Showing posts with label obesity. Show all posts
Showing posts with label obesity. Show all posts

Wednesday, January 30, 2019

Unhealthy, unhappy lives aren't fair exchange for higher incomes

In his Australia Day address, social researcher Hugh Mackay said that "the Australia I love today – this sleep-deprived, overweight, overmedicated, anxious, smartphone-addicted society – is a very different place from the Australia I used to love".

He identified three big changes: the gender revolution, increasing disparity in wealth, and social fragmentation.

He approves of the first, but laments that we’re "learning to live with a chasm of income inequality" and that social fragmentation means Australians are become "more individualistic, more materialistic, more competitive".

The third big change, he said, posed the biggest challenge – preserving social cohesion.

Earlier this month, the playwright David Williamson lamented that, since the advent of neoliberalism, "the world has become a nastier, more competitive, more ruthless place".

"There’s no perfect society, but I don’t think it needs to be as brutal as it is now."

As we move on from our officially required season of national navel-gazing – "yes, but what does it mean to be Australian?" – these concerns are worth pondering.

Economists object to being blamed for every ill that’s beset our country in the past 40 years. Where’s the proof that this economic policy or that has caused a worsening in mental health, they demand to be told.

It’s true that few developments in society have just a single cause. It’s also true there’s little hard evidence that the A of “microeconomic reform” caused the B of more suicides, for instance.

But there’s a lot of circumstantial evidence. After all, the specific objective of micro reform was to increase economic efficiency by making our markets more intensely competitive. The economists’ basic model views us as individuals, motivated by self-interest, and the goal of faster growth in the economy is aimed at raising our material standard of living.

And if some of our problems stem from changing technology – pursuing friendship via screens, for instance – can economists disclaim all responsibility when one of their stated aims is to encourage technological advance in the name of higher productivity?

Economists assume that economic growth will leave us all better off. Most take little interest in how evenly or unevenly the additional income is shared between households.

The Productivity Commission’s recent and frequently quoted report, finding that the distribution of income hasn’t become more unequal, refers to recent years, not the past 40. And the report averages away the uncomfortable truth that the incomes of chief executives and other members of the top 1 per cent have increased many times faster than for the rest of us.

Sometimes what’s happened since the mid-1980s reminds me of the old advertisement: are you smoking more, but enjoying it less?

Our real incomes have grown considerably over the years – even for people at the bottom – and economic reform can take a fair bit of the credit. It can take most of the credit for the remarkable truth that, unlike all the other rich countries, we’ve gone for 27 years without our least fortunate experiencing the great economic and social pain of recession and mass job loss.

But though most of us are earning and spending more than ever, there’s evidence we’re enjoying it less. Our higher material living standards have come at the cost of increasing social and health problems.

Is that so hard to believe when the key driver of our higher incomes is more intense competition between us?

Economists generally take little interest in social and health problems, regarding them as outside their field. But though problems such as loneliness, stress, anxiety, depression and obesity were with us long before the arrival of neoliberalism, they seem to have got worse since the mid-1980s.

Last year, Dr Michelle Lim, a clinical psychologist at Swinburne University, and her colleagues produced the Australian Loneliness Report, which found that more than one in four Australians feels lonely three or more days a week.

It’s most common among those who are single, separated or divorced. Compared to other Australians, the lonely report higher social anxiety and depression, poorer psychological health and quality of life, and fewer meaningful relationships and social interactions.

Turning to increased stress, it’s an inevitable consequence of living in bigger, faster cities and working in more competitive workplaces. Our bodies respond to stressful events with a surge of adrenaline, which increases our reaction speed and helps ensure our survival.

Trouble is, our bodies aren’t designed to cope with repeated stressful events and adrenaline rushes. Our readiness for fight or flight doesn’t decline, and we remain permanently aroused, which damages our health, making us more at risk of a heart attack or getting sick in other ways.

If more "jobs and growth" and the higher incomes they bring are intended to make us happier, maybe governments would do better by us if they switched their objective from increasing happiness to reducing unhappiness.

For instance, if the banks are now being criticised on all sides for putting profits before people, why are governments – facing an epidemic of obesity and diabetes - so respectful of the food and beverage industry’s right to continue fatten its profits by fattening us and our kids?

