Alternative Health - Risk Versus Safety
Perhaps, it's true that we get the health care we ask for.
A couple of months ago, The Economist ran an article that compared the willingness to accept risk in various cultures. The premise under discussion was that Americans like the idea of risk more than Europeans do. It occurred to me while reading it that the fundamental premise might explain much about the differing ways in which various countries approach health care, doctors, and alternative therapies. To better understand what I'm talking about, let's quickly look at some of the conclusions in the article.
The stereotype is that Americans admire risk-takers (an extension of our wild west heritage), whereas Europeans prefer stability and expect the state to shield them from danger. The article points out that although a gross generalization, there is still a grain of truth in it, as evidenced in a number of ways. For example:
- The American economy is wide open to entrepreneurs, and correspondingly to any failure that may result. Bankruptcy rates are far higher in America than Europe.
- Americans are largely expected to protect their own homes and families, and, accordingly, gun ownership is far higher in the US than in Europe.
- And retirement is largely an every-man-for-himself scenario in the US (social security is pathetically low), whereas most Europeans expect the state to protect them in old age.
Risk when it comes to health
As far as it goes, this attitude carries over to questions of health and nutrition -- for both good and bad:
- The American government has embraced GMO foods, whereas European governments have not.
- Americans have built a health care system based on individual responsibility and choice. Europeans have adopted a one-size-fits-all, cradle-to-grave, state system.
- Despite any complaints about the FDA, Americans have a far greater array of choices available to them when it comes to alternative health (at least up until this point in time). The European Health Initiative (with Codex soon to follow) has determined that when it comes to alternative health, at least on the continent, anything beyond pixie dust is unacceptable..or soon will be.
And these attitudes are reflected in the number of visits that people make to CAM (Complementary and Alternative Medicine) practitioners in various countries. For example, a 2007 study out of Norway found that only 1.5% of the people surveyed visited a CAM practitioner exclusively during the year of the study versus 64% who visited a medical doctor. That contrasts significantly with the 20% who opted for alternative health care in Canada in a 2003 study. (Keep in mind that there are a lot of "cowboys" in the western provinces, where usage is highest.) But when it comes to alternative health care, Europeans and Canadians are mere wussies compared to Americans. According to a 2002 National Center for Complementary and Alternative Medicine study (the last major study on CAM in the United States), 36% of adults were using some form of CAM in 2002 -- with that figure likely to have increased over the last six years. However, according to the study, when megavitamin therapy and prayer (specifically for health reasons) were included in the definition of CAM, that number rose to an astounding 62% -- again likely to have increased in the last 6 years. Incidentally, this number parallels the 68 % of Americans who are reported to regularly take an all purpose multivitamin pill to supplement their diet -- which leads us to the next issue.
Risk when it comes to supplements
When it comes to supplements, we see the same kind of disparity between Europe and North America -- and the same kind of growth across the board. Global demand for dietary and nutritional supplements is steadily escalating throughout the world, with worldwide sales hitting approximately $53.4 billion in 2007. This represents a 38.7 percent increase in just the last decade. This data is based on figures from 2007 and was drawn together from figures published by Euromonitor, Datamonitor, Mintel and Nutrition Business Journal, and presented at the Supply Side East trade show in Secaucus, New Jersey by Capsugel's global business development manager for dietary supplements, Peter Zambetti.
But again, we see the same lack of adventurousness in Europe when it comes to supplements that we saw with CAM visits. In Western Europe, sales hit $7.4 billion, accounting for a 14.4 percent global market share. Significant growth, however, was registered in Scandinavia, Belgium, the Netherlands, Spain, Switzerland, Ireland, Greece, Turkey, and Portugal. Italy represents the largest market in Western Europe, valued at $1.6 billion. This is around 23 percent of the total European market. Germany comes in a close second, with $1.5 billion in sales and the UK is third, accounting for $1.1 billion in sales. France sits in fourth at $837 million, with ten other European markets together making up the remaining third of overall European sales. These are led by Scandinavia at 10 percent, followed by Spain, Belgium and the Netherlands, each accounting for 4 percent of European sales.
Austria, Switzerland and Turkey each hold 2 percent of the market, while Portugal, Ireland and Greece each represent 1 percent.
At first glance, Eastern Europe seems to lag far behind with sales totaling $1.4 billion. On the other hand, this represents a 313 percent increase in the last decade. Major category trends include minerals, fish oils, CoQ10, and glucosamine.
