The Cold Skinny
This post has been a difficult one to write. We’re talking about obesity here, and what governments are trying to do to prevent it, curb it and reverse it. Obesity has recently replaced smoking as the health cause-du-jour among social marketers. Like smoking, obesity qualifies as a preventable cause of disease. Unlike smoking, human beings need to eat to survive.
This is a health concern that I take personally, because sometime last year, I slipped into the overweight category. Not obese mind you, but overweight. I recently shed most of those excess pounds, and am now sitting precariously at the top-end of my healthy Body-Mass-Index (BMI). Someone asked me the other night, “you’ve lost weight, what’s your secret?”
“Thousands of dollars spent in personal trainer costs and gym membership fees over 4 exhausting months, and a highly restricted diet that leaves little room for any fun,” I replied.
That’s the secret.
I’ve never taken to blaming the culture around me for accumulating that mass in the first place, I only blame myself for clinging to a teenage fantasy of immortality, and the its infinitely efficient youthful metabolism. I let my guard down, and I blame myself.
But kids today, that might be a different story. In spite of the sorta’ slovenly lifestyle I allowed myself to lapse into in my 20s, I still had an active childhood, that was also devoid of junk food. I suspect that many young Canadians will not grow up with memories of playing baseball, or skiing, or cycling to school every day, making the challenge of adopting an active lifestyle all the more difficult.
Remember these guys?
In this fairly thoughtful piece on Canadian social marketing efforts to combat obesity featured in the Globe and Mail, writer Eric Anderssen posits that old Hal Johnson and Joanne Mcleod didn’t manage to get Canadians off the couch. Sure, we watched all 250 of those PSAs, all the while munching snacks and flipping through basic cable. He writes “such earnest, government-sponsored exhortations failed miserably. Instead, we packed on pounds and slurped back junk until, according to Statistics Canada, today half of the adults in this country are either overweight or obese, and our kids aren’t far behind.”
Were those commercials too soft? Too mockably sanctimonious?
Here’s a more contemporary ad coming from the Ontario Government, currently running on television:
Do you think this kind of approach will work? In his article, Anderssen espouses the notion that the government “can’t embarrass or nag us thin”. He instead advocates establishing financial incentives.
What you’ll see below is an analysis of Jean-Michel Gilibert’s presentation at Leading Social Change this year, about his work with EPODE, a comprehensive outreach/awareness/education methodology that endeavors to positively influence childhood dietary behaviour at the community level; the essential idea being, that those environments themselves foster the unhealthy behaviours in the individual.
EPODE focuses on positive messaging and no stigmatization, the philosophy is “no stigmatization of any culture, any food habits, and no stigmatization of any diets, food groups, behaviours and body image“.
Further, and perhaps most controversially, EPODE embraces corporate sponsorship from the food-industry; from the likes of Orangina-Schweppes, Kellogs, Mars Incorporated and Nestle.
A lot of questions have been nagging at me since Gilbert’s talk and my subsequent thinking on the matter:
- Are poor dietary habits the result of cultural pressure?
- Can you shame people into getting fit?
- What kind of advertising messaging will work in a country like Canada?
- Is there a place for corporate sponsorship by companies whose products are mostly undeniably unhealthy? I mean, nobody asked the tobacco companies to sponsor anti-smoking programs, we simply taxed them and funded those programs that way…
- Can behavioural economics solve the problem?
I haven’t arrived at any solid conclusions on the matter, so I’d love to hear your feedback. Pardon the pun, but it’s a big issue…
Just the Fats Ma’am. Just the Fats…
The statistics are staggering. According to Forbes Magazine, as of 2007, Canada ranked 35th in its list of the World’s Fattest Countries.
Here’s how Canadians measure up globally:
Whoa! That red line there, that’s us. It’s significantly steeper than the trend line for the United States. Soon, Canadians won’t be able to rely on the old refrain: “well, at least we’re better off than our neighbours to the south”.
A World “Wide” Problem
But, we’re not alone. Globally, obesity (and more worrying, childhood obesity) is on the rise. In 1997, the World Health Organization declared obesity to be an epidemic. Which is why for the past several years, so many governments the world over have been attempting to take action; using a variety of social marketing techniques.
