My view is, in between environmental determinism and personal responsibility, we say, "where there's a will there's a way." It's not true. You really need both and they're somewhat independent. We must both cultivate will and pave the way. If you inspire an impassioned people so that they have the will but there's no way, all around them are walls with no doors or windows. It's terribly frustrating. On the other hand, if you put a very nice way at their feet and they have no will to follow it, that doesn't produce anything very good either. Will is not way. You need both.
David KatzWe don't control everything. There are genetic influences. There are environmental exposures we don't control. I cannot guarantee anyone I counsel that by following what I hope is the good advice I offer them, they will live long and prosper. That's what I'm hoping for but I can't guarantee that. What I can tell them is this: "Look, I can help you firmly grip the wheel, and you can steer the ship. You're never going to control the winds and you're never going to control the seas. But if you sail well you can get through just about anything."
David KatzWe are facing a flood tide of factors into our daily lives and the lives of our children that conspire against weight control, and for that matter, health, any single policy or program we use to turn the tide is like a single sandbag. You put down the sandbag on the banks of the river. You could ask the question: Have we held back the flood? A sandbag isn't designed to hold back the flood. A sandbag is designed to be part of a levy to hold back the flood. It doesn't matter if it's a good sandbag, maybe a perfectly good sandbag. By itself it can't fix the problem.
David KatzI think basic disease care access and basic access to health care is a human right. If we need a constitutional amendment to put it in the Bill of Rights, then that's what we ought to do. Nobody with a conscience would leave the victim of a shark attack to bleed while we figure out whether or not they could pay for care. That tells us that at some level, health care access is a basic human right. Our system should be aligned so that our policies match our morality. Then within that system where everybody has access, we need to incentivize prevention, both for the patient and the provider.
David KatzMy view is, in between environmental determinism and personal responsibility, we say, "where there's a will there's a way." It's not true. You really need both and they're somewhat independent. We must both cultivate will and pave the way. If you inspire an impassioned people so that they have the will but there's no way, all around them are walls with no doors or windows. It's terribly frustrating. On the other hand, if you put a very nice way at their feet and they have no will to follow it, that doesn't produce anything very good either. Will is not way. You need both.
David KatzWe have literature indicating that overwhelmingly, health is influenced by a very short list of modifiable behaviors topped by three: tobacco use, physical activity and dietary pattern. You could modify those three things; you can change people's fate. I wanted to change those. Smoking cessation, important but relatively simple - a lot of people are working on that. Physical activity: important to me, important to health but also relatively simple. I like nutrition. It's complicated; you really need to learn a lot of stuff to be an expert there.
David KatzI naturally gravitate toward the big picture which isn't necessarily advantageous when you go on to a career in research because successful researchers usually choose a pretty narrow channel. So having tunnel vision actually helps you stay where you are supposed to stay. The big picture in medical care was looking at the underlying causes of all of this pathology. I really wanted to do something about that and play a meaningful role in changing the trajectory of people's lives and their health and by changing their health, changing the quality of their lives.
David Katz