Under One Roof

Ignoring the nation’s growing health crisis risks structural failure on every floor of American society

Think of America as a house that a few billion people have built over the centuries. This house has kept us warm and alive. Our house has many rooms. It functions in accord with complex operating systems that allow people, resources, knowledge and ideas to move around. Most of the time, America’s house meets the needs of most of us before some of us get the short end of the stick.

Like our real-world houses, America’s house is constantly changing because the environment it exists within is changing. Plus, the demands placed upon America’s house have steadily grown in step with our numbers and our sense of what “the good life” should deliver.

As more of us don’t get or achieve what we feel we deserve, though, discord arises that, like cancer in the human body, can begin to tear apart essential connections and undermine core operating systems in the house that is America. Over time, it becomes more and more difficult to fix a break in a pipe or to resolve a conflict over who gets to sleep in what room.

The Framework We Agreed On

To weather storms, repel invaders, survive plagues and famine and avoid civil unrest, we agreed upon a Constitution that speaks to how we can build a more perfect house. We have established rules, laws and invented ways to get things done to keep our house in order and to ensure it is a house built to last.

There are only a few things shared by every person who gets a chance to live, breathe and walk the Earth. We are born, and we will all die. We all have basic needs, among them a house to live in. But good health is the one thing essentially everyone hopes for during our trips around the sun.

Health is a complex notion. It’s defined most clearly in its absence. At least at the extremes, most of us aggies can tell the difference between healthy and unhealthy soil, animals and farms. Likewise, those in the medical profession can do the same when it comes to the presence or absence of disease, diabetes, a broken bone or a torn ligament.

For most people, sustaining good health is our single most important lifelong goal. Given a choice, most people would rather be healthy than rich or famous. Health exists in many dimensions that individually and collectively determine how healthy we are during our time as residents in house America. There is soil and environmental health, physical health (the absence of injuries and diseases and the ability to have healthy kids), mental and spiritual health, and cultural and communal health.

A House Falling into Disrepair

By most measures, America’s house is no longer able to sustain the good health of all people currently living in it. Most Americans now agree that the collective “we” is getting less healthy and less able to manage the affairs in our house in ways that make most people a little healthier day by day. In short, we are no longer moving toward a more perfect union.

Near-term success now depends on assessing the current state of our affairs through the prism of reality. If we do not, we will fail to realize the scope and magnitude of the problems that now threaten us and pose an even greater threat to our kids and grandkids.

Failure to acknowledge problems is usually all it takes to kick the collective can down the road and hope and pray for the best. There is lots of praying and kicking going on these days.

President Trump struck a political nerve with the MAGA movement. One of its side channels — Make America Healthy Again (MAHA) — has already done some good by making it possible for political leaders to talk more openly about declining public health and what is causing it.

The MAHA movement is drawing physicians and scientists into the public square and giving them a platform to help America do a sound check on our collective health. This brings me to the two existential challenges facing America and our one really big problem.

Challenge One: Health in Decline

Our first challenge is that public health in house America is in steep decline, with no end in sight — as is the health of our climate, soils and water resources from sea to shining sea.

The erosion in personal health, including mental health, is driving the troubling, self-reinforcing upward trends in depression, despair, isolation, addiction, suicide and violent crime. It is, furthermore, severing family and community ties and any shared notion of, and commitment to, the public good. All of the above makes it harder to either MAHA or MAGA.

Challenge Two: The Money Problem

The second consequential challenge is rooted in money — who has it and who doesn’t. How much does it take for someone to feel secure and ready to share, and what should we do now that income and wealth inequality have become a primary driver of the problems spreading in house America?

By some metrics, we have made progress on the economic front. According to Census Bureau tracking data, the official poverty rate in the 1960s was around 22 percent and has fallen by about half, to about 11 percent in 2023. But compared to the late 1980s, the top one-tenth of 1 percent of U.S. households has gained almost $1,000 in wealth for every $1 increase among the bottom 20 percent of households. The richest 1 percent of Americans own about one-half of all stocks, compared to about 1 percent held by the bottom one-half of all U.S. households. Over 40 percent of the U.S. population, and almost 50 percent of children, are considered poor or low income.

More money is not going to make the rich happier or healthier. It cannot buy a person love or respect. Hunger for money is like an aggressive cancer, always looking for a way to take wealth from someone else. Growth for the sake of growth and wealth for the sake of more wealth is akin to the operating philosophy of a cancer cell. Both cancer and wealth can become malignant and ultimately lethal if left unattended.

Our Biggest Threat

During the last presidential campaign, then-President Biden used to end most of his stump speeches with some version of “When Americans put their minds to it, there is nothing we cannot do.” This uplifting dose of patriotic optimism depends on a big caveat — that all Americans agree to do their part and work in harmony to achieve a common goal. President Biden excelled in appealing to our shared values and aspirations but failed to slow the social unrest and discontent that has now spread into our politics and about everywhere else.

The one existential threat in house America is our failure to draw upon facts and science to define the scope and severity of problems and then forge agreement on steps to begin the healing process.

We know many of the things most directly and significantly undermining physical and mental health in America. Many are rooted in the poor and declining nutritional quality and safety of the U.S. food supply and our dietary patterns. Unhealthy food is now imposing on our healthcare system an impossible burden. Despite all the advances in medical knowledge and technology, children in America — our most precious asset — will consume some 60 million servings today, and tomorrow, and every other day for the foreseeable future, of food that is neither nutritious nor safe.

What we are feeding our children is placing far too many on the path to a suite of chronic physical and mental health problems for which the healthcare system, with or without universal coverage, can only “manage” the progression of ill health. Is that the best we can do?

What Must Change

Becoming healthy will require big changes in many rooms in America’s house and in how residents manage their collective affairs.

There are two things that history shows could break our house apart, and perhaps with shocking speed. One is sickness that spreads from room to room and floor to floor, despite our best efforts to seal the contagion. The second is when the poor become infused with frustration and anger that can no longer be contained. Eventually, it begins to break through walls and floors, and the foundation of house America begins to crumble.

To nudge house America back on the road to health, big changes will be required in how we grow, process and distribute food, as well as wealth, income and opportunity.

Healthy food must become the most profitable food moving along value chains. This is not now the case because of policy choices and how our tax dollars are deployed in support of American farmers and ranchers. But policy choices are just that and can change when a sufficiently united and engaged majority of people accept the need to do so.

Inequality in incomes, wealth and opportunity is denying too many among us access to what it takes to stay healthy or regain health when it begins to slip. Perhaps the ultra-rich will eventually realize that we will all be better off when wealth is used to seed opportunities to create more of it that is spread more evenly among all of us.

In the interim, Congress needs to craft and pass a new farm bill that addresses the root causes of the economic crisis facing row crop and grain farmers. For that to happen, our political leaders need a sustained dose of straight talk about what is eroding the health of U.S. agriculture.

But straight talk about the need for food and agriculture policy reforms is in short supply these days. It is drowned out by the chorus of voices hoping to keep things mostly as they are. We seem more committed to perpetuating myths about American agriculture and our food system than fixing what ails both.

Charles Benbrook is an advocate for health-driven transformation in all things food and ag. He has served as an expert witness in recent litigation against Bayer/Monsanto.