Thanks to money from the $10 billion Prevention and Public Health Fund, Oklahoma City residents now have new bike lanes, walking paths and an Olympic rowing complex. But will any of this do any good?
In response to the obesity epidemic overtaking his community, the Republican mayor of Oklahoma City has embraced the program funded through the Obama administration’s Affordable Care Act, as Sabrina Tavernise reported in The New York Times last week.
Many experts believe that measures like these will not reduce the obesity rate all by themselves. Government will have to intervene, they argue, whether by enacting taxes on sodas, regulating marketing to children or reforming agricultural subsidies.
Of course, critics will speak of a nanny state that has no business dictating the American diet. They point to personal choice, arguing that every consumer has a right to eat whatever she wants, however it affects her health. They point to personal responsibility, arguing that the overweight and obese, who make up two-thirds of the American population, just have to learn to exercise some self-restraint and say “no.” Critics of government intervention also point to the self-correcting mechanisms of the marketplace which are supposed to induce Big Food to respond to public concern over obesity by, for example, introducing healthier products and developing its own rules for front-of-pack labeling.
On Personal Responsibility
It’s true that every consumer chooses what she wants to eat, and no one’s making her eat anything she doesn’t want to. But she’s certainly urged to buy the latest meal replacement bar through millions of dollars in advertising, greeted by it at the checkout line in a convenient to-go package and offered it at an introductory price that can’t be beat.
Ours is an obesogenic environment, one conducive to “passive overconsumption” with the availability of more and more hyperpalatable, “processed, affordable, and effectively marketed” foods every year, say the authors of one article in the Lancet’s Obesity Series. Passive overconsumption is a predictable outcome of an environment overloaded with food. Several studies have found that this excessive supply of calories is “more than sufficient” to explain the rise in obesity in America as well as in the U.K., and one epidemiologist notes that the “excessive consumption of food occurs in ways that defy personal insight or are below individual awareness.”
In order to reverse the obesity epidemic, the environment has to change. And against Big Food, only government has the reach and the resources to implement the systemic change required to promote an environment that supports rather than undermines public health.
Next: On the Right to Personal Choice
On the Right to Personal Choice
That government risks infringing on our right to choose what to eat, the authors of the Lancet article suggest, is a phantom argument: “Policy interventions for obesity can only be realistically directed at the environment (making healthy choices easier) rather than the individual (compelling them to take the healthy choices)… For this reason, obesity prevention policies do not proscribe particular eating and physical activity behaviours and are thus much less intrusive of human liberties than many policies already in place to control other public health problems,” such as seat belt laws and smoking restrictions in public spaces.
Taxing sodas and restricting marketing to children does not mean that Coca-Cola and Pop-Tarts will be taken off supermarket shelves. What these measures do, rather, is discourage people from making bad choices on a regular basis. The junk food will always be around for anyone who wants it.
On Industry Regulating Itself
Adopting meaningful measures to reverse the obesity epidemic is simply not a tenable option for the food and beverage industry. Big Food’s mandate is to make a profit and to make more of it year after year, which it can only do by getting people to buy and consume ever more food. The food industry does, however, put on a good face.
As Kelly Brownell, director of the Yale Rudd Center for Food Policy and Obesity, says, “I expect history will look back with dismay on the celebration of baby steps industry takes (such as public–private partnerships with health organizations, “healthy eating” campaigns, and corporate social responsibility initiatives) while it fights viciously against meaningful change (such as limits on marketing, taxes on products such as sugared beverages, and regulation of nutritional labeling).”
But there’s evidence of self-correcting market forces at work, isn’t there? In response to the obesity epidemic and other health concerns, food companies have developed many healthy alternatives. “But introducing healthier processed foods,” writes Dr. Brownell, “does not mean unhealthy foods will be supplanted, and might simply represent the addition of more calories to the food supply. Furthermore, the companies have not promised to sell less junk food. Quite the contrary…” Big Food’s chief objective — to sell more food — is simply at odds with public health goals.
The introduction of the Prevention and Public Health Fund through the Affordable Care Act marks a pivotal change in government’s approach to health care, directing resources to programs that look to prevent illness and disease before they happen. But, as many public health experts argue, government will have to take far bolder measures for any real progress to be made against the epidemic of obesity, diabetes and many other diet-related diseases the world now faces.