Wednesday, November 23, 2016

'Nanny state' is cover for exploitation by commercial interests

Oh no, the nanny state brigade is at it again. In their certainty they know what's best for us, they're back with their social engineering, wanting to punish us for being fat and use a tax on sugary drinks to push us towards "healthier choices".

On Wednesday the Grattan Institute will release a report urging the federal government to impose an excise of 40¢ per 100 grams of sugar on non-alcoholic beverages that contain added sugar.

What part of personal freedom don't they understand? If people want to drink sugary drinks, why should anyone else try to stop them? What harm are they doing to others?

Surely this is a matter of personal choice and responsibility. If being fat is bad for the health, it's up to the individual to accept responsibility for their own fate and decide to eat less and exercise more.

How much of our lives is the government going to take over? What willpower will be left if they keep doing more of this stuff?

Actually, I'm never convinced by these arguments from the professed defenders of our personal liberty.

Whenever I hear people banging on about "the nanny state" I wonder about their motives. Many of the critics are trying to keep government small so they're required to pay less tax.

These souls are often full of their own virtue. They attribute their comfortable circumstances entirely to their own efforts (forgetting the outside help they invariably had) and can't see why they should help others who aren't as disciplined as they are.

As for the libertarian think tanks leading the charge against the nanny state, you wonder how many of their undisclosed (but tax deductible) donations come from alcohol, tobacco and food companies anxious to resist any government measure limiting their freedom to profit from unhealthy products.

As the Grattan report – written by Hal Swerissen and Professor Stephen Duckett, a leading health economist – reminds us, there's little doubt that excessive overweight increases the risk of premature death, diabetes and cardiovascular disease.

Yet the incidence of obesity – a body mass index of more than 30 – is growing in the rich countries. The proportion of obese Australian adults is 28 per cent, up from less than 10 per cent in the 1980s. That's not counting the further 36 per cent who are overweight.

About 7 per cent of Australian children are obese, up from a negligible number in the '80s.

Although it may have plateaued among children, obesity continues to worsen among adults and seems likely to increase further.

Research suggests the main cause is overeating of processed food laced with sugar, fat and salt, which grows ever cheaper and available. The amount of exercise we get hasn't changed much over that time.

Health authorities and governments have been worried about an "obesity epidemic" for years, but nothing they've done so far seems to have worked.

This is probably because they've been tiptoeing around the powerful commercial food interests, focusing on individual responsibility, physical exercise and voluntary food labelling.

I agree it's time we did something more assertive and, though a tax on sugary drinks is far from a cure-all, it's a good place to start.

Lots of other countries are doing it, and have shown it works in discouraging consumption of sugary drinks and reducing obesity somewhat.

For us to impose it as a federal excise would be simple and administratively cheap. We already have excises intended to discourage us from smoking and overconsuming alcoholic beverages.

It would be paid by manufacturers and importers, then passed on to consumers, which would encourage people to move to bottled water, artificially sweetened drinks or even tap water.

A principle of libertarianism is that you should be allowed to do as you please as long as you're not harming others.

But as well as harming themselves, the obese also harm the rest of us. Evidence shows that, relative to others, the obese make more use of doctors, hospitals and pharmaceutical benefits.

All these impose higher costs on other taxpayers. Obese people are more likely to be on welfare benefits and less likely to be employed and paying income tax, which imposes further cost on other taxpayers.

Grattan estimates the cost to the rest of us is about $5 billion a year. The sugary drinks tax would recoup about $500 million a year of that.

Libertarianism assumes no one could possibly know our best interests better than ourselves. That's because we are unfailingly rational in the decisions we make. We have an iron will which stops us doing anything we later come to regret or being influenced by the behaviour of those around us.

In reality, all of us have a problem with self-control in at least one area of our lives and probably several.

And here's the bit nanny's critics never get: most of us are pleased when governments help us with our self-control problem by taking temptation out of our way.

Governments have used compulsory seat belts and random breath testing to reduce road deaths per head of population by more than 80 per cent. They've used sky high tobacco tax, bans on indoor smoking and other things to cut the rate of smoking by more than half.

It's high time they stood up to the processed food industry and did something effective about obesity.

Wednesday, October 6, 2010

Obesity problem is bigger than we think, despite GDP benefits

I have bad news and good about the O-word. Although there has been a suggestion in some quarters the media got over-excited about the "obesity epidemic", a report from the Organisation for Economic Co-operation and Development - unlikely to be a purveyor of faddish enthusiasms - has confirmed the seriousness of the problem.

