As a graduate student in public health, I read with interest the Nov. 9 letter titled “Treat eaters like smokers.”
Although it reads like an ironic criticism of the punitive response to smoking in this country–a point well taken–the parallel drawn between smoking and obesity betrays a lack of understanding about the complexities and differences involved.
The suggestion that we tax junk foods is one example. Such taxation would be a veritable economic sanction on the entire population, and is not a just strategy. Nor is it a viable one.
Unlike taxing tobacco products, which are easily identified, taxing all unhealthful foods would be impossible.
There is no common catalog or agreement regarding which ingredients or foods are unhealthful. A diet heavy in carbohydrates could benefit and be effectively metabolized by a triathlete, for instance, but the same diet could contribute to weight gain for someone less active.
Further, the letter challenges the tactic of segregation, and rightly so.
Yet, the situations are not truly parallel: While smoking sections mitigate non-smokers’ exposure to secondhand smoke and thereby protect the public’s health, segregated seating for obese people would do nothing to protect the health of the non-obese.
Finally, unlike smoking, which relies only on the intake of tobacco, obesity is most often the result of an unhealthful diet combined with physical inactivity. Accordingly, there is overwhelming empirical evidence that the combination of a healthful diet and daily physical activity is essential to the prevention of obesity.
Experts have not determined, however, that exercise–or a similar healthful habit–could moderate the long-term effects of smoking.
Despite these inconsistencies or simplifications, the letter is a welcome commentary on the irresponsibility of punitive interventions, which fail to effect population-wide change.
We in public health work to promote positive behavioral change as a means of improving the health status of the population, and we prioritize social justice.
Ultimately, a proactive approach that emphasizes opportunity and education is a more socially responsible and effective antidote to public health problems.
