Posts Tagged ‘Ireland’

Denmark pulls back on fat taxes

September 19th, 2012

Denmark has decided to repeal its tax on saturated fats and forego other taxes on sugar-sweetened beverages and foods after finding that Danes simply went to Germany to buy the foods at lower prices. See FoodNavigator: Fat-tax-why-is-Denmark-such-a-quitter

If you want to see a really well-informed discussion of such taxes, see these presentations from Professor Mick Gibney, Dr. Anne Nugent, Dr. Kevin Denny and Professor David Madden at University College Dublin, Ireland. UCD: Seminar fat and sugar taxes

 

Obesity The Irish Way: No Blame, No Shame

January 27th, 2012

A few weeks ago I wrote about how Ireland is dealing with its obesity epidemic. I call it the “No Blame, No Shame” approach. Ever since my visit with the Irish government’s point person on obesity, I have been trying to think about “obesity” without thinking about “blame”. I recall that the first media call when I took over the American Obesity Association asked me, “Who is to Blame?” It seems to me still that we cannot move beyond blame.

So, it was with some interest that I read this report from The Lancet about the British Government’s new approach to move from nudging patients to a healthier lifestyle to nagging them which The Lancet’s editors predicted will be a failed policy. Public health in England: from nudge to nag : The Lancet

On the other hand, this editorial in the Irish Times points out something I think is obvious:

“Negative lifestyle messages lead to stigmatisation, victim-blaming and health inequalities. Discussing obesity and diabetes as if these problems are the individual’s fault stigmatises people with weight problems. Everyone may feel fearful when listening to health experts being interviewed about the latest lifestyle report, but only those in the higher socio-economic groups are able to comply with the message to, say, eat more fruit and veg. Poor people stay scared with no way of alleviating their fear. Telling people to exercise more is pointless if they live in an area with no facilities and no footpaths”. Forget lifestyle advice, it’s policy that matters – The Irish Times – Tue, Jan 03, 2012

The editorial goes on to call on the government to enact policies which change the food/physical activity environment.

Nagging or positive improvements? What’s the choice?

 

Obesity In Ireland

December 28th, 2011

Obesity is a problem in Ireland with a prevalence similar to that of the United Kingdom and northern Europe.  On our trip this summer, my wife and I could not help looking for the similarities and differences in the approaches to obesity between our two countries.

This exercise was more than just a bus man’s holiday. Both of us had family from Ireland who came over during the Great Famine (1845-1850).  During this period, one million people died of starvation and disease and another million emigrated. The population of Ireland has never recovered. 

The presence of the famine is quite real in Ireland. Not only are there replicas of the “coffin ships” which brought the Irish to the United States and Canada under horrendous conditions. But there are several monuments, including this one in County Mayo, to the victims of the famine.

 

But the most sobering reminder is the presence of hundreds of famine houses throughout the south and west, where the famine was most harsh. These are stone houses, usually with the roofs caved in or now covered with metal sheets. Some seemed to be converted to barns but most seemed untouched since the family left…or died.

 

To leap from viewing these relics of famine to discussing the problems of obesity seems like an enormous leap in 160 years or so. It is a testament to the improvements in agriculture, food science and transportation that famine is so remote. A telling illustration of where we are today was the display of the BMI chart in the windows of many pharmacies we passed, such as this one. No doubt the diets rich in Guinness and potatoes

 

Famine may be a remote threat to Ireland today. However, television news had extensive reports of the famine in Dafur, as well as appeals for contributions.(Television also had numerous reports of a gentleman who was suing to receive bariatric surgery. He had failed to meet the weight requirement of the National Health Service but was suing because quality of life was not one of the criteria to be considered. Obese Man Tom Condliff, 62, Takes PCT To Court To Persuade Them To Fund Gastic Bypass Surgery | UK News | Sky News. He lost the case.) 

