{"id":2709,"date":"2006-09-18T02:33:19","date_gmt":"2006-09-18T09:33:19","guid":{"rendered":"http:\/\/www.amptoons.com\/blog\/archives\/2006\/09\/18\/the-fat-panic-health-and-proportionality\/"},"modified":"2006-09-18T02:33:19","modified_gmt":"2006-09-18T09:33:19","slug":"the-fat-panic-health-and-proportionality","status":"publish","type":"post","link":"https:\/\/amptoons.com\/blog\/?p=2709","title":{"rendered":"The Fat Panic, Health, and Proportionality"},"content":{"rendered":"

Over at Creek Running North<\/a>, Timothy Burke<\/a> (in comments) writes:<\/p>\n

It\u2019s the language of \u201cpublic health panic\u201d that worries me. Language like \u201cepidemic\u201d, which slips away from precision and proportionality just as the language of \u201caddiction\u201d does. Suddenly there\u2019s a whole army of experts who have staked their claim and hung out their shingle on trying to advise people about their \u201caddiction\u201d to this and that. It becomes ok to spend millions, even billions, on pointless PSAs, on interventions of various kinds, on consultation contracts, and so on.<\/p>\n

There are a great many \u201cpublic health panics\u201d of this kind in the past that have been more or less baseless or more commonly disproportionate.<\/p>\n

In this case, I think the main problem, if you\u2019ll excuse the unintended pun, is a proportionality problem. There\u2019s no question that obesity is a public health issue and that it is occurring in more people and in more ways. But how big an issue is it, and how much should we worry about it? If life expectancies in the developed world are up to a very significant extent over the last century, and obesity curtails that slightly, so what? Why does that matter, how much does it matter, and how much effort should that occasion from us? How much does obesity negatively affect quality of life vs. efforts to curtail obesity negatively affect quality of life?<\/p>\n

I particularly get frustrated with the language of efficiency in these kinds of \u201cpublic health panic\u201d discussions, about how much money is allegedly wasted on treatment, because they\u2019re impoverished both as hard-nosed economics and as a kind of humanistic discourse. On the hard-nosed side, it\u2019s the kind of thing that some economists are good at being playful at but do-gooder experts and suchlike make many bad assumptions about. For example, is it a net loss or gain if people die at earlier ages from smoking tobacco? You want to make a big deal out of this as a purely economic question, you have to run the numbers. How much does that affect productivity? How many people make their living out of selling the tobacco? How many people make their living out of treating the people who get sick from it? How much money in various costs do those people save by dying earlier? If you reject on principle those kinds of questions, don\u2019t talk about how much money public health problems cost, just talk about the humanistic issue of quality and length of life. Which takes you back to having to make philosophical arguments that may limit or constrain the kinds of interventions or projects you entertain under this heading. If if turns out that obesity costs you three years on average, and has a relatively minimal effect on life satisfaction rates for the average person, then maybe you say it\u2019s not a good thing, but you don\u2019t lead a huge and expensive crusade with targeted interventions about it, you save your efforts for something else. The problem here is that people reason from themselves in really flawed ways and get to major projects that consume public resources and energy. I\u2019ve personally been liberated by literacy and scholarly thought, but it\u2019s not clear to me that literacy beyond basic competencies is equally liberating to all people. I would want to think about evidence for that, step back from my own satisfactions, and then think about cost\/benefit ratios to making literacy a chief or driving objective of social policy.<\/p>\n

That\u2019s my issue: that there are a zillion people out there desperate to make a given issue a huge, prepossessing public priority, using the language of epidemic or crisis or disaster, without offering either hard cost\/benefit analysis or thoughtfully situational humanism to explain why the issue at hand ought to be at the top of a list of concerns we all ought to share. I\u2019d like to be thinner and in better shape myself, but I\u2019m not at all certain why you or anyone else should really care that much if I\u2019m not–or if you do, why you shouldn\u2019t care equally about whether I drink, about whether I wear seatbelts, about whether I\u2019m male, about whether I like to climb mountains, about whether I use my computer too much, and much else besides. If my employer should care about my weight because they don\u2019t want me to croak or cost them too much in health insurance, every single one of those other issues is also potentially relevant. And frankly, maybe they want me to croak: a 27-year old version of me is a lot cheaper for them. My family and friends should care; should my society? If society should care because all people are valuable and full of potential, aren\u2019t there issues which impede the value and potential of people far more pressing than whether a middle-class white professional is 50 lbs. overweight? Or even whether a working-class black man living in inner-city Philadelphia is 50 lbs. overweight? <\/p><\/blockquote>\n

My thanks to Timothy for the permission to quote him so extensively.<\/p>\n","protected":false},"excerpt":{"rendered":"

Over at Creek Running North, Timothy Burke (in comments) writes: It\u2019s the language of \u201cpublic health panic\u201d that worries me. Language like \u201cepidemic\u201d, which slips away from precision and proportionality just as the language of \u201caddiction\u201d does. Suddenly there\u2019s a … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[],"class_list":["post-2709","post","type-post","status-publish","format-standard","hentry","category-fat-fat-and-more-fat"],"_links":{"self":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/2709","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2709"}],"version-history":[{"count":0,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/2709\/revisions"}],"wp:attachment":[{"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2709"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2709"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/amptoons.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2709"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}