Failure.Gov

The failure of government intervention is not a new phenomenon. Since the beginning of the 20th century, the U.S. has experienced a series of well-intentioned federal interventions that have failed to achieve their intended outcomes. History reflects a pattern of ineffective government actions aimed at improving Americans’ lives that spans the social, economic, and political domains. These great visions have been contaminated by facts.

Prohibition of Alcohol

The Prohibition Act, adopted in 1920, the 18th Amendment to the US Constitution, led to a complete ban not only on the production but also on the sale and distribution of alcoholic beverages nationwide. Dubbed the “noble experiment,” it was initiated with the aim of reducing crime and corruption, addressing social issues, lowering the financial burden of prisons and poor houses, and improving health and hygiene in America. However, the results clearly demonstrate that it was a complete failure in all respects. Prohibition not only failed to achieve its intended goals but also exacerbated the very problems it sought to solve.

Although consumption of alcohol fell at the beginning of Prohibition, the positive influence was short-lived as it subsequently increased and coincided with the exchange for harsher and more hazardous forms of consumption (12,13). Alcohol became more dangerous to consume; crime increased, the court and prison systems were stretched to the breaking point; and corruption of public officials was rampant.

Prohibition eliminated a significant source of tax revenue and greatly increased government spending. It also led many drinkers to resort to opium, marijuana, patent medicines, cocaine, and other dangerous substances that they would have been unlikely to use in the absence of Prohibition (12,13).

A rise in amateur moonshiners led to products that could harm or even kill consumers. These underground-produced spirits often contained dangerous contaminants not subject to regulation. Speakeasies surfaced in business districts, middle-class neighborhoods, and other areas that were previously dry or gave the impression of being dry. Meanwhile, the Bureau of Prohibition’s annual budget tripled during the 1920s. Yet, the resources devoted to enforcing Prohibition increased alongside consumption, even though heightened enforcement did not reduce it (12,13).

The Great Depression and The New Deal

While some have attributed capitalism’s failure to the Great Depression, retrospective analyses suggest that federal government intervention fostered the economic crisis and even prolonged its deleterious effects. Nobel Laureate economist, Milton Friedman, along with other notable economists, maintained that the Federal Reserve System’s misguided monetary policy exacerbated the late- 1920s recession, ultimately transforming it into the catastrophic Great Depression of the 1930s (1,2). In his 1963 book, A Monetary History of the United States, 1867– 1960, Friedman and his co-author, Anna Schwartz, presented empirical evidence showing that the Fed made 2 critical errors with tragic consequences (15). First, they raised interest rates to curb stock market speculation. This reduced the money supply, severely impacting businesses and consumers and leading to reduced spending and investment. Secondly, the Fed failed to act as a lender of last resort. When banks began to fail, the Fed did not provide enough money to support the banking system, making the situation worse. The collapse of the banks led to a decline in the money supply, further deepening the economic downturn (1).

Ironically, despite this failure, the federal government convinced the general public that more government intervention was the necessary remedy for economic instability. Consequently, these events resulted in an increase in government power and control over various facets of economic life, including banking practices, labor relations, and social welfare programs, profoundly shaping the American economic landscape (1).

The government’s response was the emergence of President Franklin D. Roosevelt’s (FDR) “New Deal”, a series of programs and reforms aimed at economic recovery. Through nearly 3800 executive orders, FDR exercised unprecedented, arbitrary power and imposed price and wage controls through legislation, such as the National Industrial Recovery Act, the Agricultural Adjustment Act, and the Fair Labor Standards Act, and the expansion of the Federal Reserve Board’s authority through the Banking Act of 1935, which allowed for more direct influence over monetary policy and banking regulations. Yet these policies, inspired by Soviet-style central planning, are believed to have prolonged the Great Depression by several years (2,14).

