Wild Turkey Hunkered Down

Hunker in the Bunker

After more than two decades of rising obesity rates, signs of a bunker mentality among people dealing with the problem should not be surprising. And indeed, they’re not hard to find.

On one hand, you have dedicated, but frustrated, public health professionals feeling threatened by their foes in big food and big soda. They are unwavering in their conviction that they’re pursuing the right strategies. They just need to press on harder and longer. They keep finding “fragile signs of progress” in their long struggle.

One such report came from Philadelphia public schools this week, where they found that:

The prevalence of obesity and severe obesity continued to decline among children in Philadelphia, but in some groups initial reductions were reversed in the later period.

The study has lots of caveats. The data are cross-sectional, not longitudinal. The methods for taking height and weight were not standardized. And throughout the period under study, dramatic shifts in the sample — public school children — were taking place. The population of children in Philadelphia public schools dropped substantially as students moved into charter schools. And the proportion of school children who were assessed dropped significantly by the end of the study. So it’s reasonable to ask if they have a stable, consistent sample.

Also significant is the question of how biologically improbable values for BMI were handled. The researchers made no mention of this. But other researchers have shown that it can have significant effects on reported childhood obesity rates because severe obesity is growing so much. Values that used to be regarded as biologically improbable (i.e., erroneous) are now much more likely to be correct. If they are thrown out, it skews rates downward.

But when you find something in the bunker that squares with your hopes and beliefs, it’s best to go with it. “We’re making progress and need to work harder at what we’re doing.”

Outside the bunker, the view is a little different:

Health experts should first examine the design and implementation of previous failed policies and try to understand the deeper causes for their failure. Otherwise, policymakers risk repeating the same mistakes and creating policies that will similarly fail.

These observations come from a recent commentary in The Hill by Sherzod Abdukadirov of George Mason University.

In a bunker on the other side of “enemy lines,” the siege is just as overwhelming for food and beverage companies. This week, when confronted with an undeniable PR disaster, Coke published a near apology in the Wall Street Journal for “creating confusion and mistrust.” But in the confusing atmosphere of the bunker, they ignored the number one PR rule for a public apology: make it clear and unqualified.

Instead, CEO Muhtar Kent said he was “disappointed.” He was clearly saying mistakes had been made, but he stopped short of actually apologizing.

Life is tough in the bunker. It’s time to get out and make some real progress against obesity.

Click here to read the study of childhood obesity rates in Philadelphia public schools and here to read more about biologically improbable values for BMI. Click here to read Abdukadirov’s commentary and here to read Coke’s almost apology.

Wild Turkey Hunkered Down, photograph © Ingrid Taylar / flickr

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August 23, 2015