Obesity and 'Public Health'

The Washington Times (Washington, DC), July 21, 2004 | Go to article overview

Obesity and 'Public Health'


Byline: David Boaz, SPECIAL TO THE WASHINGTON TIMES

Health and Human Services Secretary Tommy Thompson says, "Obesity is a critical public health problem in our country."

Wrong. Obesity is a problem for many people, but it is not a public health problem. By calling it one, however, Mr. Thompson can promise we, the taxpayers, will pay for everyone's diet programs, stomach surgery, and behavioral counseling. Get out your wallet.

The meaning of "public health" has sprawled out lazily over the decades. Once, it referred to the project of securing health benefits that were public: clean water, improved sanitation and the control of epidemics through treatment, quarantine and immunization. Public health officials worked to drain swamps that might breed mosquitoes and thus spread malaria. They strove to ensure water supplies were not contaminated with cholera, typhoid, or other diseases.

The U.S. Public Health Service began as the Marine Hospital Service, and one of its primary functions was ensuring sailors didn't expose domestic populations to new and virulent illnesses from overseas.

Those were legitimate public health issues because they involved consumption of a collective good (air or water) and/or the communication of disease to parties who had not consented to put themselves at risk. It is difficult for individuals to protect themselves against illnesses found in air, water, or food. A breeding ground for disease-carrying insects poses a risk to entire communities.

Plenty of people in Africa and Asia still need those basic public health measures. As Jerry Taylor writes in Regulation magazine: "Diseases associated with inadequate sanitation, indoor air pollution from biomass stoves and furnaces, and contaminated water occur mainly in developing countries and account for 30 percent of the total burden of disease in those nations. Diarrheal diseases, brought on by poor sanitation and contaminated water, alone kill more than 3 million children annually, and experts believe that 2 million of those deaths could easily be prevented with even minimal improvements in sanitation and water quality. Approximately 7 million die each year from conditions like tuberculosis, cholera, typhoid, and hookworm that could be inexpensively prevented and cured and are virtually unknown as serious health problems in advanced countries."

In the United States and other developed countries, those public health problems have been largely solved.

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