Buy Walking VideosObesity and Public Health
This article from the Behavior and Health Blog at John Hopkins Public Health brings up an interesting question. What can public health do about obesity? This quote from Daniel Hale, a pediatric endocrinologist at the University of Texas Health Science Center at San Antonio:
“The problem is, most of the potential solutions rest either on very large changes in public policy or very small changes that individuals and families must make in the context of their own home. [later] There is very little we in the public health community can do. We don’t have very much control over what children eat, we don’t have much control over safety, which affects where children play, and we’re not in people’s homes, where kids are taking part in the major sedentary behavior, known as television watching…….”
Do I want the government controlling what the nation is allowed to eat or do? Do I want public health aggressively addressing the obesity problem? The idea of public policy on this issue brings to mind a scene from 1984 by George Orwell…
Winston is required to do exercises in front of the two-way monitor. He is watched and the middle aged woman who conducts the exercise class reproaches him for not trying harder. She shows him that she can touch her toes even after having several children. She commands that he try again.
This technology is available to us today. I’ve actually fantasized about online exercise classes that I can attend from my home using my Xbox and a spiffier version of Yourself! Fitness and an Eye Toy type of device. I actually wished that a real person could see how I was doing the exercises to see if I was doing them right. Of course, it isn’t compulsory.
Do I want public health officials telling me what I can and cannot eat? Do I want them monitoring my exercise? No. That scares me.
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January 10th, 2005 at 9:12 am
I agree with the fact that the state should not be controlling my diet and exercise, but playing the devil’s advocate for a moment…
While we balk at the idea of the state controlling our food and activity, we (as a majority) seem to wholeheartedly believe that the state should accommodate both those who are healthy and those who are not. Accessibility for the obese has become an increasing need for our population, and that segment of the population would be quick to criticize the state for not working with expediency to upgrade (upsize?) facilities to allow the obese greater comforts. Certainly, the state must pass those increased costs right back to the public, which results in greater criticism from everybody that feels the impact of increased taxation.
Of course, I’m purposefully ignoring the other side of things – the increased cost of the government bureaucracy that would be required to do health monitoring and control. Surely, the cost of such a program would be astounding.
So what can public health do about obesity? Not much. They can make recommendations, they can track the problem, but it comes down to self-control. What can the police do about murder? Not much. Until the murder happens, the law has not been violated. It comes down to self-control. So how do we keep people from murdering? We set up negative consequences – kill a person, be imprisoned. Are there ways to create negative consequences for those whose obesity occurs through lack of control, lack of activity, rather than, say, a medical condition? Not without seeming cold and heartless, no. But perhaps the answer, then, is to reward those who do maintain a healthy lifestyle. What if being healthy got you a tax break? Would that be a sufficient form of motivation? Is it acceptable to say that the healthy are less of a burden on government and, as a result, they should bear less of a tax burden? Or is that nullified because the unhealthy are typically high consumers who make up the difference through sales and (in the case of smokers) cigarette taxes?
I can say with certainty that a website promoting an active lifestyle (President’s Challenge) that lets you order an award for $4.50 isn’t sufficient motivation for the public at large to maintain some semblance of healthy living. It would be ideal for the population to motivate itself but that ideal has little reflection in reality.