By Sonja Ausen-Anifrani
On 13 September 2012, New York City’s Board of Health passed a divisive ban on the sale of soda and other sugar-laden drinks (greater than 16 ounces in size) at those food service establishments regulated by the Department of Health and Mental Hygiene. This conglomerate includes restaurants, street carts, stadiums, arenas, and movie theatres. Led by New York City Mayor, Michael Bloomberg, the ban will go into effect on March 12th, 2013, and is aimed at targeting the rising rates of obesity. Similar to sky-rocketing obesity rates throughout the United States, the ban was aimed at curtailing growing rates of obesity in New York. According to the city’s health department, one in eight adult New Yorkers has diabetes and approximately 6,000 New Yorkers die annually from obesity related health problems.
This soon-to-be law joins a squadron of previous measures aimed at preventing illness and disease, but challenging personal freedom and autonomy. Seatbelts, vaccines, smoking bans—these interventions have saved numerous lives and led to significant strides in the field of public health, but they have also created controversy in regards to introducing legal implications on an individual’s personal choice. Public health has and continues to wrestle to find a proper balance between this ethical teeter-totter. David R. Buchanan states: “In the end, the field of public health needs to engage the public directly in building consensus on what we owe each other in creating a society in which all citizens feel supported in living decent lives characterized by dignity, integrity, and mutual responsibility.”
Therefore, at what point should the population’s consensus of “dignity, integrity, and mutual responsibility” infringe on individual self-government? Certainly, the population of the United States is facing an obesity crisis and steps must be taken to ameliorate the social, economic, and psychological impacts of this epidemic. Childhood obesity rates have more than tripled over the past 30 years and 17% of children and adolescents are now obese. Furthermore, 35.7% of United States adults are obese and in 2008, medical costs topped $147 billion for conditions associated with obesity. A recent study published in The New England Journal of Medicine deduced that predisposition to obesity and high BMI levels in both men and women was linked to a greater ingestion of sugar-sweetened drinks. The data was collected across three cohorts of men and women, totaling over 30,000 qualified participants. Evidence abounds that obesity is creating an epic impact in our society. Individuals inhabiting and visiting New York City, of course, will still have the ability to buy soda in larger quantities from supermarkets, vending machines, and convenience shops throughout New York City; however, these individuals will likely be personally aware of the effects of a public health policy that aims to address a population problem.
Likely to be challenged in the court system, the ban stands to serve as an example for other states. The growing prevalence of obesity directly impacts how MCH researchers and providers approach both outreach and preventative health care measures in their daily work settings. How might such a measure impact Minnesotans on both sides of the debate? Furthermore, how can we continue to promote dialogue that highlights the necessity of prevention for populations while keeping individual autonomy in mind?
(Ausen-Anifrani is a graduate student in the Maternal and Child Health program at the University of Minnesota.)