Obesity no less a health priority than asthma or diabetes
THE sounds of awakening — yawning, stretching and throat-clearing — are emanating from Canberra. Indigenous health and wellbeing are featuring in the headlines of the morning newspapers, with the Prime Minister taking a personal interest in redressing the ghastly revelations of the report Little Children are Sacred . Details are scarce, and until what exactly the Prime Minister and his colleagues have in mind when they refer to compulsory health checks of indigenous children, we are jumping ahead.
Concerns about the ethics of compulsory medical examinations are old, deep and wellfounded. There is a clear need for consultation with the indigenous communities in question, especially to learn the wisdom behind many locally-produced programs that have dealt with problems of alcohol abuse and violence.
While remedying deficiencies in law and order make good sense, and can be done immediately, the consequences of long decades of health impairment will require patient, comprehensive attention. The best thing that may follow from the current wave of concern is the provision of money and people to assist communities to deal with these problems.
Little Children are Sacred is, justifiably, a highly emotive statement. It could be extended beyond concerns to prevent sexual abuse. We may reflect whether our current approaches to childhood obesity are consistent with a view of the sacredness of childhood.
The political response to the national obesity problem has been feeble. Perhaps there are lessons to be learned from the Prime Minister’s approach to indigenous wellbeing.
I attended an excellent symposium recently in Canberra, hosted by of the indefatigable Senator Guy Barnett, a political champion — almost solo marathon champion — of those who have concerns about childhood obesity and its prevention and treatment. What was especially encouraging was that representatives of the food, media and advertising industry attended and participated in discussions about what might be done. Long pilloried as the causes (or causers) of the problem of childhood obesity, and understandably defensive and suspicious as a result, they nevertheless came up with constructive suggestions about what we might do.
First, they argued (without dissent) that there needs to be community ownership of the problem of obesity. If asthma is a national health priority, and if diabetes is, so surely should obesity be. The notion that obesity is a disease may upset some, but by nominating it as a health priority, there is no need to spend long on the fruitless debate as to whether it is a disease or not.
The second suggestion, which also came from the group of industry representatives that met during the symposium with a few public health academics and others, was (and this was before the Prime Minister announced his indigenous health and law initiatives), that the Prime Minister should put his hand on the wheel in relation to obesity, and childhood obesity in particular. He should convene a meeting of his ministers (not the bureaucrats at this point) with the chief executives (not middle management) of the farmers, urban developers, food wholesalers and retailers, the alcohol industry, the advertising industry and the media for this purpose.
The point of the meeting would be to establish that we face a major problem with obesity, that it is due to a raft of causes that funnel down to eating too much and moving too little, that this is not a problem to hand to the churches (because being fat is due to lack of character and self-discipline) or the schools (because it is an educational problem) or the parents (because they don’t switch off the TV enough and aren’t at home enough to supervise afternoon snacking and computer games). This is not a blame game.
Like the symposia that Bill Clinton organises that seek, and get, top-level commitment from competitive donors and captains of industry, so the prime ministerial meeting with ministerial colleagues from trade and industry, education, agriculture and the treasury, together with industry CEOs, would expect those attending to commit to action to address the problem. As the industry representatives reminded us at the Barnett seminar, if the CEO commits to something, it happens.
And to close the loop and show that this approach is not all that far removed from a concern over indigenous health, think for a moment about the horrific obesity rates among indigenous people. While fizzy drinks cost the same in remote communities as they do in Sydney and Melbourne, fresh fruit and vegetables, if obtainable at all, cost much more. Now there’s an inequity that could be remedied by industry action now. And it would not cost a bomb. And there are dozens of other things that would make a difference as well.
Well, Prime Minister, how about it? Professor Stephen Leeder is director of the the Australian Health Policy Institute and co-director of the Menzies Centre for Health Policy at the University of Sydney