Legislative Strategies to Reduce Obesity

Abstract:     
In 1850, The Report of the Sanitary Commission of Massachusetts (the Shattuck Report) found that the average life expectancy in the United States was between 25 and 35 years, and the major cause of mortality was infectious disease. This galvanized the first public health revolution in the United States. Over the next 100 years life expectancy more than doubled and infectious diseases were no longer the primary cause of mortality and morbidity in the U.S. The first public health revolution was based on the science of Snow and Jenner, and later Pasteur and Koch, and combined intensive environmental and sanitation regulation with personal health measures such as disease reporting and investigation, mandatory vaccinations, and personal restrictions. Law was an integral part of this public health revolution and the United States Supreme Court gave public health authorities almost unbridled powers over persons and property when it was necessary to protect the public's health.

Since the 1950s, chronic diseases have become the major threat to the health of the public in the U.S. Some of these diseases are the inevitable consequences of old age and the increased lifespan, but most can be greatly ameliorated or even prevented through environmental and lifestyle modifications. The second public health revolution will be the transformation of a health care and public policy system based on the treatment of the consequences of chronic diseases to one that is based on the primary and secondary prevention of chronic diseases and their sequella. As with the first public health revolution, law will be a key tool in shifting behavior in ways that reduce the incidence and severity of chronic diseases. Law is already the primary tool for the control of smoking, the most important preventable cause of chronic disease. Law will be a major tool in the control of obesity, the second most important preventable cause of chronic illness, and in increasing levels of physical activity. Physical activity has a role in obesity prevention, and an independent role in the prevention of the complications of chronic diseases. Law is also key to reshaping the medical care system to provide better access to preventive care for chronic diseases such as diabetes and hypertension, which would reduce the severity and progression of these diseases

Number of Pages in PDF File: 22

Keywords: obesity, public health, legislation, diabetes, chronic illness

JEL Classification: I18

working papers series