The report says obesity is worsening throughout the developed world and becoming the top public health concern. One in two people is now overweight or obese in almost half the developed countries. In some, two out of three people will be in trouble within 10 years.

In Australia, 61 per cent of adults are overweight or obese, making us almost as fat as the Americans. In 20 years, our overweight rate has risen faster than in any other developed country. It is projected to rise another 15 per cent in the next 10 years.

And the good news? It's saving taxpayers money.

Although healthcare spending for obese people is at least 25 per cent higher than for someone of normal weight, and increases rapidly as people get fatter, severely obese people are likely to die eight to 10 years earlier, so their shorter lives mean they incur lower healthcare costs over their lifetime. It's even greater than the saving on smokers.

If you don't like that, try this. As measured by gross domestic product, obesity is a win-win-win situation. The more you eat the more you add to GDP and the profits of businesses. If the messages of advertising and marketing make you self-conscious about your overweight, everything you spend on fancy diets, gym subscriptions etc adds to GDP.

And then when you damage your health, everything you, the government and your health fund spend on trying to keep you going adds to GDP. Even when you die prematurely that won't count as a negative against GDP, although the absence of your continued consumption will be missed.

Get the feeling there's something amiss?

Two of our greatest campaigners on obesity are Garry Egger, the professor of lifestyle medicine at Southern Cross University and the founder of GutBusters, and Boyd Swinburn, professor of population health at Deakin University.

They've written a book, Planet Obesity, which takes a rather different tack. Since obesity is endemic, it can't be dismissed as the product of gluttony and sloth on the part of a few individuals.

Obesity has been rising since the 1980s. Before then it was rare. Clearly, it's a product of our modern lifestyle, of the way we organise our society.

We're getting fatter for a host of interacting reasons. According to the OECD report, the supply and availability of food altered remarkably in the second half of the 20th century, brought about by big changes in food production technologies and an increasing and increasingly sophisticated use of promotion and persuasion.

The price of calories fell dramatically and convenience foods became available virtually everywhere, while the time available for traditional meal preparation from raw ingredients shrank as a result of changing working and living conditions.

"Decreased physical activity at work, increased participation of women in the labour force, increasing levels of stress and job insecurity, longer working hours for some jobs, are all factors that, directly or indirectly, contribute to the lifestyle changes which caused the obesity epidemic," the report says.

See what this is saying? The rise in obesity is a product of the success of capitalism and the technological advance it fosters and exploits.

So far, those who haven't tried to blame the problem on the weakness of individuals have treated it as an unfortunate byproduct of modern life, needing to be remedied in some way so we can carry on as usual.

Egger and Swinburn see it very differently, not as a disease but as a signal. "It's the canary in the coalmine, which should alert us to bigger structural problems in society," they say.

Obesity and the health problems it often brings - type 2 diabetes, heart disease - are part of a rise in chronic conditions, including respiratory disease and many forms of cancer, that could eventually end our ever-increasing longevity, or at least make our longer lives far less pleasant.

People in developed countries have been getting taller and heavier since 1800. For almost all that time, our weight gain has made us healthier but in recent decades it's greatly accelerated and is now making us unhealthy.

So what's the signal Egger and Swinburn say the obesity epidemic is sending us? That we've passed the "sweet spot" - the point where everything's fine, the point of equilibrium, as an economist would say.

Until fairly recently, economic growth was making us unambiguously better off. Making us more secure, more prosperous and, because of scientific advances, improving our health. But now we've overshot the sweet spot and continued economic growth is starting to worsen our health.

It's a similar story with global warming. Economic growth and rising affluence - much of it based on the burning of fossil fuels - was fine as long as the world's sinks could absorb all the extra carbon dioxide we were pumping into the atmosphere.

But now we've passed that point, partly because we've been cutting down and clearing forests and other sinks, greenhouse gases have built up and are adversely affecting the climate. Should we fail to reverse this trend, much worse lies in store.

Egger and Swinburn say the trouble with humans is their tendency to overshoot by trying to maximise, rather than optimise, good things such as economic growth and plentiful food.

So the question is how long it will take us to recognise the signal that famine has turned to feast and too much feasting is bad for us. But however long it takes us, our trusty GDP meter will continue assuring us we're doing fine.