New Deal policies tripled taxes, including personal income, corporate, and gift taxes, and at the same time increased the cost of employing people, causing unemployment to remain high. It is rarely noted that, despite the New Deal’s proposed benefits, FDR presided over double-digit unemployment for most of his first two terms as president (3). The median unemployment rate from 1934-1940 was 17.2%, and at no point during the 1930s did it dip below 14% (14). By 1940, unemployment was estimated to be 8 points higher than it would have been without the New Deal policies (14). Ultimately, the New Deal failed to address the key social issue of the Great Depression – chronic high unemployment – and, rather than aiding recovery, it retarded economic growth.

​The War on Poverty

The War on Poverty, introduced by Lyndon Johnson in 1964, is another bungled government initiative too blatant to ignore. It focused on legislation and programs that provided services to those in poverty, including legal and medical assistance, supported human capital development, and encouraged social and community change. During the same period, additional legislation was passed to provide health insurance for the poor through Medicaid. The Food Stamp Program was expanded, and housing subsidies were increased.

What’s often overlooked is that the poverty rate was already declining significantly before these initiatives were launched by Johnson’s administration. In 1950, the poverty rate stood at 32.2 percent, but by 1965—the first year that any War on Poverty programs began to operate—it had been nearly halved to 17.3 percent (4).

Over the next 50 years, U.S. taxpayers would spend over $22 trillion on anti-poverty programs –three times the total cost of all U.S. military wars since the AmericanRevolution (4). However, progress in combating poverty was minimal. By 2014, 50 years after the War on Poverty began, the poverty rate was about 14 percent, essentially the same rate as in 1967, three years after the War on Poverty was announced. As Chart 1 shows, according to the Census, there has been no net progress in reducing poverty since the mid to late 1960s. Since that time, the poverty rate has fluctuated slowly, rising by a similar amount during good economic times and falling by a similar amount when the economy slows. This was despite an explosion in anti-poverty and welfare spending during the same period, as illustrated in Chart 2.

By 2013, the federal government had rolled out over 80 welfare programs that provided cash, food, housing, medical care, and targeted social services to poor and low-income Americans (4). Meanwhile, the extensive growth of the welfare state significantly diminished many Americans’ ability to be self-sufficient by disincentivizing work ethic and disrupting family structures. When Johnson initiated the War on Poverty, only 7 percent of American children were born to unmarried parents (4). Today, that figure has risen to over 40 percent (5).

The failures of federal agencies extend beyond social and economic issues. The major public health agencies have, for years, attempted to improve Americans’ health through well-meaning interventions. But as with those other wonderful government ideas, reality refused to cooperate.

The Food Guides and the Obesity Epidemic

For decades, the US government has tried to tell Americans how to eat. Committed to improving public health through awareness and education, the Food Pyramid was introduced in 1992 by the United States Department of Agriculture (USDA) to provide a visual guide to healthier eating for Americans. It outlined a hierarchy of food groups intended to promote balanced nutrition and combat a growing concern over obesity. The Food Pyramid emphasized carbohydrates as the foundation of a healthy diet, promoting high consumption of grains while relegating essential fats and proteins to the higher, less important tiers. It also failed to distinguish between whole grains and processed foods, encouraging consumers to follow a diet composed of low-nutrient, calorically dense foods (6,7). However, excessive carbohydrate intake, especially refined carbohydrates and processed foods common in American diets, has been linked to poor health outcomes, suggesting that following the principles of the Food Pyramid leads to poor health (7,9).

Instead of effectively combating obesity, consumers deferred to guidance from the Department of Agriculture and the National Institutes of Health, both funded by their tax dollars, and were duped into believing that loading up on carbohydrates— including refined grains—and reducing fat intake was the best way to achieve good health. Consumers could count ketchup as a vegetable, pudding as a dairy product, and chips as a grain. Meanwhile, the Pyramid image was marketed on cereal boxes and milk containers, and education campaigns were embedded in public schools, all while the belt size of the American public climbed out of control. By 2010, nearly 36% of US adults were obese (10), an increase of 13% since the Pyramid was introduced.

