition and wellness services in low income neighborhoods? In general, should we apply federal subsidies to make healthy options more affordable for everyone? 

Should people be allowed to allocate money in their personal Health Savings Accounts (HSAs) toward preventative health and organized sports activities? 

Should we provide meatier tax incentives for corporate wellness programs and level the playing field for small businesses? (Currently, large corporations can use pre-tax dollars to build onsite fitness offerings, while small companies can’t afford to do that, yet also can’t use pre-tax dollars to send employees to nearby gyms.) 

Much like a personal credit score, should a Personal Health Score be created with financial incentives that steer us toward healthier habits? 

These are just some of the issues that we should have been raising, debating and resolving over the last 30 years but instead, we watched obesity grow into a lifestyle contagion that has now joined forces with a viral contagion to kill hundreds of thousands of people.  

It’s never too late to turn the tide, take more personal responsibility for our personal health, and create policies that build culture of wellness. I’m optimistic that we can make it happen. But if a pandemic doesn’t inspire us to take action, what will?