A lot of the rhetoric levied against efforts to address the obesity problem in the U.S. falls into the category of “everyone has choice in what they eat.” I have read many comments on PolicyMic and others that indicate that many people believe that if the poor, the unhealthy, and the obese would just make better personal choices all of America's diet-related illness would vanish. This argument is too simplistic and negates the complexity of the issue of healthy eating.
Not to wax too philosophical, but choice is always constrained by the consequences imposed by external factors. We could all quit our jobs today. We have the right to make that choice. But how realistic is that choice for the majority of us? It is the same with many who suffer from diet-related chronic disease. They have the right, perhaps even the ability to make better food choices, but are those choices realistic given the constraints within which they live?
There is a tangled web of government regulation and corporate profit seeking that constrains the choices available to food consumers. As I wrote about in a previous PolicyMic article, government zoning policy affects where food related businesses, including food retail and production operations, can be located in relation to residential districts. Food safety codes restrict mobile food operations that might otherwise reach those in need of healthy food products. Food businesses, especially grocery stores which traditionally operate with razor thin margins, are driven by profit. Market conditions in high poverty and/or high obesity areas often preclude the building of chain supermarkets. Transportation policy, marketing, time constraints, lack of access to personal vehicles: the list of factors that constrain food choice goes on and on.
The only way to effectively fight the obesity epidemic is to create a food system that gives consumers realistic ways to consistently choose healthy foods. A combination of incentive and coercion could serve to provide customers with realistic choices when deciding what to eat. A few examples starting with incentive. Creating government regulation that allows greater flexibility in where food businesses can be located, thus bringing them closer to consumers would serve to mitigate constraints based on transportation access, proximity, and time. Modification of food safety regulations to allow more processing onsite at local farms would reduce costs and help to increase distribution of locally grow food.
Coercive methods would fall along similar lines as the Fast Food Ban instituted in California where generally unhealthy food retailers would be restricted from operating in certain areas deemed to be at risk for diet related chronic illness. In combination with an incentive that would provide monetary and other incentives for businesses willing to locate in poor health neighborhoods and sell primarily good food, this coercive method and others, while distasteful in capitalist economy, would serve to radically increase the chances that people at risk of or already suffering from diet related diseases would be able to realistically choose healthy foods.
The critics who cry choice are correct in saying that if obese people would just make better choices we would not have a problem with obesity in this country. But what this argument lacks is insight into the factors that constrain healthy food choices for many Americans. The government, people, and corporations of the U.S. must work to create real choice for people of limited means so that the plague of diet related chronic disease can be defeated.