PSYC 123: The Psychology, Biology and Politics of Food
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The Psychology, Biology and Politics of Food
PSYC 123 - Lecture 17 - The Politics of Food I: How Politics Affects National Nutrition Policy (Guest Lecture by Rogan Kersh)
Chapter 1. Introduction to Dr. Rogan Kersh [00:00:00]
Professor Kelly Brownell: Welcome everybody; hope you all had a nice weekend. I’m delighted — by the way if any of you took the make up exam, they have now been scored and they can be picked up from Ashley Gearhardt, teaching fellow in the front row. She’ll be available after class for you to pick those up.
I’m really delighted today to introduce our guest lecturer Professor Rogan Kersch from New York University. Rogan is Associate Dean at the Wagner School at New York University, and a highly esteemed national and internationally visible figure in the field of political science. You may have Rogan on TV, heard him on the radio, because he’s very often interviewed about politics in general. In fact, it may be interesting to talk to him about what’s going to happen tomorrow in the election.
More pertinent to today’s topic, Rogan has been one of the first people from political science to pay attention to the issue of obesity and has written some very thought provoking pieces, some very insightful pieces — one of which is in your required readings about the issue of obesity — giving it a historical view, that nobody else had taken before and placing it, in not only a historic but political context, which is so important.
As you know from our discussions in the class, politics play a major role in nutrition, nutrition policy, what foods people have access to, global trade policies and the like. So understanding the political environment and how it affects problems like nutrition and obesity are very important. Rogan, as I said, has a view of this that nobody else has, and is an incredibly insightful scholar on this topic.
Rogan received his undergraduate training at Wake Forest University, then came to Yale University where he received his PhD in Political Science. He spent several years back at Yale as a Robert Woods Johnson Scholar. He then joined the faculty at Syracuse University, where he was on the faculty for a number of years, taught very popular undergraduate and graduate classes in political science, and more recently was recruited to New York University where he teaches in the Wagner School and also is Associate Dean, as I mentioned. He is one of those people in the field who approaches these issues from a different point of view, is thoughtful, creative, and scholarly in the way he looks at them, and is wonderful in the way he communicates them. I am delighted that he could join us today. Let’s please welcome Rogan Kersh.
Chapter 2. Seven Triggers to Public Policymaking in the United States [00:02:26]
Professor Rogan Kersch: Thanks Kelly. Like many of you I hope someday, and like many others in this field I started doing — I’ve got mics all over, so I’ll try to clip — I started doing this research because of Kelly Brownell. You are all enormously fortunate to have him in front of you two times a week, and I’m honored to be on this stage.
Now I taught here, as Kelly said, for a bunch of years and I’ve continued on and off to teach. Last time I taught a class was just two years ago, so I have some sense of you, I think, unless Yale students have changed — although I do see a Ron Paul for President shirt — so Yale students have changed a bit since I was last here. I have some sense of how and when you do reading, so I’m not going to have the Charlie Brown with a football assumption you all pored over this piece of mine in great detail; you’ll see it before the final at least. I don’t also want to get up here and just replicate that, just reiterate what’s in that piece for those of you who did bother to go through it, so that is about the — what I call somewhat audacious I think — the new politics of healthcare and how it relates to obesity and nutrition politics.
I’m going to skip those details. If any of you are fascinated we can circle back at the end. I want to pull back and set the broader context for what you do in the next three weeks in here, including this one: the politics of food and nutrition, as they relate to obesity. I thought I’d set the stage with some of this work that Kelly was so kind to reference: this historical piece that I’ve spent a lot of time on.
Let me start with a proposition: the United States as a nation, this is us we the people, as a nation of individualists where aggressively seek to protect the private sphere, our own lives, from intrusive state or government action. We’re very concerned about big government meddling in our private lives. I see some of you nodding and some of you noddling — whatever that is — so I know you get that notion. In fact, much of our constitutional system, if you’ve taken any kind of Con Law here or basic political science, you know that much of our constitutional system turns on protecting the private sphere from intrusive state action.
Yet, let us pause for a moment. Roll your minds back to high school or Yale history classes, and remember the extraordinary range a number of times that the U.S. Government has been quick to leap into citizen’s private lives. In fact, public officials have long taxed, regulated, prohibited, or otherwise influenced a wide range of what we think of as personal behavior.
Let me start with four dramatic examples and then connect this to food and obesity. Some of you who grew up in this country will remember the happy little story of Johnny Appleseed — I want to talk about the triggers behind public policy making in the U.S. and I’ll start with this Johnny Appleseed story. You remember Johnny Appleseed is a sort of friendly character who, in the Disney version, went around and planted apples for American children, as again you heard it in grade school, to consume and grow strong and so on.
Johnny Appleseed was in fact a real person, but he didn’t plant apples for people to eat. He planted for them to turn into their personal store of fermented cider, a pretty heavy duty alcoholic drink that was the beverage of choice in most American households across the country well into the early nineteenth century.
In the realm of alcohol consumption, there has been a long history of U.S. Government moving heavily into our private, what was once considered private behavior, from the day of Johnny Appleseed, when again it was considered to be what you drank was your own business. Americans consumed far more rum than they did water. Well into the nineteenth century, rum was considered healthier, gave you that sort of medicinal kick going down.
It was only when health officials stepped in and began what actually were five different rounds of liquor prohibition in the U.S. The last of which was most famous resulted in a Constitutional Amendment to prohibit the sale or consumption of alcohol in this country, so in the realm of alcohol consumption we see an active American Government despite this laissez-faire activity.
Well, consider that most personal of activities, sex. After the Civil War both contraceptives and abortions were relatively easy to get. Abortions in this country terminated about one out of every five and a half pregnancies: legal, not that difficult to get access to, no big fights about it. That’s just the way it was.
A great crusade led partly by the American Medical Association, the docs organization, the AMA, drove both abortion and birth control into the American shadows, where they remained for a century. To this day, few nations contest family planning politics with anything resembling America’s ferocity.
Alcohol, sex. Both realms you think of as private, your business, both areas have elaborate government regulatory forms. The ferocious present day drug wars offer another example of America’s regulation of a once private activity from the first state bans on opium in the 1870s to the contemporary anti-drug regime complete with a powerful national drug czar. American politics again refutes or at least qualifies this picture we have in our heads of an individualistic, anti-government, rights rich political culture.
A couple of drug war moments. This is an 1890s advertisement, ordinary advertisement you’d see in the newspaper like you do for Filene’s Basement today. Cocaine in toothache drops, in fact, long before you guys got here — I got to Yale about fifteen or sixteen years ago — there was an exhibition in Sterling of old sort study exhortations to students. Things you got — encouraging students to study in different ways, sort of like you take Red Bull and so on today. One of them was, ‘Yale men take your cocaine before your final exam.’ That was a perfectly ordinary form of American life at the time. Now we’ve got a much more active, Just Say No drug war kind of culture kicked off, or at least advanced by a first lady of the United States Government, Nancy Reagan. So once again you see this refutation of individualistic culture.
