Kersh Rogan
NYU Wagner School, New York University, 295 Lafayette Street, New York, NY 10012, USA.
Milbank Q. 2009 Mar;87(1):295-316. doi: 10.1111/j.1468-0009.2009.00556.x.
The continuing rise in obesity rates across the United States has proved impervious to clinical treatment or public health exhortation, necessitating policy responses. Nearly a decade's worth of political debates may be hardening into an obesity issue regime, comprising established sets of cognitive frames, stakeholders, and policy options.
This article is a survey of reports on recently published studies.
Much of the political discussion regarding obesity is centered on two "frames," personal-responsibility and environmental, yielding very different sets of policy responses. While policy efforts at the federal level have resulted in little action to date, state and/or local solutions such as calorie menu labeling and the expansion of regulations to reduce unhealthy foods at school may have more impact.
Obesity politics is evolving toward a relatively stable state of equilibrium, which could make comprehensive reforms to limit rising obesity rates less feasible. Therefore, to achieve meaningful change, rapid-response research identifying a set of promising reforms, combined with concerted lobbying action, will be necessary.
美国肥胖率持续上升,事实证明临床治疗和公共卫生劝诫对此无能为力,因此需要出台政策应对措施。近十年的政治辩论可能正在固化为一种肥胖问题机制,其中包括既定的认知框架、利益相关者和政策选项。
本文是对近期发表的研究报告的综述。
关于肥胖问题的政治讨论大多集中在两个“框架”上,即个人责任和环境,这产生了截然不同的一系列政策应对措施。虽然联邦层面的政策努力迄今几乎没有采取什么行动,但诸如热量菜单标注以及扩大减少学校不健康食品的监管等州和/或地方层面的解决方案可能会产生更大影响。
肥胖问题政治正在朝着相对稳定的平衡状态发展,这可能使限制肥胖率上升的全面改革变得不太可行。因此,要实现有意义的改变,就需要进行快速反应研究,确定一系列有前景的改革措施,并辅之以协调一致的游说行动。