Electronic Food Rap
Vol. 5 NO. 46
Bill Evers, PhD, RD and April Mason, PhD
Extension Foods and Nutrition Specialists
Cooperative Extension and other government agencies are constantly deciding whether a mission is to provide education for citizens to make their own decisions or to advocate for a particular way of accomplishing a goal. The following article continues that debate as it relates to public health departments and heart disease.
Excerpted from FOOD CHEMICAL NEWS, September 18, 1995, Page 35
Centers For Disease Control: Heart Disease Prevention 'Policy' Approaches Needed
Public health departments are being encouraged to move from just providing help when a problem arises or educating the public about a problem to "empower(ing) communities to address underlying conditions that promote cardiovascular disease." This suggestion from Thomas Schmid and others at the Centers for Disease Control and Prevention (CDC) comes from an article titled "Policy as Intervention: Environmental and Policy Approaches to the Prevention of Cardiovascular Disease," which appeared in the September issue of the American Journal of Public Health
Currently, trying to directly discourage use of high-fat foods and provide tax breaks for cafeterias that offer healthful food choices would be considered unusual. That needs to change if health departments are to become "prudent stewards of the public health," according to the authors.
Examples from other nations of a more direct intervention on other public health problems were cited to encourage more imaginative approaches to dealing with heart disease risk. The authors cited tobacco smoking, gun control, and auto accidents as examples of what has been done elsewhere. Norway provides incentives for producing more healthful food, and Wales took aim at heart disease in a government wide project called Heartbeat Wales. In the U.S., the authors described a survey of six Midwestern communities suggesting public support for additional public health efforts to regulate sale and consumption of high-fat foods and tobacco through policy and environmental change.
In a time when fear of "big" government is being promoted by many politicians, it was acknowledged there is resistance to policy-level interventions and concern for individual freedoms. Some of the distrust is over where to draw the line on the needs of the society versus the freedom of choice by the individual.
The article points out that decisions affecting cardiovascular health are already being made by many government and private agencies, such as zoning boards, parks and recreation departments, licensing boards and boards of education. The CDC officials concluded:
"Setting the public health agenda so that policy and environmental options are included in public discourse, and expanding the focus from the individual or consumer to include others such as the manufacturer or retailer are appropriate goals for state health agencies."
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