Jeremy Sammut of ABC News (Australia) wrote an article in which he argued that government sponsored programs that promote public health don’t work.

While his focus is specific to the Australian experience, he claims that Australia’s government has squandered public funds on advertising campaigns…and this claim may be applicable to both Europe and North America. The fact is, obesity is on the rise in the both the ‘developed’ and ‘developing’ worlds. Attempts by national or regional governments to promote a healthy lifestyle have largely been unsuccessful in reversing this trend towards obesity.

Sammut makes a few very interesting observations.

  • First, he claims that when government assumes the role of health nazi/nanny, it absolves the individual of “their primary responsibility for the unhealthy lifestyle decisions they continue to make”, and as a result, “the lifestyle disease ‘epidemic’ is blamed on a lack of government-funded entitlement to preventive primary care”.
  • This takes us to his second point; “the limits of government authority over individual behaviour, and the importance of personal qualities in regulating it – why nearly 40 years of health promotion has coincided with ascending rates of lifestyle disease”.

And if we are going to allow government to assume authority over our behaviour, we have to question the motivations behind this program.

Quite often, “advocates of more spending on lifestyle disease prevention often draw false parallels with the success of the campaign against tobacco smoking”. This argument is specious in that smoking bans and the ‘sin’ taxes applied on tobacco products are examples of public health regulation, not health promotion.

cigarette-warning

You would think that applying this model to public exercise and nutrition would be near impossible. Smokers were a minority group and their behaviour was found to be less than enchanting by a large portion of the population. Simply put, the majority ganged up on them and enacted laws that made smoking a financial and logistical pain in the butt.

  • How would government apply this strategy when the majority of the population does not exercise, eats junk food and has no intention of changing?
  • Odds are, they would start with the children. Apply a little parental guilt. Ban junk food from school (already happening). Slap a sin tax on ‘junk food’. Expand that tax to include bacon, eggs, cheese, filet mignon, etc…

And while that is unlikely to happen, Sammut’s argument is that the health promotion programs advocated for by certain lobby groups, prepared by marketing companies and approved by governments have not been successful.

In Canada, advocates of the ParticipACTION program (historical info) have considered it a success due to it’s longevity and the fact that “two years after the agency had ceased to operate in 2001, almost 80% of Canadians still recognized the ParticipACTION logo and message”.

  • No mention of it’s positive impact on the health of Canadians.
  • Wasn’t that the point of the program?

Nope, as long as Canadians remember cheesy commercials…(Like this ,thisthisand check out this spoof.)…it’s a success.

My Two Cents

As much as I appreciate the light that Dr. Sammut has shined on this subject, I was a little disappointed by his conclusion.

“It is therefore timely to review the evidence. Because when the assumptions are questioned and the evidence examined with a clear eye, what is revealed is that there is actually slim support for the belief that preventive public health policies – be they ‘community-wide’ or ‘high-intensity’ lifestyle interventions – have in the past brought obesity and lifestyle disease under control, or that they are likely to in the future”.

  • Review the evidence?
  • Do nothing?

While I agree that most if not all governments have a great talent for throwing great big bags of money at problems that they have no hope of solving, does that mean that as a society we are doomed to accept gluttony and sloth as our birthright?

Here are two possible solutions.

  • In the U.K., doctors are able to write prescriptions for exercise.

Personally, while I believe that this plan is flawed due to the fact that when the government is looking to spend public dollars, there will always be bureaucrats and service providers ready and willing to overcharge and under-deliver. However, to be fair, I should mention that this program has not been in operation long enough to show whether it is successful or not.

  • Another possibility would be to offer tax refunds to those individuals that can prove that they are pursuing a healthy lifestyle. Instead of demonizing the couch potatoes amongst us, reward the energizer bunnies.

What do you think?