A couple of weeks ago I wrote about prohibition in the 1920’s and the documentary series about it. One of the observations made about alcohol availability during and after prohibition was striking. During prohibition you could get as much alcohol as you wanted whenever you wanted it. When legal you could buy certain amounts and only at certain times of the day.
The unintended consequence had been to make access to alcohol easier not harder.
These unintended consequences happen not infrequently in health.
I have written previously about how the “fat is bad” mantra has contributed to an increase in obesity. This came about because people were led to believe that “low fat” was synonymous with healthy. Yet when fat is removed from a food it has to be replaced with something. That something is generally sugar. (See this week’s guest article for figures on sugar.)
Whilst low fat foods have marginally (read the labels) fewer calories the sugar content is higher. This means we generally eat more to reach satiety as any fat content “fills us up”. Worse still the extra sugar means the greater release of insulin. This hormone gets sugar out of the blood stream but also inhibits fat burning.
So an unintended consequence of making everyone fat phobic has been an increase not a decrease in obesity rates.
Laws to prohibit cycling without a helmet sound sensible. The rationale is that there would be less head injuries. This has been the position in Australia and The USA but not in Europe though. In fact there they are more likely to ride a bike and there are not thousands of cracked skulls.
An unintended consequence of helmet laws is less people cycle. An interesting piece in the New York Times looked at this issue. In various European cities like Paris you can rent a bike from bike sharing facilities. These programs have got more people riding and reduce congestion. It also enables tourists to see cities at ground level. And you don’t need a helmet.
European researches concede that at considerable speed a helmet affords protection if you come off the bike. In the real world we are not pedaling like Lance Armstrong speed so such falls are exceedingly rare!
Melbourne, with flat terrain and a moderate climate has tried the bike share system but gets few takers whereas Dublin, which is cold and hilly, gets lots. The difference – in Dublin you can ride without a helmet.
If helmets made a huge difference to injuries you would expect a notable difference between head injuries in France and Australia. There isn’t because at pedestrian speeds it doesn’t. At racing speeds people absolutely need a helmet.
And yes a car can hit you but increasingly people ride on bike paths.
I am more a runner than a cyclist but see the health benefits of cycling. There is also the advantage of reducing congestion in busy cities. Plus as a tourist it would certainly be fun to pedal the streets.
Unintended consequences come in other areas of life too.
A couple of months ago an online campaign was started by a University student against Sydney “shock jock” Alan Jones after offensive comments he made at a function were publicized. The aim was to get him off air. Interestingly it turns out that his listener numbers have increased. Whilst the petition gathered over 100,000 signatories, I doubt that any of these people were actually listeners and one could wonder how many even live in his broadcast region of Sydney.
Considering the old advertising adage of they’re being no such thing as bad publicity, the blanket media coverage seems to have had (from the petitioners perspective) the unintended consequence of increasing his ratings!
And the real doozey! In an attempt to make asylum laws “more humane” government policy led to deaths at sea and the filling of detention centers to bursting point after being empty. This may be the ultimate in unintended consequence. This has now led to the extraordinary move to excise mainland Australia from its own migration zone! I shudder to think what unintended consequence this may have.
Unintended consequences may not be avoidable but we can learn to change tack when they become apparent. At present most authorities are too pig headed to do so.
Medical Doctor, author, speaker, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
Joe writes for numerous medical and mainstream publications, is clinical editor at Medical Forum Magazine, and is also a regular on radio and television.
Joe is Medical Advisor to Medicinal Cannabis Company Little Green Pharma, Chairman of Australian Tobacco Harm Reduction Association and sits on the board of Arthritis and Osteoporosis WA. He is often called to give opinions in medico legal cases.
Through all this he continues to see patients as a GP each week.