The "SOME PEOPLE" Essays
Welcome to Diabetes Country: Corporate America's Benefit-Cost Ratio Harms Public Health by Dr. Chip Thomas | Edited by Kimberly J. Soenen
(“It Used to Read: Welcome to Pepsi Country.” Protest Art Action by Nurse Laurie Smith and Dr. Chip Thomas. Highway 89 outside of Tuba City, Arizona near the Moenkopi Arroyo, Navajo Nation, 1987. Photo by Dr. Chip Thomas.)
When I first arrived in Arizona to work on Navajo Nation land as a physician in 1987, street art was in its infancy. I was influenced by the street interventions of artist Robbie Conal and the Billboard Correction movement.
Before leaving northern Ohio, where I completed my Family Practice medical residency, I corrected a billboard advertisement for cigarettes that I changed from “Thrills with Pleasure” to “Kills with Pleasure.” Years later, thanks to whistleblowers and moral leadership from attorneys, the CEOs of the major cigarette companies were exposed for their Harm-for-Profit scheme. Evidence revealed they had been aware of the harm their products were imposing on consumers, yet tobacco companies continued to aggressively advertise and sell cigarettes. At that time, the cover-up by the tobacco industry was one of the largest corporate responsibility legal cases in the United States. On April 14, 1994, the top executives of the seven biggest tobacco companies in the United States appeared before the House Energy and Commerce Subcommittee on Health and the Environment. Each executive solemnly testified that, no, they did not think that nicotine is addictive.
That harm—when CEOs are intentionally harming citizens willfully—also parallels the business practices of the Commercial Health Insurance industry, which generates wealth for employees and shareholders from deliberately untreated illness, injury, disability and preventable death. The Big Tobacco case paralleled the case brought against the Nestle Corporation for overly aggressive marketing of their infant formula in developing countries, as well, which led to an epidemic of infant deaths.
“And just as tobacco companies lied for 40 years about the dangers of smoking, so too have the oil companies lied for decades about the dangers of burning fossil fuels. They saw today’s climate crisis coming – their own scientists repeatedly warned top executives about it – and decided, bring it on,’ writes Mark Hertsgaard for The Guardian.
The tobacco industry case resulted in a national education campaign about the harm cigarettes cause to the health to people, both users and those in close proximity, to cigarette smoke. In modern day, the velocity of haste, speed and greed has increased harm to health, healthcare and Public Health in ways never imagined. Today, people on the Navajo Nation, where I practiced medicine and called home for more than 30 years, suffer from an array of preventable illnesses.
The parallels with big oil today are uncanny. The big tobacco lawsuit was “premised on a simple notion”, said Mike Moore, the attorney general of Mississippi, who initiated the Big Tobacco case: “You caused the health crisis – you pay for it” by reimbursing states for the extra costs that smoking imposed on their Public Health systems. Replace “the health crisis” with “the climate crisis” and you have the very same argument that New York, Massachusetts, Minnesota and dozens of other state and local governments have made in their pending lawsuits against oil companies.”
—Mark Hertsgaard, The Guardian
I had been living and practicing on the Navajo reservation for one year when the Pepsi Corporation erected a billboard enticing motorists to drink their ice-cold sugary beverages. It was impossible to ignore the bold, large-scale advertisement. As much as I wanted to imagine its primary audience was for nonindigenous tourists traveling from Phoenix to Lake Powell, the billboard was located in one of the regions with the highest Type 2 diabetes mellitus rates in the country. The billboard was up for several months when Laurie Smith, a Public Health nurse colleague of mine, and I discussed our shared frustration at the insensitivity of the advertisement and disregard by Pepsi.
The Pepsi billboard was advertising unhealthy sugary drinks in a community that, at that time, had the highest per capita consumption of soft drinks and Spam. The area was considered a food desert and obesity was prevalent; the community also had the highest per capita sales of Kentucky Fried Chicken. In 2016, the United States soft drinks market was valued at $253.7 billion. These sugary drinks are nonalcoholic but contain flavoring, white sugar, and sometimes additional sweeteners which perpetuate the alarming diabetes epidemic in the United States. In many regions globally, sugary drinks are easier to access than clean drinking water.
As physicians and nurses, even back then, we were acutely aware of the high incidence of Type 2 diabetes among people on the reservation and the consequent complications associated with the chronic illness, such as leg amputations, renal disease, blindness, and heart disease. Renal disease makes people dialysis-dependent, which takes an emotional and financial toll on patients. Indigenous communities have the highest rate of Type 2 diabetes mellitus of any group in the country. The illness affects 25 percent of the adults over the age of 45 years. By comparison only 1/12 of Caucasian Americans develop this chronic illness.
The endless and extremely aggressive advertising of these “food products” presented the perfect opportunity for us, as community-responsive health practitioners, to challenge this insensitivity. We wanted the Pepsi Corporation to consider the impact their products make on high-risk communities who are living in food deserts. We were hoping to prompt people most impacted by the harm sugary drinks cause to reconsider the impact of their “food” choices.
So, late one night in 1987, we, a doctor and nurse no longer willing to accept the deceit of Pepsi and like-minded Harm-for-Profit corporations, climbed up on the billboard and corrected it to read: “Welcome to Diabetes Country.”
It used to read: “Welcome to Pepsi Country.”
ABOUT
Dr. Chip Thomas, aka “jetsonorama” is a photographer, public artist and activist who worked as a physician between Monument Valley and The Grand Canyon on the Navajo nation from 1987 to 2023. There, he coordinated the Painted Desert Project – a community building project which manifested as a constellation of murals across the Navajo Nation painted by artists from all over the rez + the world. These murals aimed to reflect love and appreciation of the rich history shared by the Navajo people back to Navajo people. As a member of the Justseeds Artists Co-operative, he appreciates the opportunity to be part of a community of like-minded, socially engaged artists. You can find his large scale photographs pasted on the roadside, on the sides of houses in the northern Arizona desert, on the graphics of the Peoples Climate March, Justseeds and 350.org carbon emissions campaign material. Thomas was a 2018 recipient of a Kindle Project gift and in 2020 was one of a handful of artists chosen by the United Nations to recognize the 75th anniversary of the UN's founding. Artists were chosen to generate work that "contributes to the envisioning and shaping of a more resilient and sustainable future. It is hoped that this work will amplify and accelerate implementation of the UN Global Sustainability Goals with a focus on communities and climate action." Follow the work of Chip here.