Kenneth Rogoff writes: To what extent should governments regulate or tax addictive behavior? This question has long framed public debate about alcohol, tobacco, gambling, and other goods and services in many countries worldwide. And now, in the United States – arguably the mother of global consumer culture – the debate has turned toward the fight against the epidemic of childhood obesity.
It is ironic that in a world where childhood malnutrition plagues many developing countries, childhood obesity has become one of the leading health scourges in advanced economies. The World Bank estimates that over a third of all children in Indonesia, for example, suffer from stunted growth, confronting them with the risk of lifetime effects on fitness and cognitive development. Yet, the plight of malnourished children in the developing world does not make obesity in the advanced countries any less of a problem.
Indeed, though perhaps not on a par with global warming and looming water shortages, obesity – and especially childhood obesity – nonetheless is on the short list of major public-health challenges facing advanced countries in the twenty-first century, and it is rapidly affecting many emerging-market economies as well. Yet solving it poses much more difficult challenges than the kind of successful public-health interventions of the last century, including near-universal vaccination, fluoridation of drinking water, and motor-vehicle safety rules.
The question is whether it is realistic to hope for success unless the government resorts to far more blunt instruments than it currently seems prepared to wield. Given the huge impact of obesity on health-care costs, life expectancy, and quality of life, it is a topic that merits urgent attention.
The US leads the world in obesity, and is at the cutting edge of the debate. Almost everyone agrees that the first line of defense ought to be better consumer education. First Lady Michelle Obama’s “Let’s Move” educational campaign aspires to eliminate childhood obesity in a generation, though its impact so far remains unclear. Other efforts include appeals by celebrities like the chef Jamie Oliver and attempts to use peer-based learning, such as the Sesame Street-inspired platform Kickin’ Nutrition (full disclosure: the creator is my wife).
The right place to start to address it is by creating a better balance between education and commercial disinformation. But food is so addictive, and the environment so skewed toward unhealthy outcomes, that it is time to think about broader government intervention. That should certainly include vastly enhanced expenditures on public education; but I suspect that a long-term solution will have to involve more direct regulation, and it is not too soon to start discussing the modalities.
