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权衡利弊:澳大利亚肥胖政策话语中缺失的社会不平等维度。

Weighing it up: the missing social inequalities dimension in Australian obesity policy discourse.

机构信息

National Centre for Epidemiology and Population Health, The Australian National University, Australian Capital Territory.

出版信息

Health Promot J Austr. 2009 Dec;20(3):167-71. doi: 10.1071/he09167.

Abstract

ISSUE ADDRESSED

Debate on obesity spans complex health and social issues drawing on varying representations of fat bodies. This paper seeks to determine whether the recent public health focus on social inequalities is reflected in broader policy debate on obesity.

METHODS

We reviewed public submissions to the 2008 Australian House Standing Committee on Health and Ageing inquiry into obesity. Using a qualitative framing approach we categorised the 95 submissions, analysing a sample of 20 of them, thereby, elucidating attitudes to obesity held by a range of interested stakeholders.

RESULTS

Two primary frames and one lesser frame were identified. While it was common for contributors to situate obesity as a problem of individuals, it was equally common for contributors to draw on environmental level arguments where obesity is located in structural forces outside of the individual. The range of attributing factors reflects disagreement as to the causes of obesity, although adherents to both the individual and environmental frames called for more government regulation and financial support. Only two submissions directed policy reform to issues of inequality.

CONCLUSIONS

Empirically, this study represents a novel investigation of the role of public health ethics in obesity debate and policy. Politically, we highlight the relative lack of explicit attention given to inequality in the debate, even though social inequalities are demonstrably relevant.

摘要

问题阐述

关于肥胖的争论涉及到复杂的健康和社会问题,这些问题涉及到不同的肥胖身体形象。本文旨在确定最近公共卫生对社会不平等问题的关注是否反映在更广泛的肥胖问题政策辩论中。

方法

我们回顾了 2008 年澳大利亚众议院健康老龄化常设委员会对肥胖问题的调查中的公众意见。我们使用定性框架方法对 95 份意见书进行了分类,并对其中 20 份意见书进行了分析,从而阐明了一系列利益相关者对肥胖问题的态度。

结果

确定了两个主要框架和一个较小的框架。虽然贡献者将肥胖视为个人问题是很常见的,但同样常见的是,贡献者会从环境层面的角度出发,将肥胖定位在个人以外的结构性力量中。归因因素的范围反映了对肥胖原因的分歧,尽管个人和环境框架的支持者都呼吁政府加强监管和提供财政支持。只有两份意见书将政策改革的方向指向不平等问题。

结论

从经验上看,本研究代表了对公共卫生伦理在肥胖问题辩论和政策中的作用的新调查。从政治角度来看,我们强调了在辩论中对不平等问题的关注相对较少,尽管社会不平等问题显然是相关的。

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