Again as with CAM visits, sales of herbs and dietary supplements in North America virtually doubled that of Europe, hitting close to $16.4 billion. Supplements on the rise include fish oil, coenzyme Q10, probiotics, glucosamine, lutein, zeaxanthin, SAM-e, phytosterol esters, and resveratrol. And thanks to the efforts of network marketing companies pushing "superfruit" beverages, noni supplements did over a quarter of a billion dollars in sales last year. Specifically, in the United States, sales are being driven by the baby boomers as they try to beat back the aging process with supplements that support eye, joint, and heart health. These account for almost half the market. As a side note, sports nutrition supplements are also a rapidly growing segment of the market and are expected to top $12.7 billion by 2011.
Now, Asia presents a slightly different picture. At $22.6 billion in sales, Asian countries account for about 44 percent market of the total market. China, of course, is the major player, with calcium the number one supplement. Interestingly, protein powder is the number two supplement in China at about three quarters of a billion dollars a year. As it turns out, since diets in China tend to be low in protein, protein powder is often given as a gift, elaborately presented in a beautiful gift box. No kidding!
But it's important to remember that the population in Asia is vastly larger than in Europe and North America. So on a per person basis, Asia falls back into third place -- followed by Latin America at $1.6 billion and Africa, the Middle East, and Australia combined at about $1.58 billion.
The bottom line is that when it comes to supplements, as with CAM visits, North Americans (and the US in particular) are more daring than the rest of the world, and Europeans in particular -- once again matching the premise established in the Economist article.
Avoidance of danger
But there is a cloud on the horizon. Part of the premise of the Economist article is that yes, things are different now, but in fact, Americans and Europeans are actually converging their attitudes in an attempt to squeeze out the last few drops of risk from life, with results that are often counter-productive. For example, when regulation is onerous, companies often move toxic industries from overregulated countries to under-regulated ones. But there are also more subtle ways in which efforts to eliminate risk can simply move the danger along. Some good instances come from behavior on the roads, where drivers may act more recklessly as safety measures (their own and other people's) make them bolder.
When it comes to alternative health, though, this so called convergence may be happening more at the governmental level than at the citizen level. At the citizen level, as we've already seen, the trend for alternative health is steadily up. No matter what the starting point (1.5 percent in Norway or 36-62 percent in the US), more and more people are choosing alternative health options -- or at least trying to. Governments, on the other hand, are universally and aggressively trying to close down many alternative health options and force people more and more into the establishment medical model.
And the effects are clearly visible. Sales of vitamin E, Ginkgo biloba, , garlic, evening primrose oil, and ginseng are all down, primarily due to "negative" media reports, flawed though the studies may be.
Conclusion -- the government assault on alternative health
It is ironic that as people around the world are turning in ever increasing numbers to complementary and alternative medicine and the use of dietary supplements to support their health, their governments are universally working to shut down those options.
Think I'm crazy? Just look at alternative health care in Canada and Europe.
- Some of the "unacceptable" herbs in Canada include: dong quai, gingko biloba, goldenseal, and horse chestnut. Look at the list. If an herb works, it's on it.
- Bill C-51 in Canada is backed by the pharmaceutical companies and seeks to outlaw some 60-70 percent of all natural health products currently sold in Canada. Even worse it would criminalize anyone -- parents included -- who continues to offer or use said supplements if the bill passes. For those who wish to make their voices heard, there's still time to petition the government -- whether you're a citizen of Canada or not.
- European Directive on Vitamin Supplements and the Traditional Herbal Medicinal Products Directive, which pretty much bans the use of most herbs in any amount and all vitamins beyond minimal doses.
- Codex Alimentarius, which when implemented will be the ultimate nail in the coffin of alternative therapies -- if allowed to stand.
- El Guapo and the FDA
Then again, maybe it's not so ironic. Many in the alternative health community would say that it's pure cause and effect -- that as CAM grows in the hearts and minds of citizens throughout the world, the multi trillion dollar medical/pharma establishment feels ever more threatened and seeks to shut CAM down by nudging governments to act. Maybe so, but only paranoid schizophrenics would feel threatened by a $54 billion dollar industry when they control a multi-trillion dollar industry that totally dominates the health industry…which they do.
Never mind! Bad argument! New studies have indeed shown that doctors, scientists, and pharmaceutical reps are in fact addicted to the same mind altering drugs they peddle to the public. So I guess we are talking about paranoid schizophrenics.