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A critical essay on the policies that have been used to tackle obesity
Free essay example:
Student No: 051605054
Module: LB3003 Managing the Publics’ Health
Title: A critical essay on the policies that have been used to tackle obesity
In the UK, projections suggest that by 2025 40% of the population will be classed as ‘obese’ and by 2050 it will increase to 60%. This alarming statistic is concluded in a report produced by the UK government published Tackling Obesities: Future Choices – Modelling Future Trends in Obesity and the Impact on Health (UK Government’s Foresight Programme, 2008).
Obesity is an issue that has garnered attention for years because of the detrimental effect it has in society. The impact of the policies that have been implemented over the years is highly controversial and disputed. The reason being the complexity of the causes and drivers of obesity, and how to combat it presents many challenges to politicians, individuals, epidemiologists and other policy decision –makers. Epidemiology is ‘the branch of medicine that deals with the study of the causes, distribution, and control of disease in populations’(Oxford English Dictionary: 132).
At the start of the paper, there is an examination of the policies that have been executed by the UK government, in order to ease the burden that obesity is having, on not only for the National Health Service (NHS), but the activities we carry out in our day-to-day lives. To what extent has these policies has helped to reduce the problem of obesity? What kind of role should the government play to tackle obesity? The research gathered in this essay is narrowed down to policies associated with child obesity and healthy living. The information contained in this paper has been gathered from various secondary sources including books, journals, newspapers and articles from the Internet. The final part of this paper draws some conclusions about the policies implemented by the government and the role in which they have played.
What is obesity?
Referring to a document produced by the House of Parliament, published Childhood Obesity (Parliamentary Office of Science and Technology, 2003), obesity ‘is a condition where weight gain has got to the point that it poses a serious threat to health’ (ibid: 1). To classify an individual to be ‘obese’ is determined by their Body Mass Index (BMI). A value of 30 or more would put an individual in this category. A study by the National Audit Office (NAO), had estimated that the cost of treating obesity in the NHS in 1998 was £1/2 billion (NAO Tackling Obesity in England, 2001). With obesity set to rise in the near future, as mentioned at the start of the paper, public health expenditure is likely to rise simultaneously. As a result, the UK government considers obesity a higher priority, then ever before.
The idea of shock tactics
In a recent study carried out by the Department of Health (DH), they concluded that the public do not consider foods that are unhealthy, to actually be unhealthy. Moreover, the research also found that people are repulsed with the idea of fat tissue building around their organs (Templeton, 2008). These two findings are stated in a recent article published in the Sunday Times entitled Anti-obesity drive to use shock tactics.
An individual reading the article may question, not only the conclusions but also the methodology in which the data was gathered. There is no mention of how the research was collected. For instance, what method of research (primary/secondary) is used? Which type(s) of people (children, middle-aged, over 60s) was the research focused on? On the contrary, this article is published in a newspaper, hence the writer’s goal is to simply to provide quick, clear and concise information, in regards to the most recent anti-obesity campaign being executed by the government. Therefore, she will provide results of the study, to attract and maintain the reader’s interest, rather then including data the reader may find mundane.
In this article, Templeton states that Change4Life will incorporate ‘this insight in its adverts to show the public that body fat is putting it at risk of serious illness’ (ibid). Change4Life is a project ‘which aims to improve children’s diets and levels of activity’ (www.dh.gov.uk). The DH strongly supports this initiative. Change4Life attempts to exploit this, and influence its marketing strategy, with the use of shock tactics. There is evidence to suggest that this device is ineffective. This type of marketing is being used to tackle smoking; the results show that anti-smoking adverts have had very little impact influencing the public. In an article called ‘Do these adds work? Or have shock tactics made us too numb to care?’(Marsh, 2004). She states that ‘the government has failed to make an impact on many Britons, despite pouring £59 million into anti-smoking.’ Since, shock tactics are being used more often, the public aren’t as receptive to them. Research carried out by OMD Snapshots, illustrates that images has no influence on people whether they donate money to charities. ‘Out of 1,097 people asked whether they were shocked by the images, 62.5% said they were not’ (ibid).