Then finally in the last generation, in your own lifetimes: a coalition of national and state political actors have mounted a serious and sustained challenge to the tobacco industry, resulting in dramatic restraints on what maybe some of you smokers here consider your personal choice. In each of these cases, government charged into what had been considered purely private behavior. In all these spheres, other industrial advanced democratic nations take a more laissez-faire attitude.
Alcohol, sex, drugs, tobacco. In the abstract you thought no way, government never interferes with our private activities. If you look at the historical record of how the U.S. Government got involved with these private behaviors, I think we can learn something about obesity, nutrition, and food as a subject of public policy.
I’ve done this kind of talk before for various audiences from high school students to the food industry, and it’s so interesting to ask them at the beginning what their impression of the U.S. Government is. You’re sophisticated enough I assume; you had something like this portrait of our individualistic, anti-government view in your heads. It’s remarkable to see how qualified it actually is.
How did the government step in and regulate personal behavior? I’m going to take these four areas as an example, and then connect to obesity and food politics. There are seven triggers in the work that I have done, that move us from purely private, again, people drinking rum in their own households, people having sex the way they want — there’s a long list of prohibited sexual behaviors — if you didn’t know this you’ll have to find out someday. How do we move from purely private to subjects of public regulation and what does that mean for obesity? I’ll do the seven triggers to public policy and then we’ll circle back and look at food and nutrition. This pointer isn’t working so I’ll have to hide back here to move this along.
First trigger: social disapproval. Condemnation first stirs in society among us. At least some social groups stigmatize some private behavior. Victorian feminists condemned aggressive male sexuality and held up purity as a male ideal. Mill owners and urban elites in 1830s worried about the disruptive effects of drinking. Social groups, we the people, begin casting judgments long before the American government moves into action. Eventually, in most cases, this social condemnation wins broad support.
Second trigger is already up there too, you got a bonus two for one on this tricky little PowerPoint. Medicalization or medical science is the second trigger moving us from public to private — sorry, from private to public activity. Public health crusades generally require a kind of scientific base. It’s a necessary but not by itself condition for political action, at least in these historic examples I’m trying to give you.
The science can be true. Tobacco really is harmful. The science can be partially true, liquor contributed to health problems, but it was not poison as prohibitionists insisted, or the science can be entirely fictitious as when Victorian era physicians warned men — physicians again issuing medical warnings — that too much self abuse, meaning masturbation or too much sex, could maim, blind, or kill them.
There’s a very popular cartoon from back in the day showing this poor guy who’s masturbated too much, one hand’s already ruined and destroyed, he’s got some terrible disease from masturbation. This was medical science in the 1880s and 1890s, when your great grandparents were somehow moving to create you. Medical knowledge can rapidly transform society. It can challenge everyday activities in ways that would have seemed unimaginable even a few years earlier.
Again, in our own lifetimes, in our own time, the backlash against tobacco, which was initially rooted in medical findings about its dangerous effects has transformed the popular culture. Once again, those of you who aren’t interested in history I’m going to draw on it here and there, to reach back to a historic example. Americans at the start of the eighteenth century, I noted earlier, drained prodigious amounts of rum and viewed water, or avoided water as unhealthy. As physicians began to issue warnings about the dangers of rum in the 1840s and 1850s the American consumption, the average consumption of rum plummeted, fell about 75% in just a few years. So doctors make warnings, we start to respond around behaviors we’ve already begun to condemn socially.
The third trigger to public policy is self help. When medical authorities issue warning, especially about socially sinful behaviors, this is a nation of self help movements. They spring up to encourage people to live more healthy lives. Today, you know this: America’s landscape is dotted with associations dedicated to all manner of social behaviors. Alcoholics Anonymous, Smoker’s Anonymous and so on.
Turns out this urge is also deeply rooted in American history. In Jacksonian America — that’s the late 1820s into the 1830s — urban working men organized Washington temperance, meaning to be non-alcoholic. Washington Temperance Societies to help one another swear off liquor. Women, not to be outdone — these are the first mass organized women’s political groups in United States history, though they weren’t exactly political yet — they formed Martha Washington Societies, the first again female prohibition groups. Abraham Lincoln, no less a figure then Abraham Lincoln, gave a series of talks to Martha Washington Societies trying to court what wasn’t the women’s vote, at least women’s influence.
A couple of examples of what things looked like back then. This is the tree of temperance from the 1840s, towns would erect these, something like this. Then this is old political cartoon that shows all the wonderful virtues, industry, humility, good will, contentment, economy, patience, all those virtues that spring from not drinking alcohol. You see these are ordinary working men around the country, who would erect these sort of tall poles and this was a newspaper version of the virtues you would have come to if you just stopped drinking alcohol, kind of self help movement again. You got the modern version through Alcoholics Anonymous.
Now social disapproval, medical research, and self help movements are all private sector activities of course, but together they help move these public health issues towards the realm where politics, government starts to step in. Reformers — it’s a fascinating and even somewhat disturbing feature in America life — reformers start to become frustrated by offenders’ resistance to reform. Let’s all get together and swear off alcohol, they said in the 1830s, then some people didn’t, that’s when they turned to government help. When their message of uplift and self improvement is not heard, they start to turn in a more negative direction and that trips a couple of other triggers. I’ll take you back through these each time just to remind you where we’ve been and where we’re going.
The fourth trigger is demonization. This is a dark side of American public life. The next two triggers will both have to do with what I call demonization, meaning taking some at least neutral or virtuous, in this case, industry or producer, and turning them into agents of the dark side. Now just note there’s a very deep religious aspect or strain to almost all of these, you’ll see as I go. Talking about socially sinful behaviors; demonizing often associating with Godlessness, the producers of these dangerous or evil substances. The demon in the first case, in trigger four, can be the industry that produces some substance. ‘Demon rum’ became what all alcohol producers were referred to casually in the nineteenth century or you can think of big tobacco in our time.
This is another old political cartoon showing a hearty able young man who turns to liquor, becomes more and more distraught, within two years this political cartoon said, this young fellow turns into that as a result of this demonic industry. This is a modern book but that thing is on the cover. Think of big tobacco in our own time. It wasn’t that long ago the tobacco companies had a positive reputation in American life. They sponsored sports events and concerts, and all kinds of positive things. Now, again, Big Tobacco has this sort of ominous reference.
