Signild Vallgårda1, Morten Ebbe Juul Nielsen2, Mette Hartlev3, Peter Sandøe4. 1. 1 Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark siva@sund.ku.dk. 2. 2 Department of Media, Cognition and Communication, University of Copenhagen, Copenhagen, Denmark 3 Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark. 3. 4 Faculty of Law, University of Copenhagen, Copenhagen, Denmark. 4. 3 Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: In assigning responsibility for obesity prevention a distinction may be drawn between who is responsible for the rise in obesity prevalence ('backward-looking responsibility'), and who is responsible for reducing it ('forward-looking responsibility'). METHODS: We study how the two aspects of responsibility figure in the obesity policies of WHO (European Region), the EU and the Department of Health (England). RESULTS: Responsibility for the emergence and reduction of obesity is assigned to both individuals and other actors to different degrees in the policies, combining an individual and a systemic view. The policies assign backward-looking responsibility to individuals, the social environment, the authorities and businesses. When it comes to forward-looking responsibility, individuals are expected to play a central role in reducing and preventing obesity, but other actors are also urged to act. WHO assigns to individuals the lowest degree of backward- and forward-looking responsibility, and the Department of Health (England) assigns them the highest degree of responsibility. DISCUSSION: Differences in the assignment of backward- and above all forward-looking responsibility could be explained to some extent by the different roles of the three authorities making the plans. WHO is a UN agency with health as its goal, the EU is a liberal economic union with optimization of the internal European market as an important task, and England, as an independent sovereign country, has its own economic responsibilities.
BACKGROUND: In assigning responsibility for obesity prevention a distinction may be drawn between who is responsible for the rise in obesity prevalence ('backward-looking responsibility'), and who is responsible for reducing it ('forward-looking responsibility'). METHODS: We study how the two aspects of responsibility figure in the obesity policies of WHO (European Region), the EU and the Department of Health (England). RESULTS: Responsibility for the emergence and reduction of obesity is assigned to both individuals and other actors to different degrees in the policies, combining an individual and a systemic view. The policies assign backward-looking responsibility to individuals, the social environment, the authorities and businesses. When it comes to forward-looking responsibility, individuals are expected to play a central role in reducing and preventing obesity, but other actors are also urged to act. WHO assigns to individuals the lowest degree of backward- and forward-looking responsibility, and the Department of Health (England) assigns them the highest degree of responsibility. DISCUSSION: Differences in the assignment of backward- and above all forward-looking responsibility could be explained to some extent by the different roles of the three authorities making the plans. WHO is a UN agency with health as its goal, the EU is a liberal economic union with optimization of the internal European market as an important task, and England, as an independent sovereign country, has its own economic responsibilities.
Authors: Phillip Baker; Corinna Hawkes; Kate Wingrove; Alessandro Rhyl Demaio; Justin Parkhurst; Anne Marie Thow; Helen Walls Journal: BMJ Glob Health Date: 2018-02-10