However, returning to Templeton’s article she presents evidence, to the contrary, to suggest that shock tactics can influence people. M&C Saatchi, a marketing firm, which has designated responsibility in designing obesity adverts. This organisation had gathered research, on the impact of shock tactics. The conclusions drawn from this study suggests that the use of graphic imagery provokes a reaction from individuals. An image, with the intention to shock or scare, actually does influence an individual. (Templeton,2008 ).
Working with food associated companies
As part of this strategy, the government has managed to influence major companies, which supply products that are associated with unhealthy living, to pledge £200 million to support the campaign. The list includes the likes of Cadbury and Coco-Cola. (ibid). The main problem with this approach to work together with companies, which supply unhealthy food, is that these firms may exploit this strategy to increase revenue. As Tony Fry, the chairman of the Child Growth Foundation said;
‘If these companies have realised that we have got to tackle the problem, then I welcome their support. If they use this as a means of kowtowing to government and pushing up sales, that would be disappointing’ (Smith J, Harding S, 2007: 96).
Is it possible for junk-food companies to obey the government, by devaluing their products, which can be detrimental to their revenue? This conflict of interest, you would think would discourage the Government, to work with the private sector. The term private sector means ‘the part of the economy which is both run for private profit and is not controlled by the state’ (Alcock, 2003:269). The willingness of such firms to not only pledge to this strategy with this strategy but to also contribute actively to tackle the level of obesity, is the focal issue in this scheme. In contradiction to this, in an article in the Telegraph, to quote from Baroness Buscombe the chief executive of the Advertising Association ‘persuading companies to support this campaign wasn’t that difficult’ (Drake, 2008). Buscombe argues that companies are altering their products to reduce the level of fat, sugar and salt, to coincide with the Recommended Daily Intake (RDI). RDI ‘is the daily dietary intake level of a nutrient which is considered sufficient to meet the requirements for an healthy individual.’
In today’s modern life, people tend to have less time to exercise, cook meals and usually opt for ready meals and other convenience products. The fact that technology is becoming sophisticated and much easier to use, we opt for public transport rather then walking. This way of living is called a sedentary lifestyle, and plays a factor in obesity. The nature of some jobs may not allow people to have the time to exercise and to watch what they eat. Over the years, we have noticed a shift from manual to more sedentary forms of work, as a result of globalisation. This factor should be taken into account in the policy decision-making process. Obesity is determined by an individual’s diet and fitness. Therefore, as technology continues to make one’s life much easier, are people going to opt for the more difficult choice. For instance, would people spend time to cook their own food rather then opt for ready-made meals? The government haven’t as yet, tackled the obesogenic environment in today’s lifestyle. An obesogenic environment is the ‘sum of the influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals and populations’ (Foresight Report, 2007: 52).
As I have already mentioned earlier, the government’s policy of adopting a collectivist approach in working with food companies and supermarket chains does have its flaws. The tendency on food products from such firms is to entice shoppers with ‘buy one get one free’ and ‘ three for the price of two’ offers on unhealthy products. In addition, a study carried out by the National Consumer Council discovered that ‘more then 4,300 cheap deals, the council found that promotions for items in high in fat, sugar and salt made up 54% of all in store promotions’ (Worral, 2004: 52). This contradicts Buscombe’s statement earlier about food companies having little resistance in helping the government tackling obesity. The reader can be very sceptical about this statement since there is no evidence to support this, for all we know this could be just mere speculation. In contrast, to the National Consumer Council, whereby an investigation was carried out and a sensible conclusion was drawn from it. Hence, with doubts surrounding the co-operation of food companies, it does beg the question why is the government adopting this approach and is there a better line of attack to deal with obesity?
