6 Lifestyles in context
The Black Report on Inequalities in Health (Department of Health and Social Security, 1980) has been described as a seminal document in debates about health. This report judged material and structural factors (such as income, housing and employment) to be the main contributors to health inequalities. In her review of The Black Report, Professor Dame Margaret Whitehead (1987) concluded that material and structural factors severely limit a person’s choice of lifestyle. In other words, living and working conditions impose severe restrictions on an individual’s ability to choose a healthy lifestyle.
Subsequently published related reports, such as The Acheson Report (Acheson, 1998) and, more recently, The Marmot Review (Marmot, 2010) support this perspective, and highlight the importance of social, cultural, political and economic elements, which are at times labelled ‘structuralist’ factors. Based on this, it has been suggested that an individual’s efforts to change their lifestyle will frequently fail unless the foundations for such changes are established through economic and social supports.
In the next activity you will be asked to read an article that challenges the use of individual choice or lifestyles as a means to reduce obesity. Instead the author argues that obesity as an issue should be tackled at a societal level.
Activity 5 Obesity as a societal issue
Read the articleby Martin Cohen (2018), then answer the questions below.
1. According to the article, what is obesity a product of?
In the second paragraph Cohen argues that despite a medicalisation of the issue, obesity is a social problem that is a product of social inequality, and therefore it requires a collective social response.
2. According to the article, who is usually treated as being ‘responsible for obesity’?
In the fourth paragraph the author writes that obesity is usually treated as the responsibility of individuals or families, and is not viewed as a social problem in the same way as, for example, low-educational achievement. As a result the solutions provided are pitched at the individual or family level.
3. In terms of children, which borough in London is England’s ‘most obese council’?
In the ninth paragraph Cohen reports that Brent is England’s ‘most obese council’; it is also England’s ninth poorest. Of the ten areas with the most children who are overweight or obese, half are also areas in the top ten of greatest levels of child poverty.
4. According to the article, how supportive is the food industry of public health initiatives?
In the fourteenth paragraph the author suggests that, presumably because of the impact on profits, the food industry has resisted public health initiatives (in the article, the investigative work of journalist Michael Moss is cited as evidence of this resistance).
5. In concluding, what specific social factors does Cohen link to obesity?
In the final paragraph the author states that collective action is required, and the issues which allow ‘obesity germs’ to ‘breed’ should be the focus. In particular, this includes addressing insecure and erratic employment, stress, inadequate education, mental health issues and a lack of social cohesion in communities.
Research evidence suggests that people’s ability to change or choose a lifestyle depends upon a range of social and environmental factors. This evidence takes the form of both quantitative and qualitative research. You have already seen how quantitative research is key in terms of exploring aspects of a health issue such as obesity, whereby obesity can be determined using a statistical measure like BMI. In the next section, you will develop your understanding of the need for and role of qualitative evidence in furthering our understanding of issues like obesity.