Farrell Lucy C, Warin Megan J, Moore Vivienne M, Street Jackie M
School of Public Health, University of Adelaide, 178 North Terrace, Adelaide, SA 5005, Australia.
Discipline of Gender Studies and Social Analysis, University of Adelaide, North Terrace, Adelaide, SA 5005, Australia.
Soc Sci Med. 2016 Apr;154:1-8. doi: 10.1016/j.socscimed.2016.02.028. Epub 2016 Feb 18.
The potential for regulatory measures to address escalating rates of obesity is widely acknowledged in public health circles. Many advocates support regulations for their potential to reduce health inequalities, in light of the well-documented social gradient in obesity. This paper examines how different social groups understand the role of regulations and other public health interventions in addressing obesity. Drawing upon focus group data from a metropolitan city in southern Australia, we argue that implementing obesity regulations without attention to the ways in which disadvantaged communities problematise obesity may lead to further stigmatisation of this key target population. Tuana's work on the politics of ignorance, and broader literature on classed asymmetries of power, provides a theoretical framework to demonstrate how middle class understandings of obesity align with dominant 'obesity epidemic' discourses. These position obese people as lacking knowledge; underpinning support for food labelling and mandatory nutrition education for welfare recipients as well as food taxes. In contrast, disadvantaged groups emphasised the potential for a different set of interventions to improve material circumstances that constrain their ability to act upon existing health promotion messages, while also describing priorities of everyday living that are not oriented to improving health status. Findings demonstrate how ignorance is produced as an explanation for obesity, widely replicated in political settings and mainstream public health agendas. This politics of ignorance and its logical reparation serve to reproduce power relations in which particular groups are constructed as lacking capacity to act on knowledge, whilst maintaining others in privileged positions of knowing.
公共卫生领域普遍认识到监管措施在应对不断上升的肥胖率方面的潜力。鉴于肥胖问题中已被充分记录的社会梯度，许多倡导者支持监管措施，因为其有可能减少健康不平等现象。本文探讨了不同社会群体如何理解监管措施及其他公共卫生干预措施在解决肥胖问题中的作用。基于澳大利亚南部一个大城市的焦点小组数据，我们认为，在实施肥胖监管措施时，如果不关注弱势社区对肥胖问题的看法，可能会导致这一关键目标人群受到进一步的污名化。图阿纳关于无知政治的研究以及关于权力的阶级不对称的更广泛文献，提供了一个理论框架，用以说明中产阶级对肥胖的理解如何与占主导地位的“肥胖流行”话语相一致。这些话语将肥胖者定位为缺乏知识，从而支持对福利领取者实行食品标签和强制性营养教育以及食品税。相比之下，弱势群体强调了另一套干预措施的潜力，这些措施旨在改善限制他们对现有健康促进信息采取行动能力的物质环境，同时也描述了并非以改善健康状况为导向的日常生活优先事项。研究结果表明，无知是如何被用作肥胖的一种解释，并在政治环境和主流公共卫生议程中广泛传播的。这种无知政治及其合乎逻辑的补救措施有助于再现权力关系，在这种关系中，特定群体被建构为缺乏根据知识采取行动的能力，而其他群体则保持着有特权的认知地位。