Especially effective in these kinds of public health crusades going back two hundred years nearly, especially effective is targeting a greedy industry or going after a greedy industry that targets children unable to help themselves, luring helpless children to self destructive habits. A contemporary case again is tobacco. This Joe Camel ad, you’re probably shockingly a little too young to remember any of this, but there was huge fuss in the tobacco days around Joe Camel who was this sort of glorious icon, a sort of cool, some 1990s version of cool, who went from this kind of icon once tobacco began de-demonize to a very different kind of figure, from Joe Camel to Joe Chemo.
These charges let me note again, can be accurate, they can be wildly exaggerated, or they can be completely false about the producers or the purveyors of whatever the substance is. What matters in American political life, is that they pack real political power and so you see us starting to move again in all these examples towards a very different kind of realm.
The fifth trigger, and I do this research with a fellow up at Brown, Jim Morone, and the two of us get positively depressed when we rummage back through American history and look at how this fifth trigger has seemed to be necessary, at least it has been part of the story of moving us from something you do in the privacy of your own home or bedroom or wherever, to a subject of public activity.
The fifth trigger also has to do with demonization but it tends — it’s around demonization of users. This is again, a series of dark chapters in American history. Demonization of users of these prohibited substances and they tend to be people on the social and economic margins of American life. No surprise if you studied U.S. History. Foreigners, racial minorities, urban masses, the lower classes; an immigrant nation like this one with a steady stream of strangers never lacks for dangerous others who are easily portrayed as bringing their foreign destructive habits into American cities.
In fact, the history of American drug wars can be told as a series of waves of racial and ethnic fears. Prohibitions on smoking opium but not using liquid morphine, which was the sort of practice of middle and upper class white women, they used to take a little nip or other forms of morphine to get through the day, that was continued to be fine as the drug wars began to take shape a century ago. Prohibitions on smoking opium were inspired specifically by fears of Chinese immigrants beginning in the 1870s.
You get these sort of horrifying examples, again I’m using popular culture examples this is a cartoon of a — the caption is something like the typical Chinese in his opium den in San Francisco. National campaign to portray Chinese as engaging in these destructive habits, they came from somewhere else, they did these bad things.
Another target of this, by the way, in the drinking realm earlier was Catholics, who were considered to be degenerate, disreputable, and so on in American life. You see here the model of an indulgent — the home of an indulgent mother, this is a typical Catholic mother supposedly, once again you see her child who — you can’t quite see all this but — begins by just playing, and then has plenty of pickles and pork, a first vice. Mexicanized dishes and pepper sauces — the road to ruin as you can see. Then down through candies and rich pastries, tea, coffee, cocoa, sodas, pop, and ginger ale, tobacco and cigarettes, cars, dice and pool, finally liquor and strong drink and a drunkard’s grave. These again are the kinds of foreign habits, Asian Americans as they soon came to be in this case, Catholics in this case, who were helping to destroy the fabric of American society as the story went.
The worst story, no surprise, given American history, had to do with African Americans. There was a series of cocaine panics around — right around a century ago beginning in 1908, 1909 and going forward for a bit. They sprang from these sort of racist fantasies about drug crazed black men. The New York Times — let me get this quote right actually, I’ll read it precisely. This is The New York Times, then as now, the paper of record in our country, and this is a news story, not an OpEd reporting objectively the news. I’m quoting, “Bullets fired into in — into vital parts that would drop a sane man in his tracks,” writes the Times in its news stories, “Cannot slow down the Negro cocaine theme.”
Once again, you see demonization of people who are engaging in these habits or practices we consider — we the majority consider destructive, and you see this movement towards reform. Congress’ response to these cocaine panics, mostly targeting black men: the Harrison Narcotics Act of 1914, our first foray into the modern drug wars. Demon providers, an industry peddling poison and demon user, the people who get hooked on these practices, usually again, folks on the margins of American society. These fears become widespread and lead to trigger six.
Social movements or mass movements in American life. Activists: you and me organized and mobilized to act politically can cut through barriers to political action by seizing the attention of policy makers. When small groups of women began kneeling in prayer outside saloons in the 1870s, praying loudly as men went past them on their way, they were brushed aside by men eager to get their lunch time or even breakfast beer, rum, etc.
When the Women’s Christian Temperance Union, the WCTU, got 200,000 to 300,000 women involved in fighting liquor consumption — one of the first major mass movements in the United States, or indeed, any country’s history. Let me just note, lots of places have people who rise up in the streets and tear things down and build barricades. A social or mass movement has a different character, it’s organized, it’s relatively peaceful, it’s people moving in enormous numbers trying to bring about some kind of political or social change. Think Million Man March in our modern times.
So it’s interesting by the way that the mass movement has begun to fade a bit. We look more at sort of litigation class action lawsuit strategies today, but there still are occasionally mass movements that come together around changing some aspect of American behavior. An interesting piece is the last two, the two most current I can think of in American history have both been all male, The Million Man March and the sort of Promise Keepers Movement, where stadiums full of 70,000,80,000,90,000,100,000 men almost entirely men vow to be more respectful to their families, seize the sort of manly head of the family kind of status and so on. It’s an interesting kind of moment we’re in in American history. Back in the day, around these various issues, mass movements would rise up as in this example around liquor consumption and so on.
To finish the thought, when small groups of women kneeled in prayer, swept aside or knelt in prayer. When 200,000 or 300,000 women marched together, then their leaders were welcomed into meetings with top policy makers in Washington. Seven states passed alcohol prohibitions and fourteen more considered them in response to WCTU agitation and the stirrings of federal prohibition began.
Once more a historical piece, this ran all over the country back then, Woman’s Holy War, it says and goes on through the anti-alcohol army and you can see in the name of God and humanity, The Temperance League; all these rum, brandy, gin, whiskey barrels being shattered by this brave form of woman representing this — again, hundreds of thousands of women joined together in opposition to liquor and alcohol.
Mass movements trigger political action. They overcome entrenched bureaucracy or entrenched industry power like tobacco and breweries and also move us past most of the inertia built into America politics. The war on drugs, interestingly, the one that existed more or less in your lifetimes never quite made it to the movement stage, although there were many carefully staged events that tried to suggest that. This was an infamous moment where journalists were invited to see an enormous anti-drug rally, so the claim went, and there were big American Flag and for some reason the Air Force had a plane there, I guess they were going to fly into your living room and stuff, you on drugs.
But it turned out that almost everybody there had been bussed in or — it wasn’t a group of people rising up spontaneously to stop drugs. There’s all kinds of details and aspects around this. Part of the reason that the drug war never quite got to social movement phase is people pushed back, this is actually an anti-drug war or I guess you could say pro-drugs in some sense, at least anti-heavy duty laws against marijuana group trying to suggest that you’re a victim not a beneficiary of this so called war.
