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    Survey : Public Supports Government Action On Obese People
    By News Staff | March 4th 2013 06:24 PM | 11 comments | Print | E-mail | Track Comments

    A survey analysis finds both that the public is supportive of government action to curb obesity, diabetes, and other noncommunicable diseases - but don't like interventions that appear intrusive or coercive.

    The Harvard School of Public Health (HSPH) analysis also found that support was higher for interventions that help people make more healthful choices, such as menu labeling requirements, than for interventions that penalize certain choices or health conditions, such as charging higher insurance premiums for obese individuals.


    There's no question that government wants to use legal action to stop any public health choices that could cause taxpayers to foot the bill - and with the Affordable Care Act the demographic most likely to be obese is almost most likely to get far more than they spend in government health care programs.

    In recent years, lifestyle choices such as overeating, physical inactivity, and alcohol and tobacco use have led to troubling increases in chronic ailments in the U.S. In response, health departments and legislative bodies have adopted policies aimed at combating the behavioral risk factors that lead to ill health, such as banning trans fats in restaurants, banning Big Gulps in New York City, boosting 'sin taxes' on cigarettes and screening schoolchildren for high body mass index. 

    More conservative pundits and government officials have criticized such social authoritarian mearues, saying that they impinge on personal choice and exceed the scope of governmental authority. HSPH scholars decided to examine which factors play into public support for the "new-frontier" of public health initiatives, where government tells you how to behave, and it can lend insight into how heavy-handed government can be using the Commerce clause of the Constitution to force personal compliance.

    Co-authors Stephanie Morain, a doctoral candidate in health policy at Harvard University, and Michelle Mello, professor of law and public health in the HSPH Department of Health Policy and Management, analyzed the results of an online survey of 1,817 American adults conducted in October 2011 by Knowledge Networks (now part of GfK), a professional survey organization. In the survey, respondents were asked about their support for various types of public health policies, as well as the factors that influenced their support. There were questions about seven noncommunicable health conditions and 14 specific strategies to address them.

    The researchers found a high level of support—between 70% and 90%—for government action on each of seven areas: preventing cancer, heart disease, childhood and adult obesity, and tobacco use; helping people control their diabetes; and reducing alcohol consumption.

    Support was quite high for interventions that facilitate healthy choices, such as increasing the affordability of fruits and vegetables or requiring more instruction in public schools about the health risks of obesity. However, support waned when government actions were viewed as focusing on penalties or on limiting choices—such as adding insurance surcharges for obese individuals or making it illegal to smoke in private spaces.

    The researchers also found that African-Americans and, to a lesser extent, Hispanics, are significantly more likely than whites to support government action to address noncommunicable diseases. In addition, the survey indicated that people are much more supportive of government public health initiatives if they believe that "people like me" can influence public health priorities and if they think that public health officials understand the public's values.

    "The message for public health officials and legislators is, if you want the public to buy into these legal interventions, you've got to engage them early on," said Mello. "You've also got to communicate about policies in a way that resonates with the public's values. For example, how does the intervention support healthy choices? Why is it fair?"


    Published in Health Affairs.

    Comments

    The question about "how heavy-handed government can be using the Commerce clause of the Constitution to force personal compliance" was addressed in the SCOTUS decision on Obamacare. The dissenters correctly maintained that to employ the Commerce Clause to force commerce is "to make mere breathing in and out the basis for federal prescription." In a word, slavery. Odd then that, as you say, African-Americans are more likely to support such heavy handed government action; one might think that we've all had enough of slavery. Perhaps it's the Obama effect; slavery is okay if the slaver is so cool and hip, and Obama is definitely cool and hip.

    It is rather distressing that a science article refers to overeating as a simple "lifestyle choice." Is the author really so unaware of all the research demonstrating non-lifestyle components to overeating -- from genetics to the relative distribution of the bacteria that we use to obtain energy from food? Not to mention the changes in food production/distribution that make overeating much easier. It is not believable that 70% of people in the U.S. are overweight or obese due solely to a change in lifestyle choices.