The Irish government put together a comprehensive national strategy in 2005. Obesity – the policy challenges; Obesity – the policy challenges: executive summary. The very first recommendation is that “The Taoiseach’s (the prime minister) office should take the lead responsibility and provide an integrated and consistent proactive approach in addressing overweight and obesity and to the implementation, monitoring and evaluation o f the National Strategy on Obesity in conjunction with all government departments, relevant bodies and agencies, industry and consumer groups.” The strategy goes on to make specific recommendations for high-level government action, the education sector, the social and community sector, the health sector, the food commodity, production and supply sector,  and the physical environment sector. The 2005 recommendations were reviewed and evaluated in 2009. Report of Inter-sectoral Group on the Implementation of the Recommendations of the National Task Force on Obesity They reported significant progress on 32% of the recommendations. Not too bad given Ireland financial crises. 

There are two aspects of this plan which are important. First, everyone has skin the game. Every sector is tasked with making a contribution to an improvement in the obesity epidemic. But importantly, the top political leader, took responsibility for leading a united effort. Second, they monitor and report on the progress of their recommendations.

 Related to that is the broad absence of “blame” in the Irish approach to obesity. We had the opportunity to discuss this with Dr. John Devlin, Deputy Chief Medical Officer of the Department of Health and Children.

The Irish approach has been to skip arguing over who or what is to blame for obesity and to get all the players to make practical contributions to making improvements in their domains. It took a while to imagine discussions of obesity without the “blame factor.” It seems virtually every conversation in the United States about obesity has to do with who is to blame: the individual, the parents, the environment, television, schools abandoning phys ed and bringing in bad foods, food company marketing, especially to children, genes, your mother, etc, etc.

This “blame factor” may be easier to reduce in a society more homogenous than our and less litigious. But whatever the reason, one has to think that this obsession with who is to blame has done nothing but frustrate reaching solutions. It may be a bit of ethnic pride but the United States could learn a lot from the Irish approach: have the top levels of government lead all sectors in reaching practical.

Photo Credits: Dotty Lynch

We are pleased to provide the post in Irish:

Is fadhb Otracht in Éirinn a bhfuil leitheadúlacht cosúil leis sin de na Ríochta Aontaithe agus dtuaisceart na hEorpa. Ar ár turas an samhradh seo, ní raibh mo bhean chéile agus mé ag lorg cabhair na cosúlachtaí agus na difríochtaí sa chur chuige a otracht idir an dá thír.Bhí an cleachtadh seo níos mó ná fear bhus ar saoire. Bhí an dá linn teaghlaigh ó Éirinn a tháinig os cionn linn an Ghorta Mhóir (1845-1850). Linn na tréimhse seo, fuair duine amháin milliún duine de ocras agus galar agus ceann eile milliún ar imirce. Riamh Tá daonra na hÉireann a aisghabháil.Is é an láithreacht an ghorta fíor go leor in Éirinn. Ní amháin go bhfuil macasamhla de na “longa cónra” a thug na hÉireann chuig na Stáit Aontaithe agus Ceanada faoi choinníollacha horrendous. Ach tá roinnt séadchomharthaí, lena n-áirítear an ceann seo i gContae Mhaigh Eo, chun an íospartaigh an ghorta.Ach is é an meabhrúchán is sobering láthair na céadta teach gorta ar fud deisceart agus san iarthar, áit a raibh an gorta is harsh. Tá na tithe cloiche, de ghnáth le caved na díonta i nó anois clúdaithe le leatháin miotail. Roinnt chuma a thiontú go sciobóil ach an chuma untouched an chuid is mó ó d’fhág an teaghlach … nó a fuair bás.Chun breathnú ar na léim ó iarsmaí den ghorta chun plé leis na fadhbanna an otracht is cosúil cosúil le léim ollmhór i 160 bliain nó mar sin. Is fianaise ar na feabhsúcháin sa talmhaíocht, eolaíocht bhia agus iompar go bhfuil an ghorta chomh cianda. Ba léiriú ag insint an áit ina bhfuil muid inniu a chur ar taispeáint ar an chairt BMI sna fuinneoga na gcógaslann rith muid go leor, ar nós an ceann seo. Níl amhras ar an aistí saibhir i Guinness agus prátaí