Movements, let me note, do not define or promote concrete policies. They organize, they mobilize, but until we get to the last stage, the last of these seven triggers, you don’t see actual political result. Interest group action is our seventh and final trigger to political action. Cultural images again like Big Tobacco and mass movements win political attention, but its interest groups that flame issues and policy solutions. They translate popular energy into a political plan.
This process turns — involves taking this general dissatisfaction, all these ingredients, medical warnings, and self help groups, and these terrible demonization movements and the rise of mass politics, interest groups skillfully take all that and turn it into a kind of blueprint, a set of specific complaints and detailed policy proposals. In the anti-alcohol struggle, the WCTU, again Women’s Christian Temperance Union, they got the attention but it was a much smaller and little known group called the Anti-Saloon League, the ASL that got prohibition through the U.S. Congress.
I’ll just note as someone who does research on lobbying — forgive this lapse into political science for a moment — but the Anti-Saloon League practically defined the modern interest group. It was one of the first political science studies of interest groups was a now classic monograph from the 1920s analyzing the ASL’s success as an interest group in moving prohibition through Congress’ then as now complicated channels in achieving this remarkable constitutional amendment that again, banned sale production of alcohol for fifteen years in American life. Instead of mobilizing people around the country, the league hired lawyers and lobbyists. Instead of demonstrations, it sponsored legislation. Even the name Anti-Saloon League suggests a kind of narrow, no nonsense objective.
Seven triggers, social disapproval, private behavior, medicalization or medical science, self help, demonization of industry and its users, demonization of individuals, mass movements, and interest group action. This is not a recipe to be followed. For those of you advocates, especially in the public health realm out there who want to make something public, it doesn’t necessarily work this way, but historically it’s remarkable how we’ve seen these triggers, more or less in sequence over a period of time establishing real regimes of political regulation, again prohibition and so on in alcohol, drugs, sex, and tobacco realms.
Chapter 3. Obesity/Nutrition and the Seven Triggers [00:28:14]
Where does this leave us on food? I’m now going to spend the next twenty minutes or so taking us through obesity and nutrition along each of these seven trigger lines and then wrap up and we can take questions or mettle this through as you like.
Social disapproval of, in this case, obesity and overeating of fatty foods. This is a fascinating chapter in U.S. history and I don’t know how much in the early part of this course you got into how obesity and overweight became a kind of sin in American life, but research I did on that was some of the most interesting historical research I’ve done in a long time. I know for many of you the words interesting historical research sound like an oxymoron but there it is.
It was once desirable to be, what used to be called well formed, corpulent, pleasingly plump in American life. Well into — actually through the nineteenth century into the twentieth century, thinness was associated with illness in the United States, and in fact many other advanced industrial countries of the time.
Around the turn of the twentieth century, and I’ve done research as have others, to try to pinpoint when we go through what’s a pretty remarkable cultural shift in American life from sexy desirable to be large or well formed again as the term went back then. It’s a sign of wealth, it’s a sign of in some cases higher education. Again if you’re thin you’re diseased, you’re sick, you’re poor, something’s wrong with you.
Right around the turn of the twentieth century — nobody’s gotten this exactly — but there’s about a five to ten year period where social morays, society just shifts on this. And there’s some reasonably good research but nobody’s nailed why. I’d be fascinated if some of you have read or done work, or even this class, has taken of the details but nobody’s nailed why we change the way we do. It changes dramatically and obesity becomes a topic of disapproval.
I did a lot of magazine research around this, so I looked in popular magazines, Time or Newsweek, or Elle and so on of the day. I looked in those to see the shifts in advertisements and stories and you can really track it. You see advertisements for Catholic statuary, for example. Catholics would buy statutes of saints to put in their yards on in their homes, and up until about 1905, 1906, right in there, the statues are — of saints are all large. I mean Mother Mary as a fairly large figure in American homes in this period — no pun intended both large in context — and then all of a sudden these statues get really skinny. Same saints, more or less the same figures, and yet they’ve changed.
Living Age Magazine, which was a very popular form of Ladies Home Journal, which you haven’t heard of but someday you women in the group will probably subscribe too, the version of that in the early 1900s was something called Living Age. I’m going to read this quote exactly, they wrote in an editorial, this is not just some random comment, this is them editorializing, telling young and middle mothers of the time how to live their lives basically, “Fat, this road is now regarded as an indiscretion and almost as a crime.”
You can also trace this change — other interesting ways of tracking it are through shifts in common language. There’s a historian who actually traces major insults that mostly young people give each — playground, high school, those kinds of exchanges. Around the late 1890s, early twentieth century, you see for the first time in currency the most popular insults as best as these researchers can tell, were things like ‘jumbo,’ ‘butterball,’ ‘fat slob,’ never before traced or noted in American history, all of a sudden these all come into Vogue in the early twentieth century.
You don’t need me to tell you that Americans prejudices against obese and in some cases even moderately overweight people remain extremely powerful, affecting everything from person self esteem to college acceptance and hiring decisions. Obesity is regularly termed an ‘epidemic’ in popular and scientific journals. You can read, again to quote The New York Times, they’ve had a whole series called The Fat Epidemic, and you even casually scan TV listings these days if they’re not about the bailout, they’re still about things like the obesity epidemic.
The first trigger for perhaps 100 years has been tripped so to speak in American life. Medicalization, interestingly, doctors viewing the medical industry such as it was back then, viewing overweight and obesity as a problem, lagged well behind this social turn against obesity and overweight. Doctors still saw obese patients as pleasingly plump. That was an official medical term from a Journal of the American Medical Association into the 1920s.
Only in 1950s was obesity fully what we might say medicalized with terms like obesity or adipose, so much of what you’ve read in here, stems from medical findings that really start the 1950s, fifty or so years after the initial social turn against obesity and overweight. Nonetheless, this trigger, I think we can say has fairly been tripped.
Self help: as physicians began to classify obesity as a medical problem a whole range of private associations developed to combat obesity and overweight. Many of these centered — I want to tie back to this religious point again — many of these centered around moral disapproval of the condition of overweight or obesity. Overeaters Anonymous was founded in 1960, and modeled explicitly on the quasi-religious Alcoholics Anonymous.
I have a brochure I meant to bring for this but couldn’t find it my many boxes — I still haven’t quite moved into NYU after two years. In my many boxes last night, but it was a brochure from one of the first Overeaters Anonymous meetings and it promises you the potential attendant that you — they will allow members to confess your eating sins and receive approval and absolution for your commitment and for your actual weight loss. Listen to those words: sins, approval, absolution; those are again from our extremely powerful religious strain in American public life. These triggers seem to me, at least, doing this research well tripped. The others are less certain. Let’s go through the rest and see how obesity might have moved again from a subject of private, the food we eat from a private realm into a public or political realm.
