One of the most influential sociologists of the 20th century – C. Wright Mills – once wrote that a need becomes a social problem when it is a widely-shared experience in a community.
In turn, sociologists and other social scientists analyse social conditions which create the problem, social perceptions and judgements on the issue, and policy processes to create solutions. Some also ask who is defining the issue as a problem, for which purpose and for whose benefit.
An issue which is increasingly being defined as a social problem, both nationally and globally, is obesity. The World Health Organisation (WHO) recently announced that there are at least 41 million children under five who are obese or overweight across the world, and that the numbers are increasing, especially in developing countries.
Previously, a WHO report had shown that Malta has the highest obesity and overweight rates in the European Union. According to the Today Public Policy Institute (TPPI), which has released a report authored by George Debono, Malta is “one of the fattest, laziest and most car-dependent nations on the planet”.
Basing its conclusions on scientific studies and lifestyle factors, TPPI explained that Malta is the least physically active country in the world, has the least physically active children in the EU, and has a 22 per cent obesity rate (our neighbour Italy has 10 per cent). Child obesity, one of the highest in the world is around 25 per cent when one also factors in pre-obese children.
Malta also fares poorly in statistics related to Type II diabetes, active mobility including bicycle use, alcohol use, and other examples.
Health authorities should work hand in hand with stakeholders to identify which types of policies are more suitable for particular areas
There are many reasons for Malta’s poor performance. This ranges from policies which give priority to cars over everything else, to Malta’s dietary habits, which in many instances differ from typical Mediterranean diets. The increased usage of information communication technologies is also encouraging many to do less physical activity.
Indicators such as those referred to above have impacts on people’s quality of life. This may include health consequences (both physical and psychological), educational attainment as well as social stigma.
Medical sociologists such as my colleague Gillian Martin at the University of Malta have emphasised that there are both medical and social factors related to being obese and fat respectively. This includes biomedical discourse and policies, as well as people’s everyday experiences, their interaction with others and how these are interpreted in relation to social practices, aspirations and beliefs. And the latter may also include negative experiences such as labelling and social exclusion.
In relation to all this, a social welfare perspective may welcome the recent statement of Health Parliamentary Secretary Chris Fearne, who said that tackling obesity will be one of Malta’s health priorities during its upcoming EU presidency. Fearne added that obesity should be acknowledged as a disease and appealed for more funding on the issue.
My appeal to the health authorities is to officially recognise that there are various factors, interests and interpretations related to obesity. This requires a multidisciplinary and multidimensional approach which includes different disciplines – and not only the medical, important as it is – and which also involves a wide range of stakeholders from civil society and government.
One policy aspect that should be taken into consideration among others has to do with the welfare perspectives adopted to tackle the issue.
For example, some perspectives emphasise altruism and equality, others emphasise self-interest and welfare incentives. Some believe that policymaking is best implemented through paternalistic and compulsory schemes, while others give more importance to education, trust and community building. In an increasingly individualised setting, some also believe that welfare should equip us to confront the opportunities and risks in our everyday lives through rights and responsibilities.
Health authorities should work hand in hand with stakeholders to identify which types of policies are more suitable for particular areas, ranging from transport to school diets.
The alternative to a proper policymaking approach would be millions of euro in public and private expenditure to combat ill-health, and, above all, people facing illness, social exclusion and other factors which impinge on their quality of life.