10:832:356 Lecture Notes - Lecture 12: Jacob Sullum, Nanny
9 May 2018
School
Department
Course
Professor
Lecture #12: Obesity, Poverty, and the Built Environment
I. Somethings to Consider
• Should obesity be considered a disease?
• Why is obesity an ethical issue?
• What about your built environment effects your health?
• Are college campuses built to encourage or discourage healthy eating, exercising, overall
healthy lifestyle?
II. Should Obesity be Classified as a Disease in Regards to Public Health?
• “The simplest thing the government can do is inform us about our eating choices more, so we
can decide what we want to eat.” - Peter Uber, M.D.
• Should start with “least burdensome policies."
• Example: PSA and education programs.
• Soon after the symposium, the American Medical Association defined obesity as a disease.
• Do not ban a food, suggest a replacement.
• We do not live in “nanny states,” i.e. every decision is made for us.
III. Further Insight
• “This tendency to call every perceived problem that affects more than two people an epidemic
obscures some important distinctions when you think about the classic targets of public
health.”- Jacob Sullum.
• Is every issue a “public heath crisis”?
• Does this minimize public health crisis that affect a greater number of people?
• Is voluntary behavior a public health issue or does this get away from the public health
purpose of preventing the spread of communicable and/or infectious diseases?
• Isn’t this just legislating behavior that some people disagree with? (smoking, overeating,
driving without a seatbelt) Aren’t these behaviors voluntary and self regarding?
IV. Causes of Obesity
• Formerly, it was believed obesity was solely an individual’s choice and was caused by a lack of
self control.
• Environmental and social factors contribute to obesity.
• A lack of healthy food education and availability contribute to obesity.
V. Principal Environmental Determinants of Health
• 1.) Physical or Build Environment.
• Example: Roads, buildings, and transportation.
• 2.) Economic Environment.
• Example: Health care related factors, socioeconomic factors, etc.