On demonization, both of industry and users, hard to say — hard to fix this exactly. Since I started studying the subject under Kelly’s guidance eight or so years ago, you couldn’t find a sort of — a lot of demonization in the popular culture of the industry’s purveying this. In fact, one of the first examples I found was a parody where Rush Limbaugh, yes that Rush Limbaugh — our Ron Paul supporter perhaps that listens to Rush occasionally — Rush Limbaugh in a — I happened to hear him on July 4, 2001 in which he did a kind of Rush style rant, in this case targeting — he was very upset about the tobacco settlement and he was complaining about the next target he said in a kind of parody is going to be Big Food.
Let me actually give you the quote, he again predicts a kind of demonization, he then ironically it turned out somewhat to happen. “The next target of nanny state reformers,” Rush said — and let me just parenthetically note that Rush is part of a group that awards the Nanny of the Year to the person they believe to be the most interfering with Americans’ robust private sphere, your own Professor Kelly Brownell was the Nanny of the Year what, in 2003, 2002. Previous awardees include — the previous year’s awardee was Bill Clinton, so he’s in good company. Limbaugh said, “The next target of nanny state reformers is going to food. You’re going to have to find big food, big fat, or whoever and blame them and make someone pay.”
Now Limbaugh’s exaggerating, but I think it’s possible to note a kind of trend towards the demonization of industry. I actually have a couple of research assistants at NYU who are going back systematically since 2001, and looking through popular culture references to find the turn from McDonald’s being this friendly happy clown, to something much more ominous and dangerous. There are some interesting examples that some of you may have seen in here.
Some of the main points or the main moments in this cultural shift I think, this movement towards demonization have been things like the movie Supersize Me, a famous documentary, for a while the biggest grossing documentary in American history; or Eric Schlosser’s classic muck raking track Fast Food Nation, which thinking back to children, argues that a cynical industry, I’m quoting now, “Targets children, reshapes their eating habits, and finds that hugely profitable,” Schlosser writes, “To increase the size and fat content of children’s portions.” He then concludes that in this Fast Food Nation book, that the food industry has literally sponsored an epidemic and writes, “No other nation in history has gotten so fat so fast.”
Bizarrely to me at least, that fascinating and important piece of non-fiction got made into a movie, which was not a particularly good one. But there you see popular culture beginning to shift its imagery and the particular — one of the particular subjects I have one of my research assistants looking at is how Ronald McDonald, this icon of happy friendly clown, started to urn more sinister to the point that at one time he was — Ronald McDonald was the single most recognized figure on the planet, living, fake, whatever of any kind of creature — this is ten or fifteen years ago.
Now, McDonald’s has almost entirely removed him from their advertising because he’s been successfully if not quite demonized, at least turned into a more dangerous figure in the eyes of children by some advocates who have sought to portray Ronald as a dangerous figure. Again, I suspect you get this some of this popular culture or lots of it in this class; I just want to note that what you may be seeing as this kind of movement to demonization that has predicted political action in so many other cases in American history.
How about demonization of users? Here again, we’re on complicated ground. I don’t think we see overweight or obese people as genuinely dangerous to society on the order of drug-using criminals, or smokers polluting their surroundings with second hand toxins. You do hear concerns — and I spent a fair bit of time on this in the article that you may or may not have read for today — you do hear concerns about the economic costs of people who can’t control their self-destructive appetites, as it’s often put, and get themselves sick, as it’s also often put, and then cost us as a nation, you and me the taxpayers, some figure that gets bounced around by this sometimes currently estimated around $120 billion dollars a year in excess health costs owing to over consumption.
To me there’s at least a hint, a seismic tremor of something like demonization of users in the increasingly widespread editorials and OpEds suggesting- this again is not stuff that we political scientists read, this is what you’re reading in the papers. I actually have done a kind of viral marketing study where you can trace a single editorial, a single OpEd that ran in The Baltimore Sun about three years ago, suggesting that something like the economic cost of obesity is everyone’s business. It’s in the piece you all read.
You can see this piece spread. USA Today picked it up and in the end over 100 different newspapers and other media outlets ran a version of this, so you can see this notion that that person there, due to their overeating and self destructive appetitive practices, is costing me money. This is at least the edge of a kind of demonization of the users.
What about the social movement’s piece? Again, you don’t see people marching in the streets to stop M&M’s or McDonald’s or so on. Ad I think also absent all out demonization of big food or consumers of it, sustained popular movements against overweight have not coalesced in American society, despite a century of disapproval and failed diets. Obesity politics doesn’t stir anything remotely resembling the WCTU’s marches against alcohol or even a just say no anti-drug crusades.
But again, this is something that I explore in the paper, take it with you guys if you want; we live in a somewhat different age. We’re not as prone to take to the streets around political action as in earlier generations of Americans were. The modern variant may be — and the tobacco case shows us this — the modern variant of social action, mass social action, may actually be legal action, litigation; particularly mass torts, where in a class action suit many affected people come together and seek monetary remand.
There’s lots of interesting examples. I’ll just flag this for you now, as a possible example of social movement so to speak around obesity. Lots of examples of class action or even individual case lawsuits being brought against the food industry. The piece you — again may or may not have read — suggests that the judiciary, the courts may actually be the locusts of major action in this area, as opposed to our elective branches of government, the executive, i.e., White House or down at the state level governors and so on and legislative branches.
It’s an interesting, and I try to suggest in my piece, a kind of historic shift in the way we make politics, literally the way we make policy in this country from members of Congress and elected presidents and their supporters in the executive branch, from them being the locuses of major policy change to the courts being the locuses of major policy change.
Again, I’m happy to take that up if you like later. There’s some real concerns that things that happen in courts, policies that actually take place in court, aren’t that — don’t last that long, they don’t endure as powerfully as a law that is made by the representatives of the we the people; but nonetheless, it is an interesting possible shift and may herald the kind of change in obesity politics as well.
Then finally, interest group politics. This is still only stirring I would say. The tobacco — anti-tobacco movement attracted a large number of very well financed organizations that sought to really reshape the landscape, eventually successfully of what happened with smoking and tobacco. In the obesity — or pro-nutrition let’s say realm — there’s a smaller number of groups and they don’t have as much funding yet. You see that starting to change.
Again, I gesture to both the folks in the front row here who come from Yale’s own Rudd Center, and I’m sure you’ve heard lots and lots of details and aspects of that. This is one of a handful of groups that is really moving towards trying to make a difference in nutrition and overweight. One encouraging — interest group action, people actually fanning out across Capitol Hill to bring amount major changes in American diet, or otherwise try to effect policies that would change the way we eat or the change the way the food industry markets, or portion sizes, lots of different possibilities we can get too, but actual interest group action here has been smaller then we saw in these other cases I described.