D’fhéadfadh a bheith ina bhagairt Gorta iargúlta ar Éirinn sa lá atá inniu. Mar sin féin, bhí tuairiscí nuachta teilifíse fairsinge na gorta i Dafur, chomh maith le hachomhairc i leith ranníocaí. (Teilifís Bhí tuairiscí iomadúla de fhear uasal a bhí agairt a fháil máinliacht bariatric. Gur theip sé chun freastal ar an riachtanas meáchan na Seirbhíse Náisiúnta Sláinte ach bhí agairt mar nach raibh caighdeán na beatha ar cheann de na critéir a bheidh le breithniú murtallacha Man Tom Condliff, 62, Takes CCP Chun Chúirt a áiteamh orthu a Ciste Máinliacht Seachbhóthar Gastic |. Ríocht Aontaithe Nuacht |.. Sky News Chaill sé an cás)

An rialtas na hÉireann a chur le chéile straitéis chuimsitheach náisiúnta i 2005. Obesity – na dúshláin bheartais; Otracht – na dúshláin bheartais: achoimre feidhmiúcháin. Is é an moladh an-sin den chéad uair “Ba chóir an Taoisigh (an príomh-aire) oifig a chur ar an freagracht ceannais agus cur chuige comhtháite agus comhsheasmhach réamhghníomhach i ngleic le róthrom agus otrachta agus le cur i bhfeidhm, monatóireacht agus meastóireacht ar an Straitéis Náisiúnta ar Mhurtall i gcomhar le fáil gach roinn rialtais, comhlachtaí agus gníomhaireachtaí ábhartha, tionscal agus grúpaí tomhaltóirí. “Téann an straitéis maidir le moltaí sonracha a dhéanamh le haghaidh gnímh rialtais ard-leibhéil, an earnáil oideachais, an earnáil shóisialta agus phobail, an earnáil sláinte, an tráchtearra bia, a tháirgeadh agus a soláthair san earnáil, agus an earnáil timpeallacht fhisiciúil. Rinneadh athbhreithniú ar na moltaí 2005 agus a mheas i 2009. Tuarascáil an Ghrúpa Idir-earnála ar Chur i bhFeidhm na Moltaí an Tascfhórsa Náisiúnta um Fhoircheasacht Thuairiscigh siad dul chun cinn suntasach maidir le 32% de na moltaí. Níl sé ró-olc a tugadh Éirinn ghéarchéimeanna airgeadais.

Tá dhá ghné den phlean seo atá tábhachtach. Gcéad dul síos, tá gach duine craiceann an cluiche. Tá gach earnáil de dhualgas ag cur le feabhas ar an eipidéim raimhre. Ach tábhachtaí fós, an ceannaire polaitiúil barr, ghlac an fhreagracht orthu as iarracht aontaithe. Dara, siad monatóireacht agus tuairisciú ar dhul chun cinn a gcuid moltaí.A bhaineann leis go bhfuil an easpa leathan “milleán” sa chur chuige na hÉireann le raimhre. Bhí orainn an deis seo a phlé leis an Dr John Devlin, Leas-Phríomh-Oifigeach Míochaine de chuid na Roinne Sláinte agus Leanaí. Tá an cur chuige na hÉireann curtha ag argóint a scipeáil thar a bhfuil nó a bhfuil an locht ar otracht agus do na páirtithe uile a fháil chun ranníocaíochtaí praiticiúil a dhéanamh ar fheabhsúcháin ina gcuid réimsí. Thóg sé tamall a shamhlú gan an otracht plé Dealraíonn sé beagnach gach comhrá sna Stáit Aontaithe faoi mhurtall bhfuil a dhéanamh leis atá an locht “fachtóir milleán.”: An duine aonair, na tuismitheoirí, an comhshaol, an teilifís, scoileanna phys thréigean ed agus a thabhairt i mbianna olc, margaíocht cuideachta bia, go háirithe do leanaí, géinte, do mháthair, srl, srlD’fhéadfadh sé seo “fachtóir milleán” a bheith níos éasca a laghdú i sochaí níos mó ná ár n-aonchineálach agus níos lú litigious. Ach is cuma cad é an gcúis sin, tá ceann a cheapann go bhfuil an obsession le atá an locht déanamh aon rud ach frustrate réitigh a bhaint amach. D’fhéadfadh sé a bheith beagán de bród eitneach ach d’fhéadfadh na Stáit Aontaithe a lán a fhoghlaim ón gcur chuige na hÉireann: Tá na leibhéil is airde de rialtas mar thoradh ar gach earnáil a bhaint amach praiticiúil.

