What's law got to do with it part 1: A framework for obesity prevention

Abstract

This article provides a conceptual framework for thinking about the role of law in responding to population weight gain in Australia. Part 1 focuses on two core questions. Firstly, in pursuing the aim of weight reduction at the population level, what should law be trying to influence? The challenge here is to identify a model of the determinants of obesity that is adequate for legal purposes and that illustrates the entry points where law could best be used as an instrument of public health policy. Secondly, what kinds of strategies and tools can law offer to obesity prevention? The challenge here is to identify a model of law that captures the variety of contributions law is capable of making, at different levels of government, and across different legal systems.In Part 1 of the article, I argue that although law can intervene at a number of levels, the most important opportunities lie in seeking to influence the social, economic and environmental influences that shape patterns of eating and nutrition across the population as a whole. Only policies that impact broadly across the population can be expected to influence the weight distribution curve that has shifted relentlessly to the right in recent decades. Part 2 of the article builds on this analysis by offering a critical review of selected legal strategies for healthier nutrition and obesity prevention.

Figure 1

A simplified hierarchical model of the determinants of health and disease.

Figure 2

A simplified hierarchical model of the influences upon health, and corresponding policy interventions*. *This figure was partly adapted from J. McKinlay and L. Marceau, "A Tale of 3 Tails," American Journal of Public Health 89 (1999): 295–298, at 296.

Figure 3

A model of the ecological determinants of health encompassing environmental and socio-economic factors.

Figure 4

A framework for thinking about law and public health.

Figure 5

A typology of legal interventions for public health improvement. *This figure is heavily indebted to Lawrence O. Gostin, "Law and Ethics in Population Health" Australian and New Zealand Journal of Public Health 2004, 28: 7–12. It also draws on Wendy C. Perdue, George A. Mensah, Richard A. Goodman, Anthony D. Moulton, "A Legal Framework for Preventing Cardiovascular Diseases" American Journal of Preventive Medicine 2005, 29(5S1): 139–145.