    Hank
    You don't think cheap, tasty food - a miracle brought on for the first time in history - means people won't choose to eat more?  They must have addictive chemicals that nasty Big Business put in?  It's silly. There is no genetic propensity to eat too much, that is social science nonsense trying to sound science-y.
    Gerhard Adam
    There is no genetic propensity to eat too much...
    Not true.  It happens in virtually every animal given free access to readily available food.  Whether you want to specifically claim it is genetic, or merely a trait of life, the point remains that it occurs with high predictability.  There are a significant number of genes that will contribute to obesity, as well as the double-edged sword of our microbiota [which can be more efficient resulting in more extracted calories from our food]. 

    So, regardless of how you want to frame it, the point is that no animals evolved with the dietary traits of assuming high food availability.  Energy conservation and efficiency are the requisite traits, so when they are no longer necessary we become fat.
    http://www.health.harvard.edu/newsweek/Why-people-become-overweight.htm

    So, if your point is simply that there's no specific behavioral gene to make you eat in excess, then that's probably true, but not particularly relevant.
    You don't think cheap, tasty food - a miracle brought on for the first time in history - means people won't choose to eat more?
    Choose?  I suppose so, but as I stated previously it happens to all animals.  However, let's also recognize that we have far more foods available today that consist of essentially empty calories that help contribute to this problem. 

    It is telling that the term "lifestyle choice" was used, as if to imply that somehow being hunter-gatherers was still an available option.  In many ways people aren't free to choose their "lifestyle" being driven by the requirements of commutes, jobs, traveling, etc. which often don't leave much time for regularly planned meals. 

    Mundus vult decipi
    I see Gerhard has already provided a good answer. I just want to add a few points.

    1. I already stated that changes in the food supply have large responsibility for the increasing weight problem. If you eat the same amount but the food that is widely available is gets worse, more people will gain weight without any lifestyle change.

    2. It is quite clear that in humans and other animals there is a significant genetic influence -- which evolved for the reasons cited by Gerhard. That is why, among other things, some people can eat way more calories than they burn, yet not gain weight. The old saw that weight is determined solely by calories in minus calories burned is simply untrue.

    3. Rather than cite you to dozens of studies, I suggest you read the relevant chapter in a recent book called Zoobiquity.

    Hank
    Unlike Gerhard, who nails the answer in the first sentence, you seem to think genes make people eat junk food. That is not a correct understanding of biology.
    Apaprently you need to brush up on your reading skills, as i never said that. That is on top of not reading my original statement about changes in the food supply.

    Overeating is strongly influenced by your genetics, as is any aspect of your disposition, but really an epigenetic matter, where genetics combine with everything else that happens to you, from experience in the womb to life experiences.

    Gerhard statement did not deny that it is genetic, just that it is not necessarily one specific gene. Indeed, his explanation regarding the evolutionary aspect requires a genetic component.

    It is one thing for you to be ignorant, it is another thing for you to compound your ignorance with rank foolishness. You apparently understand neither Gerhard's comment nor mine. Get an education in biology and genetics before you make such moronic comments.

    Hank
    Go ahead and believe your genes - any combination you choose to want to rationalize as the culprit - made you fat, if that helps. But there is no science to it.
    Write back when you have YOUR PhD in biology and genetics. Until then, it is not worth my time to deal with you. Why don't you try reviewing a dozen or more studies a week and see if you learn something. As yuou cannot even read well, I highly doubt that they will do you any good.

    Hank
    You're sort of the archetype for the puffy goofball who seems to believe they can find functions correlated to every behavior. It's a real intellectual weakness. I don't care how many PhDs you have - I actually never heard of someone getting them in both biology and genetics, but it makes as much sense as the rest of your commentary. Anyway, you clearly only learned just enough to be wrong.
    Gerhard Adam
    More bullshit, predicated on trying to save money.
    Mundus vult decipi