The Department of Agriculture adjusted its course by replacing the Food Pyramid with the MyPlate initiative in 2011. MyPlate simplified dietary guidelines into an easier visual representation, dividing a plate into four sections: fruits, vegetables, grains, and protein, with a corresponding side for dairy (11). Over the next 10 years, the USDA allocated taxpayer funds and resources to outreach efforts to communicate and market the MyPlate message to schools, health professionals, and the general public. But like the Food Pyramid, MyPlate failed to distinguish between whole grains and processed carbohydrates. Despite its intended benefits, MyPlate failed to combat obesity, and by 2020, the prevalence of obesity among US adults exceeded 42% (8).

As it pertains to improving Americans’ physical activity behaviors, the federal government has not fared much better.

Physical Activity Guidelines

Physical activity (PA) is essential for maintaining health and preventing chronic diseases. In recognition of its critical role, the evolution of Physical Activity Guidelines (PAG) has shaped public health strategies in the United States.

The roots of physical activity recommendations in the United States date back to the 1970s. The first formal guideline was released in 1975 by the American Heart Association, which emphasized the importance of exercise in reducing the risk of cardiovascular disease (16). However, it was not until the first edition of the Dietary Guidelines for Americans was published in 1980 that physical activity was formally acknowledged in government publications (17).

In 1996, the Surgeon General’s Report on Physical Activity and Health provided the impetus for future guidelines, linking insufficient physical activity with public health concerns, including obesity and chronic diseases. The report set the stage for subsequent guidelines by highlighting the need for regular physical activity and establishing minimum standards (18). So, the Department of Health and Human Services (HHS) gathered a team of 13 leading scientists from some of the most prestigious academic institutions to develop a more comprehensive set of physical activity recommendations. The recommendations for physical activity became formalized when the HHS published Physical Activity Guidelines for Americans for the first time in 2008. The document consisted of 76 pages and was intended as the primary source of information for policymakers, physical educators, health providers, and the public. The general recommendations stated that adults should engage in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity each week, along with muscle-strengthening exercises on two or more days per week (19). That same year, the guidelines were incorporated into the Healthy People initiative , a set of goals and objectives with 10-year targets to guide national health promotion and disease prevention efforts and improve the health of all Americans. However, the US National Health and Nutrition Examination Surveys indicated that adherence to the Physical Activity Guidelines for Americans for aerobic activity did not increase by 2016, yet the amount of time spent on sedentary activities did (22).

In 2018, the guidelines were reviewed and revised. The updated guidelines echoed the 2008 recommendations but incorporated new evidence on the health benefits of physical activity across various populations and age groups (20). The revisions emphasized a more inclusive definition of physical activity, acknowledged the benefits of small amounts of activity, and highlighted the importance of reducing sedentary behavior. That same year, the CDC launched the Active People, Healthy Nation campaign, a national initiative coordinated by the Centers for Disease Control and Prevention (CDC), and the Office of Disease Prevention and Health Promotion (ODPHP) developed the Move Your Way campaign . Both initiatives aimed at increasing the number of people who meet the Physical Activity Guidelines for Americans.

Despite the rigorous development of the Physical Activity Guidelines and significant promotional efforts, adherence to the recommendations has not improved significantly since 2018. The CDC’s Active People Healthy Nation reported that the proportion of US adults meeting the aerobic physical activity guidelines remained unchanged from 2020 to 2024 (23). Moreover, less than 1 in 4 US adults met the recommendations for both aerobic and muscle-strengthening physical activity (24). Although evidence shows a modest increase in adherence to muscle-strengthening guidelines, it remains low, with only 27% US adults meeting the recommendation (25).

With a “dream team” of exercise scientists, mountains of supporting evidence, and 2 major nationwide public health campaigns, what could have possibly gone wrong? What is preventing Americans from getting active? What information are health professionals and public health agencies withholding from us?

