Politics, Regulations and Obesity
Warisa Panichkriangkrai DDS, MPHInternational Health Policy Program Fellow
Ministry of Public Health, Thailand [email protected]
apps.who.int/infobase/report.aspx?rid=118&print=1
2005
apps.who.int/infobase/report.aspx?rid=118&print=1
2015
The Politics of Obesity: A Current Assessment and Look Ahead
Rogan Kersh, New York University
The Milbank Quarterly, Vol. 87, No. 1, 2009(pp. 295-316)
Outline
1. Obesity Politics: An Issue regime Emerges2. State and Local policy responses
3. Looking Ahead: Promising Approaches
OBESITY
“ Supersizing of America ”
Health Effects
$120 billion lost
NEWS and Reports
“ISSUE REGIME”
BIG & CHAOTIC SMALL & SYSTEMATICideas, arguments,
viewpoints,
opinions from many
parties
Issue regime
1. Familiar voices
2. Solidifying frames
3. Limited national options
1. Familiar Voices
www.ific.org/research/obesitytrends.cfm
2. Solidifying Frames
2.1 Personal responsibility
2.2 Environmental frames
2.1 Personal responsibility = concern of individual consumers
overeating and consuming high-fat, low nutrition foods
Responsibility and Political effect
Obesity = Personal failure
• difficult to mobilize• point away from robust legislative solutions“ SOFT MEASURE ”
Government-sanctioned nutrition education Exercise promotion
2.2 Environmental frames
• expanding portion sizes• foods high in fat, sugar and sodium• availability of food at outlets• advertising of high-fat, low-nutrition foods
“ induced demand ”
3. Limited National Policy Optionsexercise
promotionobesity-
education program
consumer-injury
lawsuits
No policy change effort
3. Limited National Policy Options
Regulations
Successful food-indust
ry lobbyi
ng
Little support from Congress
subsidizing healthy food,
restricting advertising,
limiting unhealthy food sales, offering
economic incentives,
Federal litigation
Issue regime
Minimal federal government action
Positive sideNegative
side• Source of political stability• Shape and guide policy action
• Deterrent to innovative reforms• Difficult to alter the path of action
State and Local policy responses
1. Calorie Menu Labeling
2. School Policies
1. Calorie Menu Labeling
www.worldchanging.com/archives/007241.html
http://www.restaurantdietitian.com/menu_labeling_law.html
Menu Education And Labeling Act
+
-
Calorie Menu Labeling
Questions remain:
• consumers see or understand label?• any difference in consumers behavior?
2. School Policies
• Limits on sugar, fat and sodium consumption in school cafeterias
• Voluntary bans on sodas in vending machines
• School Nutrition Policy Initiative (SNPI)
SNPI
• removing all sodas• encourage the consumption of nutritious foods
50% reduction of obesity incidence
Nationwide D+
Pennsylvania
Looking Ahead: Promising Approaches
1. Foods of Minimal Nutritional Value (FMNV)
2. Reformulation
1. Foods of Minimal Nutritional Value(FMNV)List of reducing
• soft drinks• water ices• chewing gum• certain candies
Remain unchanged since 1980 !!!
2. Reformulation• Removal or reduction of ingredients that linked to rising obesity rates ( fat, salt, sugar )• Government effort• a moral-suasion campaign• creating a low-interest federal loan program for food and beverage industry
• Potential danger = food safety risk
Conclusion
• Policies that gain legislative favor• Clear plan of action• A program of “rapid-response” research• The genetic component research
www.who.int
2005
www.who.int
2015
Ecological Model
Personal responsibi
lityEnvironmental
frames
VS
Policy change
RegulationsPolicy
analysis research,
Media, Food industry
Help groupConcern
about obesity problem
The National School Lunch Program
Schools get cash subsidies from USDA
Schools must serve lunches that meet Federal requirements
http://www.youtube.com/watch?v=tVfAWbitBTs
http://www.opensecrets.org/lobby/indusclient.php?year=2008&lname=N01&id=
Regulatory axes on food advertising
to children on television
Elizabeth Handsley, Kaye Mehta, John Coveney and Chris NehmyAustralia and New Zealand Health
Policy 2009, 6: 1
Outline1. The type of
program2. The type of
product3. The target
audience4. The time of day5. The content of the
advertisement
The type of program: Dedicated children’s program
Australia “ C ” programCommercial free program
Sweden For children under 12 year oldNo advertising during and immediately before or after a program
Britain Programs specially made for children
The type of product
Food generally
Lesser restriction Not contain any misleading or incorrect information
Junk food How to define? - UK: High fat, sugar and salt - High sugar VS beneficial nutrientsAdvertisements for brand VS products
Children’s food
Advertiser Code for Advertising to Children (ACAC) - aim to childrenShould include foods that children have too great preference?
The target audience
AgeNot for children under 13 year old
Criteria Advisory note• nature of product• theme of commercial• story line• visual used in commercial• language• age of actor• target audience
The time of day
Classification
• How children spend their day and when they watch TV?• When children make up a given proportion of audience?• At a given time, what is the proportion of children to be expected watching TV?
Watershed
Exact time
The content of the advertisement
Factors limit the
effectiveness of
regulations
• Personalities
• Premiums
• Pester power
• Misleading
• Promoting unhealthy
lifestyles
Conclusion
The most effective means• Limit time that children expose to food advertising
Consumers can understand the criteria
Program: Thailand view
No commercial free program 42 snack advertisements / 1 hour program
Thailand view
• government: strong regulations, strong action• broadcast system: moral• consumers: breach finding & complaint system