Once encouraging aspect of that I’ll say, is that groups like The Rudd Center, or Center for Science in the Public Interest, also one the well known groups in this area, have been much more nuanced in the politics. You don’t see the kind of demonization, the kind of stigma of the very people that they’re ostensibly trying help in this nutrition, overweight, obesity politics realm.
I find that an encouraging aspect or piece, but at the same time, you don’t see the kind of big interest group push that has — the past is only a guide, it’s not a blueprint to the future — but that has always been the hallmark of major change in American life around public health.
Three triggers tripped for sure for many years, something that looks like the beginnings of if not demonization, at least real criticism of the food industry for its practices; happily, not yet something as profound as demonization of users. No mass movement. People aren’t marching in the streets around this; but again, if you’ll accept that mass litigation, mass tort again, class action lawsuits may be a substitute, those are beginning to take shape. There is some interesting legal work done in this realm that you’ll hear about in the next couple — actually two weeks — next week I guess is when Steven Teret is in here. You’ll hear from an expert in this realm. And that interest group action, again brave action by some folks, including people in the front row here, but only nascent and stirring I’d say.
I should also note that opponents of government action are always going to try to keep these issues off the policy agenda. Tobacco is a remarkably successful industry for thirty or forty years in blunting or blocking action. And the food industry as either you’ve heard in here or you certainly will, has been very successful so far at blocking or blunting regulatory activity. Sometimes in open active interest group ways, sometimes more subtle.
I learned this actually from Kelly or Marlene, I can’t remember which, but there’s a conference of the North American Association for the Study of Obesity, NASO, a meeting that those of us who do this research go to most years. Until quite recently the — this premiere medical and public policy gathering to discuss issues related to obesity and overweight, until quite recently, the sponsors of that meeting were Hershey, Kraft, Coke, and Slim Fast. You can see ways in which the very people doing this research have at least some support and encouragement from those in the industry, to see things this way.
Okay, enough history lessons, I’m happy to talk for what is a relatively short time remaining about what government night do to regulate high fat, low nutrition foods, mandate exercise and so on. Let me leave you with this thought. Actually I’ll leave you with two thoughts. The first one is a simple straightforward one, when I arrived at Yale in 1988 to start my graduate program, exactly twenty years ago this fall; I had four graduate seminars in political science, ordinary kinds of seminars, small in this case. Those of you, who take college seminars, some have had classes this size, in classrooms in some cases where you all have sat and had seminars. In three of those four classes, the professor and many of the students smoked all the way through class.
Shocking, outrageous, astonishing. I always imagined twenty-five years from now talking to a group like this and saying, forty-five years ago, or twenty years ago when I was at Yale, students used to eat in class M&M, drink Coke — and students would look just as amazed at the idea that your predecessors, your elder siblings at it were at Yale, used to smoke in class. It was a regular thing here; nobody thought it was odd at all. I was an anti-smoker type myself — I never had smoked — but the idea that my professors, three of four smoked, no big deal at all.
That’s one thought to leave you with. The way things change remarkably. Go back a hundred years, not at all unusual for all of you take a little snort or sip of something like cocaine before you prepared, shocking, horrifying, professor suggesting these things. The world changes, sometimes swiftly and so often profoundly and dramatically; so one aspect of obesity and food politics could be a kind of regulatory prohibition that you couldn’t even imagine as you sit in these seats today.
Let me finish with a more sermony kind of thought. In the realm of public approaches to private problems — that’s what we’ve been talking about today as I hope you’ve gathered by now — public, i.e., government approaches to what is considered private problems. It’s where a lot — as my article tried to suggest, it’s where a lot of the action is in health politics and policy today.
We’ve moved in this regulating private behavior direction in a way we did not use to do in American life. It used to be big, public programs that occupied health advocates and activists. Hill Burton which established all the wonderful network of public — once wonderful network of public hospitals and clinics around the country. Medicare, Medicaid, big public programs; now we target in our health policy and politics making private behaviors from asbestos and tobacco, to perhaps food and the conditions that inspires.
In the realm of public approaches, the private problems, the lesson from one policy area after another: alcohol, drugs, sex, tobacco, perhaps obesity and food, is the same. This is the lesson I take away. Put aside prohibitions, emphasize treatment, education and well grounded public health approaches. Consider ways to reshape the offending industry and its products much as was belatedly done with alcohol, and what sort of done with tobacco, that’s a more complicated issue, we’re still in the middle of it.
There’s a danger that’s consistent across all these cases. The path to political action stirs so much heat. Those of you who perhaps as a result of this class or before you came in this class; saw political action is what we need around obesity and overweight. We’ve got to change the way America eats through government and politics. I’ll say again, there’s a danger, the path to political action in this country stirs so much heat, arouses so much activity, that the solution is almost always move beyond public health and emphasize the criminal realm.
Medical wisdom almost always falls before this kind of demon imagery. The basic view is, bad people are threatening American innocence, children particularly. Why shouldn’t we discipline them? The history of American prohibitions offers a kind of eloquent answer. Criminalizing public health problems causes far more trouble, more pain, more suffering, more social dislocation then it solves.
Let met stop with that I think warning of a thought, and if you’ve got questions or comments I’m thrilled to take it up, and do some back and forth. I think we’ve got about twenty-five minutes remaining, twenty to twenty-five minutes so let me hear what you think about this. Again, if those of you who did not sign up for a course in American History and feel somehow cheated by this trip through alcohol, drugs, sex and tobacco, at least the professor got up at 9:00 in the morning on Monday and talked about sex so you got that going for you.
Chapter 4. Question and Answer [00:49:44]
Questions, comments, pushback, ideas? You’re the shyest group of Yalies I’ve ever seen.
Professor Rogan Kersh: Interesting question if you couldn’t hear it’s no mass movements, no people in the street, what about — I’m taking as implicit your skepticism — about what about us, we the people today, who exist mostly online, what about online movements and those kinds of changes? Again, these are not blueprints and when all of these alcohol, drugs, sex, tobacco cases took place there was no significant “online community.”
Apart from — and I’m going to be on ground I suspect some of you may dispute, and that’s fine and even desirable — apart from Obama’s remarkable fundraising ability and some — and in some cases predicated or preceded by Howard Dean’s ability to link people like you wearing orange hats four years ago in American politics — it’s hard to think of a major American political movement that has been largely or even significantly situated online. I mean, most of what we do on our computers is still very private behavior. There is blogging and reading, and some threads and discussions and so on.