In my next article, I will address these questions and share my insights.

Notes

1. Friedman, Milton, Rose D. Friedman, and James Adams. Free to choose: A personal statement. Vol. 249. New York: Harcourt Brace Jovanovich, 1980.

2. Sowell, Thomas. Intellectuals and society. Hachette UK, 2012.

3. Powell, Jim. “FDR’s Folly: How Roosevelt and His New Deal Prolonged the Great Depression.” Forum Books, 2004.

4. Rector, Robert, and Rachel Sheffield. “The war on poverty after 50 years.” Heritage Foundation Backgrounder 2955 (2014).

5. The World Population Review, Out of wedlock births by country 2026 ( https://worldpopulationreview.com/country-rankings/out-of-wedlock-births-by-country

6. Savage, J. S., Marini, M., & Birch, L. L. (2020). The impact of the “Food Pyramid” on American eating habits. Nutrients, 12(4), 927.

7. Micha, R., Peñalvo, J. L., Coady, S., et al. (2017). Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States. JAMA Internal Medicine, 177(10), 1477-1487.

8. Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2020). Prevalence of obesity and severe obesity – Hu, F. B. (2022). Resolved: There is no significant relationship between sugar-sweetened beverage consumption and weight gain. Obesity Reviews, 23(S1), e13333.among adults: United States, 2017–2018. NCHS Data Brief, (360), 1-8.

9. Jo, Unhui, and Kyong Park. “Carbohydrate intake and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies.” Nutrients 15.7 (2023): 1740.

10. Ogden, Cynthia L., et al. “Prevalence of obesity among adults: United States.” NCHS data brief 2013.131 (2012): 1-8.

11. U.S. Department of Agriculture. (2011). MyPlate: A New Way to Approach Healthy Eating. Washington, DC: U.S. Government Printing Office

12. Thornton, Mark. Alcohol Prohibition was a failure. Vol. 2. Washington, DC: Cato Institute, 1991.

13. Eremin, Arkadiy А. “Why Prohibition Tactics do not Work? A Critical Evaluation of Historic Experience of the United States in Fighting Alcohol and Drugs.” (2022).​

14. Powell, Jim. “FDR’s Folly: How Roosevelt and His New Deal Prolonged the Great Depression.” Forum Books, 2004.

15. Friedman, Milton, and Anna Jacobson Schwartz. “A monetary history of the United States, 1867-1960.” (2008): 1-888.

16. Pate, R.R., Pratt, M., Blair, S.N., et al. (1995). Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association, 273(5), 402-407.

17. U.S. Department of Health and Human Services. (1980). Dietary Guidelines for Americans.

18. U.S. Department of Health and Human Services. (1996). Physical Activity and Health: A Report of the Surgeon General.

19. U.S. Department of Health and Human Services. (2008). Physical Activity Guidelines for Americans.

20. U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd Edition.

21. Fulton, Janet E et al. “CDC’s Active People, Healthy NationSM: Creating an Active America, Together.” Journal of physical activity & health vol. 15,7 (2018): 469- 473. doi:10.1123/jpah.2018-0249

22. Du, Yang, et al. “Trends in adherence to the physical activity guidelines for Americans for aerobic activity and time spent on sedentary behavior among US adults, 2007 to 2016.” JAMA network open 2.7 (2019): e197597.

23. CDC Active People, Healthy Nation retrieved from https://www.cdc.gov/active-people-healthy-nation/php/data-research/index.html 2/23/26

24. Bhattacharyya, Mehul, et al. “Disparities in adherence to physical activity guidelines among US adults: A population-based study.” Medicine 103.36 (2024): e39539.

25. Calatayud, Joaquín, et al. “Trends in adherence to the muscle-strengthening activity guidelines in the US over a 20-year span.” General Hospital Psychiatry 84 (2023): 89-95.uthfully.

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