Obesogenic Environments, Inverse Care Law, Moral Repertoire of ‘Shoulds’ and the Behavioural Justice Movement There is increasing attention being directed towards what are known as ‘obesogenic environments’. These are considered to be places which promote the sorts of behaviours that contribute towards people becoming obese. Typically a place will be considered obesogenic if the environment does not facilitate people being physically active (e.g., lack of physical activity facilities and green space, busy roads, fear of crime) and there is limited availability of fresh fruit and vegetables as well as a prevalence of fast food outlets. Research demonstrates that the environments which most commonly have obesogenic properties tend to be deprived areas which are home to some of the most vulnerable populations in society, e.g., low income families, unemployed, single parents. This unequal spatial distribution is what is known as the ‘inverse care law’. This law describes how - within free market economies - areas that are in most need of services (deprived areas) tend to be least well served (there is an inverse relationship between services needed and services provided). This is because businesses prioritise making profits and are thus unlikely to invest in places where people do not have much money to spend. This clearly demonstrates that being able to live a ‘healthy lifestyle’ is considerably more convenient and achievable for some people than others. This is particularly problematic because health promotion in neoliberal societies like the UK tends to emphasise the role of the individual rather than recognising and acting upon social inequalities. The current political and cultural climate casts individual behaviours as ‘choices’ deriving from self-control and will-power (or lack thereof). People are encouraged to act responsibly by leading a ‘healthy lifestyle’ which is generally considered to comprise not smoking, limiting alcohol consumption, being regularly physically active and/or eating a low-fat, high-nutrient diet. This presents people with what Simone Fullagar (2002: 78) has described as a ‘moral repertoire of shoulds’: that is, ways that ‘good’ citizens should behave. Therefore, leading a healthy lifestyle becomes a moral issue: responsible, good citizens lead healthy lifestyles and those who do not are considered to be irresponsible and morally inferior. The injustice of this moralisation and stigmatisation is that the previously mentioned inequalities influence a person’s capacity to comply with health advice and live a healthy lifestyle. Therefore, with existing spatial inequalities leading to vulnerable populations tending to live in obesogenic environments this individualistic approach can be seen to promote victim blaming. This is why the ‘behavioural justice movement’ argues that access to these ways of living is a matter of social justice. The behavioural justice movement argues against indiscriminately applying the responsibilising and moralistic discourse of neoliberal health promotion while there is an uneven and unfair distribution of wealth and services. This is because these social and environmental factors significantly influence people’s capacity to comply with health advice. Mass media campaigns and more formal health education have been so successful that it is now unlikely that people who smoke, drink heavily, have high-fat diets and/or live largely inactive lifestyles are unaware that these actions are likely to have a detrimental effect on their health. Therefore, the behavioural justice movement argues that vulnerable groups with poor health need to stop being framed as simply ignorant, lazy and irresponsible. Instead, they advocate for governments addressing the association between obesogenic environments and areas of deprivation. Doing so would require reversing the inverse care law by providing the vulnerable populations living in deprived areas with the facilities, services and opportunities to live healthy lifestyles.
DEADLINE: 29/1/16
CONTACT OLI: o.s.williams@bath.ac.uk