Obe­sity no less a health pri­or­ity than asthma or di­a­betes

The Weekend Australian - Travel - - Health - STEPHEN LEEDER

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

Newspapers in English

Newspapers from Australia

© PressReader. All rights reserved.