But actual urges to political action that take place online and then move into public realm? The one example I can think of that actually — as I’m saying this and thinking aloud and perhaps dating myself — meaning in age not in some weird fetishistic way; self abuse can kill you I learned that from this study — the one example that may be contrary to that, is movements for internet privacy, ironically. Those have moved around the net. I mean, Lawrence Lessig has become kind of — I don’t know if you know the name but he’s kind of rock star at NYU. He comes, he’s a professor at Stanford who comes and gives talks about the importance of preserving internet privacy, and this guy gets five hundred people turning out for his pretty dry straightforward talks, so it’s interesting.
That’s one example, but if you guys have others I’d be interested to hear them. I haven’t written or thought about social movements that take place online, but it’s hard for me to see in the public health realm at least. I mean there’s lots of information about the effects and causes of obesity, overweight and so on, the nutritional aspects. There’s a lot of information about stigma and body image. I mean this is an enormous issue of huge attention, that no doubt gets taken up in here in some detail. But I can’t think of sustained political movement in this realm that takes place online. Correct me if you all have other ideas. Good. One down, yes. A lot of Obama buttons in here today. I can’t imagine why.
Professor Rogan Kersh: I’ll ask the question again if you couldn’t hear it. What about demonization of actual products, something specific that’s produced? That to me, falls generally under the header of demonization of industry or purveyors, so if you’re demonizing Big Gulps — as Kelly Brownell has tried to do actually — these gallon sized drinks you get and stick into your enormous cup holder in your SUV. There certainly are efforts to parody, poke fun at, and so on, and again I think this realm is starting to take shape and take form. There is certainly a kind of well-established cultural criticism about the food industry, and the ways it shapes our eating behavior.
This sort of toxic environment frame that Kelly has done so much to pioneer has taken hold, at least to an extent. At the same time there’s also this powerful personal responsibility or consumer choice view that says don’t point at my Big Gulp or what I choose as a consumer to eat, keep the government out of my kitchen.
There’s basically this war of frames, and the initial frame was I think set pretty well by the food industry. American politics is a long history of the personal responsibility folks getting in first and framing the ground. Again, I suspect you’ve taken this up in here, I don’t want to tell you things you don’t know, but the idea that the food industry is going to be as disreputable as tobacco, or in the old days demon — and more specific to your question, the products they create is going to be as disreputable. It doesn’t feel that way yet. There is a sort of slow food movement, there is those locavore movement, something is changing around the way we think about food but I don’t think it’s anything like demonization, and that may be a good thing.
Again, demonizing something is to portray it as all and everywhere and completely evil, as everybody I talk too, especially food industry groups and Kelly and Marlene have heard this plenty of times too, we all got to eat. We don’t have to smoke, and we don’t have to drink, but we all got to eat is the argument. But it’s what we eat and how it’s marketed and advertised to us that becomes the possible subject of political regulation. Yes sir.
Professor Rogan Kersh: Lovely question, and again I’ll repeat it for those of you in the distant, distant back, even sitting on the floor. Kelly gets a crowd as always. The basic thrust of the question is, what if we could just skip demonization? As this gentleman said, hop right over it and go straight to policy action and come up with the assumption being a kind of well reasoned rational thoughtful way to regulate, or prescribe, or prohibit some practice that we find undesirable. Fantastic, I mean I’m an advocate in this realm as much as I’m a historian and political scientist, and I spend some time as these guys do in more detail, trying to figure out what policy solutions might look like.
You don’t get in this country, and if nothing else I say to day makes any impact on you, you do not get in American politics, especially on a national scale from (a) private behavior — industry says let us eat at peace in home — to policy solution without a hell of a lot of work and push, and pull, and blood, and sweat and tears in between. In fact, the reason we go through these kinds of stages in such enduring physean, i.e., push the rock up the hill only to have it roll down again, is because it’s so hard to bring about significant policy change in American life.
It’s so difficult in fact, that for the last fifteen to twenty years, in the realm I know best public health, more and more advocates have turned away from the usual policy channels, elective branches, write your member of Congress, here’s a great idea for something I think is bad, make it happen. So many public health advocates have become frustrated and fed up with and recognize that the interest groups society and so on makes it almost impossible to make significant change. They’ve turned to the courts because courts with one swift stroke, with one decision of a judge — after many counter appeals and so on — can actually result in policy outcomes.
Tobacco — I wrote about this in the piece you may or may not have read, I’ll stop saying that I promise, but I’m a realist. I’m Charlie Brown kicking the football but I also taught a bunch of your elder siblings as it were — in that piece, I try to suggest that tobacco — this extraordinary reshaping of the tobacco landscape where now, again ten years ago, fifteen years ago people smoked in class, now you huddle outside doorways if you dare to smoke at all, enduring the disdainful wrath of your fellow consumers off — not wanting to breathe in your second-hand smoke — in the tobacco realm, that enormous change that huge settlement and so on, didn’t come about because Congress said this must stop, or a President said this must stop. It came about because some legal actives got together, the Attorneys General in the various states, and effected a dramatic change.
I love the spirit behind the question; can’t we just leave out all this bad stuff and do something good for we the citizens, around reshaping the toxic environment or landscape of food and nutrition in this country? Yeah, it would be a glorious moment, but it doesn’t happen that way. I mean these guys have been in the trenches for more years then they probably want me to say around this. I learned this stuff from Kelly eight years ago and I’ve been working around and for obesity changes since. We’ve gone to Washington together, we’ve met with Hilary Clinton among things, these folks are regular presence in conversations with the people who hold the levers of power in Congress, and to some extent the executive branch. And not much has happened.
You know how much since the Surgeon General — I might note George W. Bush’s Surgeon General declared obesity an epidemic in 2001, so seven plus years ago this statement — you know how much Congress has passed to reshape obesity and nutrition since then? Nothing, not a single significant bill, including the most recent democratic controlled Congress, where if they one might say pushed in the right ways something might have happened quickly.
It takes a long time and it takes a lot of work, and so often it takes reaching way beyond where you want to be. The metaphor I like, and you’ve probably as a version before if you studied politics here at Yale or elsewhere, metaphor is: a battleship. To move a battleship you don’t just turn the wheel, you start turning, and turning, and turning until — I don’t know exactly I’m not a naval guy — but half an hour later this thing starts to move and thing this is long before it started to move you’re already turning back, because it’s going to move way too far if you try to steer it like you’d normally steer a car. American politics and policy making is like a battleship around obesity and many other issues in public health. You turn, and you turn, and you turn and nothing happens and then once you realize this thing actually turned, you’ve gone way too far.
Let me not — I don’t know if that will happen on obesity and associated nutritional issues. But that’s what happened with drugs, alcohol, sex and to some extent, although not as badly tobacco. Innocent people, particularly people on the American margins, got badly demonized and badly hurt, a long of pain was caused, a lot of social dislocation, because the — when you get this American policy making apparatus in action it runs right over so many people in its way. I love the question, I admire the sprit behind it. Ten years ago I would have said of course let’s just change it together tomorrow. Older, wiser, sadder, tougher, but still committed to the fight such as it is. More questions? Yes.
