The limits of the ledger in public health promotion

Abstract

Recent efforts to support state regulation of risky behavior like cigarette smoking, alcohol consumption, driving without seatbelts and riding motorcycles without helmets have focused on economic justifications--the costs to society of the consequences of these activities. However, opponents have successfully argued that the economic burdens of regulation outweigh the social benefits. To reduce the toll on society of these behaviors, we need justification for regulation that asserts the moral primacy of health and the well-being of the community.

KIE: Recent public policy debates over seatbelt and motorcycle helmet laws and taxes on alcohol and tobacco are described and evaluated. Advocates of stronger state actions in these areas are faulted for framing their justifications almost solely in economic terms, leaving their opponents able to argue that the economic burdens of regulation outweigh the social benefits. It is concluded that the justification for such regulation must include an assertion of the moral primacy of health as a social good and of the well-being of the community as a legitimate concern of public policy.