Which brings us to 2011 and an example of action taken on another continent. Jean-Michel Gilibert, Founder of the Paris-based Proteines advertising agency skipped across the pond to present his work on EPODE (the acronym translates to Together Let’s Prevent Childhood Obesity) at this year’s Leading Social Change conference.
The European Public Health Alliance (EPHA) defines EPODE as:
“A methodology designed to involve all relevant local stakeholders in an integrated and concrete prevention program aimed at facilitating the adoption of healthier lifestyles in everyday life.”
Got that? It’s a methodology, not a campaign. It’s a series of tactics derived from the principle that unhealthy behaviours can be reversed by changing unhealthy environments.
The essential strength of EPODE is its modularity and adaptability, rather than any single buzzworthy “viral” 30-second spot. Because it’s about changing one’s environs to facilitate behavioral change, EPODE coordinates with all the institutions that surround a family unit. And because these institutions vary by region, EPODE needs to be modular and adaptable enough to be relevant to any particular town. Here’s kind of what it looks like:
There’s obviously a lot more nuance to it than this, but the essential takeaway is that EPODE espouses a holistic approach to nutrition that includes stakeholders at various levels of community, including, as mentioned, the food industry. For Gilbert, the inclusion of private partners of this sort goes beyond financial necessity, he believes that “private enterprise cannot be excluded from public policy” and that “the food industry is part of real life”. In his view, by inviting such partners to the proverbial dinner table, partners that already dominate conversations about food, market-forces can propel companies into more “virtuous” behaviour.
It’s a little tough to swallow…
Gilbert is a pragmatist. He was quick to point out, that 80% of what we eat is in some way processed, meaning “the food industry is part of our lives”, whether we like it or not, and that the deliberate exclusion of the food industry amounts to a “politically correct” choice, but not necessarily a realistic one. It’s funny though, because the idea of a French health initiative getting cozy with big-food sponsors doesn’t align with my undoubtedly biased misconceptions about French culture. When I think of the political-economy of France I don’t think about public-private partnerships, I think about socialism, unions, student activism and a long history of locarian gastronomy that is only now catching on as a fad in North America.
But I don’t want to dwell on the idea of public-private partnerships here. That wasn’t the crux of Gilbert’s argument. What he was really getting at, was that there are multiple levels of community that need to be accessed to support positive behavioural change in children. The family unit, is of course the central target, and as their research naturally pointed out, the younger the child, the more important the influence of family. Then, EPODE gets deployed into communities with local project managers and a local steering committee interfacing with that community’s elected leaders. Those local bodies can craft and refine tactics for maximum impact in the communities they know so well. In a way, it’s not totally dissimilar to a brand with locally-flavored retail outlets.
That’s the key point here. EPODE is a bottom-up solution that operates at the community level, rather than being trickled-down from higher levels of government. And that is likely what makes EPODE successful: its inclusion of communities in managing their own peoples health. They’re not winning awards for flashy advertising, but what they’re doing works. The program has been running for 10 years now and has been exhaustively measured by scientists, social scientists and community leaders, and it works.
The initial test region of Fleurbaix Laventie showed a 5.5% drop in childhood obesity rates. It was then rolled out to 10 other pilot regions, accounting for some 500,000 people, each one of which has demonstrated a decline in childhood obesity.
But will it work in Canada?
We shall perhaps find out soon, as according to EPHA, Quebec is considering implementing the EPODE methodology.
Further, in September health ministers from across the country got together and endorsed: Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights.
Through the Framework, Federal, Provincial and Territorial Ministers have agreed to make childhood obesity a collective priority, to champion this issue, and to coordinate work with many areas of Canadian society.
Federal, Provincial and Territorial Health Ministers will work together to curb obesity in children under the age of 18 by focusing on three key policy priorities:
- Making the environments where children live, learn and play more supportive of physical activity and healthy eating
- Identifying the risk of obesity in children and addressing it early
- Increasing the availability and accessibility of nutritious foods and decreasing the marketing to children of foods and beverages that are high in fat, sugar and/or sodium
At its fundamental level, this approach sounds pragmatic, sensible and similar enough to the proven-successful model of EPODE. So, will it work?
I suppose we’ll have to wait and see.
Until then, keep fit, and have fun.
-AR