Grummon Anna H, Hall Marissa G, Block Jason P, Bleich Sara N, Rimm Eric B, Taillie Lindsey Smith, Barnhill Anne
Harvard Center for Population and Development Studies, Harvard TH Chan School of Public Health. Address: 9 Bow Street, Room 306, Cambridge, MA, 02138, United States.
Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center, and UNC Center for Health Promotion and Disease Prevention, University of North Carolina Chapel Hill. Address: 312 Rosenau Hall, 135 Dauer Drive, Chapel Hill, NC, 27599, United States.
Physiol Behav. 2020 Aug 1;222:112930. doi: 10.1016/j.physbeh.2020.112930. Epub 2020 May 11.
Several countries have implemented warnings on unhealthy foods and beverages, with similar policies under consideration in the U.S. and around the world. Research demonstrating food warnings' effectiveness is emerging, but limited scholarship has evaluated the ethics of food warning policies. Using a public health ethics framework for evaluating obesity prevention policies, we assessed the ethical strengths and weaknesses of food warnings along multiple dimensions: 1) Health behaviors and physical health, 2) Psychosocial well-being, 3) Social and cultural values, 4) Informed choice, 5) Equality, 6) Attributions of responsibility, 7) Liberty, and 8) Privacy. Our analysis identifies both ethical strengths and weaknesses of food warnings, including that: 1) warnings are likely to generate important benefits including increased consumer understanding and informed choice, healthier purchases, and potential reductions in obesity prevalence; 2) warnings evoke negative emotional reactions, but these reactions are an important mechanism through which food warnings encourage healthier behaviors and promote informed choice; 3) warnings appear unlikely to have ethically unacceptable effects on social and cultural values, attributions of responsibility, liberty, or privacy. Current research suggests we continue to pursue food warnings as a policy option for improving public health while simultaneously conducting additional research on the ethics of these policies. Future research is especially needed to clarify warnings' effects on stigma and to characterize the balance and distribution of costs of and benefits from implementing warning policies.
几个国家已经对不健康食品和饮料实施了警告，美国及世界其他地区也在考虑类似政策。关于食品警告有效性的研究正在出现，但评估食品警告政策伦理的学术研究有限。我们使用一个评估肥胖预防政策的公共卫生伦理框架，从多个维度评估了食品警告的伦理优势和劣势：1）健康行为与身体健康；2）心理社会福祉；3）社会和文化价值观；4）知情选择；5）平等；6）责任归属；7）自由；8）隐私。我们的分析确定了食品警告的伦理优势和劣势，包括：1）警告可能会产生重要益处，包括增强消费者理解和知情选择、促成更健康的购买行为以及可能降低肥胖率；2）警告会引发负面情绪反应，但这些反应是食品警告鼓励更健康行为和促进知情选择的重要机制；3）警告似乎不太可能对社会和文化价值观、责任归属、自由或隐私产生在伦理上不可接受的影响。当前研究表明，我们应继续将食品警告作为改善公众健康的政策选项，同时对这些政策的伦理进行更多研究。尤其需要未来的研究来阐明警告对污名化的影响，并描述实施警告政策的成本和收益的平衡与分配情况。
