Fox Ashley M, Horowitz Carol R
Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
J Health Care Poor Underserved. 2013;24(2 Suppl):168-92. doi: 10.1353/hpu.2013.0097.
The rapidly rising rate of obesity has prompted a variety of policy responses at national, regional, and local levels. Yet, many have expressed concern that these policy responses have a limited evidence base, are overly paternalistic, and have the potential to increase rather than shrink obesity-related disparities. The purpose of this article is to evaluate obesity policies in terms of the adequacy of evidence for action and along two ethical dimensions: their potential effect on liberty and equity. To evaluate evidence, we engage in a systematic review of reviews and rate policies in terms of the sufficiency of evidence of effectiveness at combating obesity. We then apply a libertarian-paternalist framework to assess policies in terms of their impact on liberty and inverse-equity theory to assess impact on disparities. This article provides a framework to assist decision-makers in assessing best practices in obesity using a more multi-faceted set of dimensions.
肥胖率的迅速上升促使国家、地区和地方各级出台了各种政策应对措施。然而，许多人担心这些政策应对措施的证据基础有限，过于家长式作风，并且有可能加剧而非缩小与肥胖相关的差距。本文的目的是从行动证据的充分性以及两个伦理维度：对自由和平等的潜在影响，来评估肥胖政策。为了评估证据，我们对综述进行了系统回顾，并根据对抗肥胖有效性证据的充分性对政策进行评级。然后，我们应用自由意志家长主义框架来评估政策对自由的影响，并应用反向公平理论来评估对差距的影响。本文提供了一个框架，以帮助决策者使用一套更全面的维度来评估肥胖方面的最佳做法。
