The government should have a role in preventing obesity and promoting other good health measures, the public thinks—just as long as their interventions don’t go too far.
Though the public is very supportive of government action aimed at changing lifestyle choices that can lead to obesity, diabetes and other noncommunicable diseases, they are less likely to support such interventions if they’re viewed as intrusive or coercive, according to a new Harvard School of Public Health study.
Researchers found a high level of support—between 70 percent and 90 percent—for government action on each of seven areas: preventing cancer, heart disease, childhood and adult obesity, and tobacco use; helping people control their diabetes; and reducing alcohol consumption.
Support was high for interventions that facilitate healthy choices, such as increasing the affordability of fruits and vegetables (84 percent), requiring more instruction in public schools about the health risks of obesity (89 percent), and requiring restaurants to post the calorie counts for food they serve (81 percent).
But support waned when government actions were viewed as focusing on penalties or on limiting choices—such as adding insurance surcharges for obese individuals or making it illegal to smoke in private spaces.
Harvard researchers Stephanie Morain and Michelle M. Mello conducted an online survey of 1,817 Americans in the wake of what they called a “new frontier” of public health initiatives aimed at changing consumer behavior. That includes New York City’s ban on super-sized soda, an initiative that’s garnered a lot of media attention and spurred criticism from various groups who argue the government is going too far.
“Policymakers everywhere are looking for ways to use legal and policy levers to stem the rising tide of health care costs related to obesity and chronic disease,” says Stephanie Morain, a doctoral candidate in health policy at Harvard University, who led the study. She says policymakers should be “heartened” by the finding that the public does see this as an appropriate role for government.
That public support is important, the study authors wrote, because it may affect people’s willingness to comply with the law.
The researchers also found that African Americans and, to a lesser extent, Hispanics, are significantly more likely than whites to support government action to address noncommunicable diseases.
Additionally, people are much more supportive of government public health initiatives if they believe that “people like me” can influence public health priorities and if they think that public health officials understand the public’s values.
“The message for public health officials and legislators is, if you want the public to buy into these legal interventions, you’ve got to engage them early on,” Mello says. “You’ve also got to communicate about policies in a way that resonates with the public’s values. For example, how does the intervention support healthy choices? Why is it fair?”