An rialtas na hÉireann a chur le chéile straitéis chuimsitheach náisiúnta i 2005. Obesity – na dúshláin bheartais; Otracht – na dúshláin bheartais: achoimre feidhmiúcháin. Is é an moladh an-sin den chéad uair “Ba chóir an Taoisigh (an príomh-aire) oifig a chur ar an freagracht ceannais agus cur chuige comhtháite agus comhsheasmhach réamhghníomhach i ngleic le róthrom agus otrachta agus le cur i bhfeidhm, monatóireacht agus meastóireacht ar an Straitéis Náisiúnta ar Mhurtall i gcomhar le fáil gach roinn rialtais, comhlachtaí agus gníomhaireachtaí ábhartha, tionscal agus grúpaí tomhaltóirí. “Téann an straitéis maidir le moltaí sonracha a dhéanamh le haghaidh gnímh rialtais ard-leibhéil, an earnáil oideachais, an earnáil shóisialta agus phobail, an earnáil sláinte, an tráchtearra bia, a tháirgeadh agus a soláthair san earnáil, agus an earnáil timpeallacht fhisiciúil. Rinneadh athbhreithniú ar na moltaí 2005 agus a mheas i 2009. Tuarascáil an Ghrúpa Idir-earnála ar Chur i bhFeidhm na Moltaí an Tascfhórsa Náisiúnta um Fhoircheasacht Thuairiscigh siad dul chun cinn suntasach maidir le 32% de na moltaí. Níl sé ró-olc a tugadh Éirinn ghéarchéimeanna airgeadais.

Tá dhá ghné den phlean seo atá tábhachtach. Gcéad dul síos, tá gach duine craiceann an cluiche. Tá gach earnáil de dhualgas ag cur le feabhas ar an eipidéim raimhre. Ach tábhachtaí fós, an ceannaire polaitiúil barr, ghlac an fhreagracht orthu as iarracht aontaithe. Dara, siad monatóireacht agus tuairisciú ar dhul chun cinn a gcuid moltaí.A bhaineann leis go bhfuil an easpa leathan “milleán” sa chur chuige na hÉireann le raimhre. Bhí orainn an deis seo a phlé leis an Dr John Devlin, Leas-Phríomh-Oifigeach Míochaine de chuid na Roinne Sláinte agus Leanaí. Tá an cur chuige na hÉireann curtha ag argóint a scipeáil thar a bhfuil nó a bhfuil an locht ar otracht agus do na páirtithe uile a fháil chun ranníocaíochtaí praiticiúil a dhéanamh ar fheabhsúcháin ina gcuid réimsí. Thóg sé tamall a shamhlú gan an otracht plé Dealraíonn sé beagnach gach comhrá sna Stáit Aontaithe faoi mhurtall bhfuil a dhéanamh leis atá an locht “fachtóir milleán.”: An duine aonair, na tuismitheoirí, an comhshaol, an teilifís, scoileanna phys thréigean ed agus a thabhairt i mbianna olc, margaíocht cuideachta bia, go háirithe do leanaí, géinte, do mháthair, srl, srlD’fhéadfadh sé seo “fachtóir milleán” a bheith níos éasca a laghdú i sochaí níos mó ná ár n-aonchineálach agus níos lú litigious. Ach is cuma cad é an gcúis sin, tá ceann a cheapann go bhfuil an obsession le atá an locht déanamh aon rud ach frustrate réitigh a bhaint amach. D’fhéadfadh sé a bheith beagán de bród eitneach ach d’fhéadfadh na Stáit Aontaithe a lán a fhoghlaim ón gcur chuige na hÉireann: Tá na leibhéil is airde de rialtas mar thoradh ar gach earnáil a bhaint amach praiticiúil.

Creidiúintí Grianghraf: Dotty Lynch