This approach by the government, to work with the market to tackle obesity can be very effective, if both parties complement each other on paper. This type of ideological perspective is known as collectivism. Collectivism ‘place great emphasis on the role of the state and other collective arrangements (such as voluntary mutual societies) and are highly critical of individualism.’ (Baggott, 2000:2). An ideology is a set of beliefs or concepts, which determine the way an individual or a group of people’s actions. A collectivist is an individual that who places importance on the role of the state, in comparison to an individualist who believes that the individual is responsible for it’s own well-being. Which perspective is the most plausible in tackling the issue of obesity? In the current financial crisis, this displays the lack of control of the banking sector, and the in competency for the market to sort their own problems out.
Drastic times, drastic measures
In certain circles they believe that, the government has to adopt a more aggressive stance in tackling obesity. Politicians and other policy decision-makers can make it difficult for existing and potential food companies such as supermarkets and fast food outlets through vigorous regulation of such firms. A highly bureaucratic mentality instilled by the government may discourage firms opening, and hinder those companies that are already in the market. Moreover, if the government adopts more of this ‘aggressive hands-on’ approach, which was shown last year when it was decided that from 1st July 2007 to make nearly all enclosed public places and workplaces in England smoke-free. This law implemented at the time, was highly political and still is but to a lesser extent. The reason being the large benefits that many people have experienced since the ban was executed. 6 weeks into the ban on smoking in public places, an article on the BBC website stated ‘a third of 1,000 smokers polled by Ciao Surveys said they now smoked less when out in bars and clubs’ ( Bezeval, 2007).
In a study carried out in 2006, by The Annual Survey of Public Opinion and Life Quality, it was concluded that 93% of the public believed that the government should intervene to prevent illnesses by providing information. In addition to this, 40% agreed too many factors outside individual control to hold people responsible for their own health. The public do want the government to play a role in tackling obesity, but the disagreement lies in what role they should play and what form of government intervention should be applied. (Nuffied Council On Bioethics,2007). There are two main different types of intervention. One is known as the ‘nanny-state,’ this type of intervention is known to be highly intrusive and to protect the state excessively. In contrast to ‘stewardship,’ which ‘implies government has a responsibility for protecting national health, and to serve in the public interest and for the public good.’
Is the government responsible?
The stewardship model acknowledges individuality but also the necessity of the government to act to protect individuals especially the vulnerable (such as children). In Childhood Obesity it outlines several programmes, which were in effect in 2003. One of them is being called Sure Start, which focuses on helping families that are living in deprived areas by providing health centres and advice on nurturing. The difficulty with this is that families are going to develop their knowledge on nutrition, but since these people have little or no income they are less likely to purchase healthier and perhaps more costly products as a result (Parliamentary Office of Science and Technology, 2003). The proportion of women who are obese had increased from 16 per cent in 1993 to 18 per cent. In addition, research has shown that obesity is higher in the lower social classes in women, with 25 per cent in class V in comparison to 14 per cent in class I(Acheson, 1998).
The social class (health) gradient tells us that a linear decrease in health is seen with decreasing social position. Mortality increases linearly with increasing degree of social disadvantage (Marmot, 2004). Hence, based on this information, it would seem logical to tackle the problem of health inequalities between the rich and the poor, without tackling the problem of obesity directly. For example, with the families living in deprived areas, the government could provide them with educational opportunities for them to go out and attain a job. According to the social class gradient, this will help ease the problem. One of many recommendations included in the Acheson Report, stated to increase benefits in cash to those families in deprived areas. In comparison, to the policy implemented is taking a different approach, which defies existing trends. The Acheson Report on Health Inequalities provides 39 recommendations to tackle health inequalities drawn from evidence on the causes and manifestations of these inequalities. If the government incorporates these findings into their policy decision-making process, then perhaps these inequalities would be declining as a result so would obesity.
