December 14, 2007

Socialism to cure obesity

A simple look at the geographical and temporal distribution of malnutrition reveals that socialism is not very good at solving problems of food scarcity. So, why not imposing socialism - or equity, as it is called these days - to solve obesity? This is what Sharon Friel, Mickey Chopra and David Satcher propose in the British Medical Journal (Unequal weight: equity oriented policy responses to the global obesity epidemic; the title, as all good titles do, says it all).

According to the authors, obesity is not simply a problem of eating too much and exercising too little. The "heart of the problem" is "the unequal distribution of factors that support the opportunity to be a healthy weight." Thus, tackling obesity "requires concerted action at national and international level to promote a more equal distribution of affordable nutritious food, and improved, more equitable, living and working conditions." There will be no obesity in the worker's paradise.

Who cares about obesity? "Physicians."

Who doesn't care about obesity? Transnational food companies that "have flooded the global market with cheap to produce, energy dense, nutrient empty foods," supermarkets that encourage "bulk purchases, convenience foods, and supersized portions," and advertisers that "persuade individuals—particularly children—that they desire foods high in saturated fats, sugars, and salt."

What about individual people's choices? No mention. Presumably we do what transnational food companies, supermarkets and advertisers tell us, and we ignore physicians, and that's all.

What is the solution? Physicians must call the help of government - or, more specifically, the police - so that we stop ignoring them.

1. Government must force us to walk to work, forbid us to watch unhealthy advertisements, ban some unhealthy foods and increase taxes on the remaining ones, subsidize healthy foods, introduce more price controls, force supermarkets to promote healthy foods, and decrease class size in schools to foster children participation in physical education.

2. Government must impose higher salaries so that we can afford expensive, healthy food; and fewer working hours so that we are empowered to make healthy living choices.

3. Government must create an equal society. This deserves to be quoted in full:
Unequal society, unhealthy weight

A person or group’s place in the social hierarchy influences behavioural choices, which are governed by the material and psychosocial resources provided by the complex system consisting of the food, built, and social environments. Unequal exposure to health protecting or health damaging aspects of these environments adds health disadvantage to disadvantages of wealth, power, and prestige. These underlying structural inequities are likely to be responsible for the unequal distribution of obesity.
And, what about resilience? No mention! Safriel, Chopra and Satcher disappoint me in this respect. They should get some lectures.

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