The Puerto Rican government has just tabled a bill that would see parents with obese children fined up to US$800 if they don’t ensure their offspring lose weight. This government is clearly at a loss in the fight against childhood obesity and its latest attempt is a panicked, or at the very least desperate, public health response.
About 30% of children in Puerto Rico are obese – well above the United States average of 18%. Obesity increases the risk of heart disease, Type 2 diabetes, cancers, sleep apnoea, infertility and many other serious health conditions. The economic burden resulting from these poor health outcomes is enormous – and you can understand why Puerto Rican leaders are searching high and low for a solution.
This current proposal would involve school teachers – how they’ll be trained is unclear – refer obesity cases to the school counsellor, who would then work with their parents to create a diet and exercise programme. The child would then be monitored by monthly check ups and any failure to show sufficient improvement after six months results in a US$500 fine, or US$800 after a 12-month period.
Obesity on the whole, however, is a lower socio-economic problem – the argument could be made that obesity is the least of their worries. Any solution that fines those already struggling to live day-to-day is a recipe for disaster. If the government really wants to get tough on fat, then you only have to look at what has changed in the country in recent decades to find the answers.
Risky business
Practically unknown until the 1980s, an estimated 2,000 fast-food restaurants now light up the Puerto Rican landscape – it’s not a big country either, about a third the size of Sicily. But its fast-food industry rakes in about US$1.3 billion each year, which is unsurprising when you consider that 77% of locals regularly step into these deep-fry havens.
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If the government is sincere about helping parents to better manage their children’s weight, then they should take a close look at the eating environments in the most disadvantaged communities. The sizable investment that would be needed to set up this proposed scheme could do wonders in these areas – reduce the cost of healthy foods, establish local markets and vegetable gardens, cooking classes, and so on. Yet this is probably wishful thinking, as the government continues to struggle to satisfy its debt obligations.
If they’re interested in a less costly public measure to help out the parents, they could place a ban on the fast-food marketing that manipulates their children’s dietary choices. Yet even this is troublesome, as a recent exposé revealed that the Puerto Rican government’s “anti-obesity campaign” is actually overseen by the same PR firm that receives millions of pounds each year to promote junk food.
But would it work?
There is no single answer to combating population-wide obesity, which is the result of so many factors, from a family’s genetics, to location, to income, to education.
Much criticism around this particular bill has come from medical professionals and public health experts throughout the US, as it runs against current US government policies committed to not penalising, but rather providing incentives for healthier choices and removing unhealthy options from schools and communities. Marlene Schwartz, director of the Rudd Centre for Food Policy and Obesity at Yale University, said:
This proposal is very unfair and inappropriately penalises and stigmatises parents. Childhood obesity is a highly complex issue, and while the home environment is important to address, much broader societal changes are required to effectively address obesity.
The answer to tackling the obesity epidemic arguably requires a cultural shift, a change in approach across all levels of society, akin to what we saw with tobacco in the 1990s. If the Puerto Rican government could table such bold policies against certain industry – and watch those conflicts of interest – it would be a major step in the right direction.