RALEIGH – Because we have taxpayer-financed programs such as Medicare and Medicaid, obesity is a major public-policy issue. Unfortunately, what you do with – and to – your own body is no longer just your own business, because your poor choices can impose tremendous costs on others without their consent. Those who profess to care about personal autonomy in such matters are often noticeably silent about this point, but it is inescapable. The welfare state puts freedom at odds with fairness. Your freedom to overeat or get no exercise is unfair to me if I am forced to finance the treatment of the consequences.
How to back us out of this dense, prickly thicket is a subject for another day. The present subject is how extensive the tyranny of public health has proliferated. Public officials, it seems, have every right to base transportation and land-use decisions on public health grounds – having adding to the list of suburbia’s transgressions that it makes people dangerously and expensively fat.
The argument is problematic for reasons other than the philosophical. As the Reason Foundation’s Ted Balaker writes, sound studies connecting suburban living and obesity are, you may be surprised to learn, rather difficult to lay one’s hands on. It sounds plausible that people who live and work in dense, downtown settings would be more physically fit than suburbanites because of the greater need to walk. But evidence of the correlation is, in the words of the Institute of Medicine, “currently sparse.” There is even some evidence for the alternative proposition that living in suburban settings is linked with lower rates of overweight and obese people, though as Balaker notes it would be a mistake to infer either that this correlation is solid or that the causality runs from living pattern to health (it could well be the people who are healthier, either for genetic or behavioral reasons, are also more likely to choose suburban living, or be able to afford it).
Despite the lack of supporting evidence or serious inquiry on this matter, I’ve heard politicians and activists here in North Carolina assert confidently that suburban “sprawl” is a public-health problem that regulation and transit projects can address. This may properly be considered an example of political simplicism, mixed with no small amount of wishful thinking and question-begging.
It reminds me of the common error, which my JLF colleague Roy Cordato and others exposed years ago and which continues to this day, of attributing increasing rates of child asthma to increasing rates of urban air pollution – even though urban air pollution has been improving, not worsening, at the same time that reported asthma problems have trended upward. It’s hard for me to comprehend how less pollution can cause more asthma, but I am famously dense when it comes to such matters. After years of trying, for example, all those well-meaning activists pushing minimum-wage hikes still can’t seem to convince me that forcing up the cost of labor will result in more labor being employed.
But because I live in the suburbs, I guess they’ll just call me a fathead.
Hood is president of the John Locke Foundation.