Whose Responsibility Is It?

It is interesting to read the news of how countries besides my own (USA) deal with public health issues. This time it is Scotland. I caught a talk show last night that was responding to some recommendations that the Scottish National Party had released. I also found a newspaper story on line regarding the same issue.

The ideas and responses are familiar. Limit high calorie foods, especially fats and sugars, and pay attention to schools and the stores that are near to them. Limit the serving size of foods and put nutrition information on labels . Make those labels easy to understand.
The grocery and retail industries of Scotland responded with assertions that they are already doing these things voluntarily and that it should continue this way. One even said that the ideas from the government were NEVER going to get passed or followed because the companies that make the foods, all over the world, are not going to participate. Of course, there is more than one political party in Scotland, so getting them to agree on legislation aimed at reducing obesity will probably go as well as the USAs attempt to reform health care.

Before I point out a few things that caught my attention, let me tell you the broader goals of the SNP and why the Health Minister published the report.

First - the extent of the problem. Recall a recent blog that noted Mexico as having a higher rate of obesity than the USA - in Scotland, the word is that the only countries with worse weight problems are the USA and Mexico. In fact, the fear is that over 40% of adults will be obese in twenty years. It appears that about 20% or 150,000 Scottish children are currently obese.

Second - the proposal. Reduce calories consumed, increase physical activity, improve "behavior" at work, and target children early.

Now two or three things from me in response to what I heard and read.
When the counter argument is that the change has to be at the individual level by individual free will and choice, it is couched in the term "individual responsibility." I agree, but when the individual is NOT responsible than who is? Who pays for and suffers the consequences for the explosion of illness associated with being overweight and obese? Society (fat and not fat) does. [same as all society pays for tobacco illness] If the behavior affects the government (which is there to protect the people) then the government not only has a right to intervene, but a responsibility to do so.

The Health Minister of Scotland is Shona Robison, and she was quoted in press (Times Online-2/22/10) as saying that NO country had been able to get a handle on obesity and that Scotland needed to. She referred to the environment and how it actually encourages and promotes over consumption and makes weight gain almost "inevitable". To this I say what is becoming a Deirdre-ism, but true is true. We have got to make maintaining a health promoting weight socially possible and sometimes that requires legislation.

That does bring me to the one point I unequivocally disagreed with in the government's proposals. The idea of using expanded labels with the additional information of how much of a certain activity, like walking, would be needed to burn the amount of calories a person consumed in whatever product they were about to eat. It is not that kind of simple. I think they would be wise instead to educate, and yes, start with kids, on calories, nutrition and the body. If not, they are going to have to have three page labels explaining how variant and multi factorial the burning of calories can be.

You guys have it easy! Just use the many websites I have thrown at you over the last year!