Professor Rogan Kersh: Another terrific question, thank you. Again, the last group I had a talk like this before with the food industry and their questions were very different and I’ll say not so sophisticated and more — the points were made with sledge hammers rather than inquisitively. I have to say I don’t know — I’ll repeat the question. It was a very intriguing one and I got lost in political scientist in thought, sorry for those of you who are — desire more animation and action.
The basic thrust of the question was, all right you’ve talked about this as a kind of political or policy issue. What about all the other ways we can look at nutrition issues relating to obesity and overweight? It’s economic, it’s psychological, it’s anthropological, and you all in this class have taken up a bunch of those perspectives and avenues and so on, and the basic thrust of the question is, in a way isn’t food different because it touches all these different areas of life?
I’ll say first, I think most public policies have — most major policy issues have these various avenues and aspects to them. I mean, tobacco was also cultural and anthropological and economic, and I don’t think there’s something specific and special about food in that respect. I mean the fact that I took a policy frame is probably because I’m a policy guy, it’s partly because you all have, looking at the syllabus at least, and I’ll be looking over some of your exams later — just kidding — but you already have mastered some of these other avenues and approaches.
In principle I don’t think food is in some meaningful way different, so the political scientist have to consider it in a different way. It feels to me like the analogy with alcohol, and drugs, and tobacco, and maybe even sex — that’s a slightly odd one but again that’s a private behavior — it feels to like those also touch lots of different areas and aspects and ways of living, in ways that really matter, and that one has to be — I’ll take the spirit of your question — one has to be very careful with how you charge into regulating something that has so many delicate and important aspects.
In my time most recently here at Yale a couple of years ago, at The Rudd Center where these folks work — actually where these folks run the show! — I really got educated about the stigma aspect of this by one of their colleagues who may have spoken to this class, Rebecca Puel who was a Kelly Brownell PhD student here. I really got a sense from Rebecca about how stigma and — well issues related to that, body image and so on, plays into this and I think I’m, as an advocate and on, I’m much more careful and cautious about saying we got to get rid of these things that cause people to become fat.
At the same time, there’s also an implication in your question that it’s so complicated, and shouldn’t we sort of get things right, get all the science and all the nuance right before we try to make some public policy change? I’m going to take your two questions as kind of bookends. The food industry loves that kind of line. It’s not you, but they love saying, it’s so complicated, it’s so difficult, the science isn’t quite right; we can’t take some action before we know what the consequences will be.
Look, this is a country, if there’s anything true about our politics historically, is that we are a country of pragmatists. Franklin Roosevelt, after a similar economic time to this one said, do something, famously he said, ‘Do something, let’s just do something, if that doesn’t work, let’s try something else.’ We are a people when we make policy and we do it more slowly because there’s so much interest group activity now.
We’ve become a demosclerotic society — I love that word. There’s a free word for you today, nobody wrote it down, but I’m pretending you did. Demosclerotic is a marvelous word coined by a friend of mine who is a journalist that basically means demos, we the people, sclerotic, like hardening of the arteries are the body of politics. There’s so many interest groups pushing so hard and in so many directions and aspects, and in this case a very powerful food industry and its allies, we’re pushing so hard against political action it’s difficult to get anything done.
At the same time, there is a spirit of let’s try some, if that doesn’t work, let’s try something else. Calorie menu labeling let’s get that on the menus and see what happens, let’s test it later, or let’s test it as soon as we can. Ban Trans fats, well let’s at least give that a try, so lots of policy options and possibilities, absolutely, it’s an incredibly complex and dynamic and confusing subject, but if we don’t do anything obesity rates, we know this from all — every projection we have, we’re going to keep going up, and up, and up. Yes, okay — last question, sorry.
Professor Rogan Kersh: Great question again, you all — I’m hugely impressed by the questions you’ve asked, and appreciate them immensely as I do this opportunity to talk. Question was if you couldn’t hear it: is the U.S. going to be the global leader in this reshaping, perhaps from a regulatory or other political standpoint? A bunch of ways to do policy, by the way, there’s regulating things, there’s taxing them, there’s prohibiting them, there’s filing lawsuits against them, lots of ways to go.
Are we going to be a global leader in this realm? The sad answer is no. We’re already a global follower by far. Most European countries, particularly those in Northern Europe, Scandinavia are far ahead of us. If you haven’t heard this yet in here, I suspect you’ll hear chapter and verse. I mean most of the Scandinavian countries — I think all of the Scandinavian countries plus some of the other Northern European countries ban — outright ban — on high fat, low nutrition, snacky, junky foods advertising on TV to kids, you just can’t do it. Can you imagine here the freedom of speech and the — I mean most advocates have just abandoned that possibility, which by the way, would be a pretty effective way of countering some of the enormous stream of messages that industry sends out to you all ten and fifteen years ago about what you should and shouldn’t eat. Sugar Smacks good, other stuff too expensive, hard to get, etc.; so the idea that we’ll be a global leader is dubious to me.
One thing you touched on though, the question about what about multi-national corporations and so on: the way the U.S. could be a global leader is something we lead the globe in already and that’s so called public-private partnerships. Where you take the public’s fear of government and you somehow marry it, connect it to a concerned, engaged, social entrepreneurial if you will, private sphere. You put together something where industry actually works with, if not government, at least think tank advocates like these guys, to reshape its activities and products. There’s some — let me finish the thought, to reshape its activities and products.
There’s some indication that the food industry, in some of its better manifestations, and again I know you’ll get to that in here, has begun to work in a few cases of advocates to rethink the portion sizes, the level of fat, salt, sugar, and so on in its foods; the way they market and advertise to young people. There’s some evidence that through some kind of public/private partnership some good could take place. When I say we could lead the world in that it’s not because we’re out in front as a government on these issues, we’re not, we lag badly, badly behind most other advanced democratic nations.
Japan, to give you one example you may have heard of, has required I think they’re still doing this, every single person in the country have something equivalent to their BMI measured and recorded. That’s a kind of solution that wouldn’t go — you couldn’t do it in this class, much less the whole country in our individualistic U.S.
I’ll say for the last time, we are an individualistic country. We’ve pushed back hard against government interference, and we resist intrusion to our private lives; and yet in lots of public health areas, in the not so distant past, we’ve seen significant changes. Those of you who are going to work in this area, who are going to be advocates, make sure those changes are done with nuance, with subtlety in ways that actually yield good results not demonized and destructive ones. Thanks, this was a great opportunity; I’ll talk to you again.
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