Sharing the responsibility for health

By: Monica Kao

The Obama administration has been characterized, in part, by its novel approaches to improving the future of the country, not all of which have gained widespread acceptance.  The $814 billion-dollar economic stimulus package has been no exception–hundreds of millions of dollars have been allocated for Communities Putting Prevention to Work (CPPW) grants and new health campaigns discouraging tobacco use and the consumption of sugary beverages–and its implications are currently the subject of intense debate [Stimulus funds aim to help kick cigarettes].  Opponents have raised objections to using federal dollars to discourage consumers from spending money on such products, which they claim runs counter to the objective of the stimulus package itself.  They also express increasing discomfort at the government’s attempts to shape consumer choices, claiming that they are intrusive and place limits on self-determination.  But perhaps the greatest point of contention is the campaign’s emphasis on personal accountability for health–the advertisements (which promote tobacco-free environments, better nutrition, and exercise programs) reflect a paradigm shift towards the belief that one can engage in specific health-promoting behaviors and actively take control of one’s own health.

In my view, the health campaigns initiated by the economic stimulus package might be exactly what the United States needs, and many of the objections can be addressed with relatively little argument.  While it is easy enough to understand how discouraging the purchase and consumption of products harmful to one’s health could be perceived as being counterproductive to the goal of the stimulus package, many health experts argue that such efforts will save taxpayer dollars in other areas.  Obesity-related illnesses, for example, cost state and federal governments billions of dollars per year–if prevention efforts are successful in curbing obesity, the economic losses suffered through diminished soda and cigarette sales will soon pay for themselves in the form of reduced health expenditures and a healthier population.  And for those critics who fear that the campaigns are the government’s attempts to exert control over consumer choices and to limit self-determination, the campaigns currently do not include any efforts to restrict or to place taxes upon available products.  Rather, the goal has been to make information more widely available so that consumers can be fully informed about the choices that they are making [to view an example, click here].

The primary message communicated by the campaigns is that consumers are able to exercise some degree of control in the preservation of their own health through the choices that they make, which raises new questions regarding accountability and the balance of individual and social responsibility for health.  The campaigns do not impose or enforce any rules requiring healthy choices, nor do they introduce taxes or require that potential risk takers pay elevated insurance fees for added risk, reflecting a belief in shared responsibility.  Rather, the Obama administration and state health departments have shouldered the responsibility of informing individuals about risk factors for disease and creating a social and physical environment that promotes health and well being.  In doing so, the federally-funded health initiatives have also left room for individual liberty–individuals are free to use that information however they may choose, whether they should decide to disregard the information given or to use it to maintain health and to avoid disease.  The shared accountability then reduces the risks associated with pinning sole responsibility on individuals and the wrongful blame that may arise if or when individuals fall ill.  There is much more that can and should be done in terms of building health equities and creating social and physical environments that promote health, and so these health initiatives cannot be viewed as a panacea for issues of public health.  However, they do seem to be a commendable start in promoting both personal and social responsibility for health and I hope to see this shared belief reflected in future funding initiatives.


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One response to “Sharing the responsibility for health

  1. Monica,

    This is a great summary of some public health initiatives that have taken place recently. It is interesting to note how we put an initial emphasis on immediate spending, but we rarely reflect on how that spending could improve economic standing later. This is the challenge of public health. We must begin to think more forwardly. I wonder how we, as a society, can implement this. How do we begin to value this innovative thinking? Are there protocols we need to establish so people begin to realize the effectiveness of such tactics? Great article Monica!

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