Is the government taking into account the health inequalities when developing new ways to combat obesity? In 1997, Blair was quoted as saying;
‘inequalities do matter and there is no doubt that the published statistics show a link between income, inequality and poor health. It is important to address that issue and we are doing so.’ (Acheson, 1998:3)
This shows that the government do consider inequalities a high priority and are eager to weaken the impact of this issue, but to what extent have they done this? In 2005, the BBC News published an article online showing that the health inequality gap is ‘widening.’ As a result, the government’s target to reduce mortality and life expectancy by 10% by 2010 is going off course. The above quote from Blair and the research findings illustrates that perhaps the government needs to adopt a better policy implementation process if they are going to reach future targets (Anon 2005).
The notion of introducing a ‘ fat tax,’ is a highly debatable issue. Whereby, adding a tax on fatty foods such as cakes and biscuits. In order, to put off people which consume these unhealthy products excessively. One of several reasons why this potential programme hasn’t put into place thus far is the argument of individualism. In a newspaper article, titled Government unit ‘urges fat tax’ in 2004. To quote Martin Patterson, an employer of the Food and Drink Federation outlined that consumers would feel ‘patronised based on the idea that they can’t think for themselves and need to be taxed on weight-loss.’(Johnston, 2004). Despite, studies showing that I have mentioned earlier, the majority of the public don’t want the government to hinder their personal choice. Having said that, the all the effects of poor diet and exercise falls back onto the government, so why should the government pay for bad choices opted by the public? They shouldn’t, and the only approach in tackling obesity is to act drastically in similar lines with the public ban on smoking, earlier last year. Clearly, there is a need to change the consumer’s behaviour in regards to eating choices and exercise. According to the Department of Health, obesity could cost the NHS up to £6.3bn by 2015. (Langham, 2008).
This is a alarming statistic, one in which the government has to do act upon with an aggressive stance, one which would mirror the introduction of a ‘fat tax.’ We have encountered the problems of a ‘laissez-fair’ approach, and what happens when the government takes the back seat, in our current financial crisis. The poor judgement of many financial institutions weren’t known, until it was to late. We are aware of the problems associated with obesity, so the government has to act upon this rapidly and forcefully, if their involvement in polices can be justified.
In conclusion, there are many factors that come into play, which can hinder the success of the policy implemented. Different political parties and other policy decision makers, as we have seen through this paper, have different interpretations of research findings. However, all of these different interpretations can’t be right, can they? There isn’t one clear-cut method in tackling obesity, because of these factors. Factors include such things like health inequalities, a sedentary lifestyle, and obesogenic environment, to name a few. These policy decision makers have different ideologies, and how the government should be controlled. Some believe in promoting free will and allowing the individual to make their own choices, yet others strongly believe that the burden of bad choices of the general public falls on the NHS, in other words the government. Therefore, they should have a greater role in deciding which policies to impose. As you can see throughout this paper, obesity is a very complex and highly contested subject, because of these differences.
These differences also extend to the causes and manifestations of obesity in the first place. Is obesity determined by biological factors or is it socially constructed because of our modern sedentary lifestyle? It is very difficult, to rule out one of the two, considering the lack of evidence on each side supporting its case. We are limited in the knowledge of our human body, about our adaptability of environment changes. We can assume as life has been made easier through technology, and as a result we have lost the incentive to exercise, but we can’t be for sure. There are a lot of reasons for and against the policies that have been introduced and will be for future polices. It’s a grey area, depending on which ideological stance we believe in, as this influences your thinking. Obesity will remain for the time being, a highly contentious issue filled with ambiguity and uncertainty.
ACHESON, D. Independent Inquiry into Inequalities in Health Report. London: The Stationery Office.
TEMPLETON, K. 2008. Anti-obesity drive to use shock tactics, The Times [ online ]. 9th November [ Accessed 11th December ].
National Audit Office. 2001. ‘Tackling Obesity in England.’ London: The Stationery Office, pp. 7.
Oxford English Dictionary
Parliamentary Office of Science and Technology. 2003. ‘ Childhood Obesity,’. 1-3.
UK Government Foresight Programme. ‘Tackling Obesities: Future Choices – Modelling Future Trends in Obesity and the Impact on Health.’ 2008. pp 47-52.
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