For the Kids

  by Michael Applebaum, MD, JD, FCLM

The results of unhealthy diet and inactivity are well-documented: epidemics of "obesity" and Type II diabetes, heart disease, certain cancers, stroke, asthma, chronic disorders, fractures and death.  The costs associated with these diseases are debatable to the dollar amount and the number of people affected, but are undeniably impressive.  One estimate, from the Center for Science in the Public Interest, places the annual expenses at 617 billion dollars, the lives lost prematurely between 310,00 and 580,000 and the number of Americans living with unhealthy diet- and inactivity- related disorders at 215,160,000.


A recent study from Harvard’s Kennedy School of Government determined that 65% of respondents blamed "obesity" on their own weakness of will and inability to maintain a regular diet and exercise regimen.  The same study suggested that adults are generally opposed to government intervention in the epidemic.  But when it came to taking action for our children, the majority favored some form of government control.


So this is where we should begin.  Let’s help the kids by implementing several approaches built on currently accepted concepts:


1.         Gram Shop Acts: grams of fat, that is.  Dram Shop Acts generally hold people who serve alcoholic beverages liable under state laws for damages consequent to their patron’s intoxication.  The customer, not a minor, usually has no cause of action.  Food service establishments, where children can obtain meals that exceed 300 calories, should be given the responsibility to deny service to "obese" minors.  Grocery stores should be similarly empowered to prevent the sale to minors of food items in excess of 150 calories with fewer than 12 grams of protein per serving.  Bar code scanning and nutritional databases make this data automatically obtainable.



2.         Child Abuse/Neglect: Each state, as well as the feds, has its own definition.  The federal definition is "the physical and mental injury, sexual abuse, negligent treatment, or maltreatment of a child under the age of 18 by a person who is responsible for the child’s welfare under circumstances which indicate that the child’s health or welfare is harmed or threatened.”  Parental/guardian omissions or commissions, harming a child’s health or welfare through poor diet or inactivity, should be handled as other forms of child maltreatment.  Starving a child is an example of an offense at the opposite end of the nutritional maltreatment spectrum that has already been prosecuted.  


3.         Battery: A minor is the victim of a harmful or offensive contact when his/her body is injured.  It is unarguable that poor diet results in childhood disease, i.e., injury.  A minor cannot consent to such contact.  Those who cause minors a nutritionally harmful contact are culpable.  


4.            Reverse Quarantine: In situations of epidemic disease, the government can impose quarantine on those affected to stop the spread.  "Obesity" is recognized as a disease and is of epidemic proportions.  For their own good and to control the epidemic, for which there is an element of social transfer, quarantining "obese" children from food service and food sale establishments should be considered.  


5.         Abused and Neglected Child Reporting Acts: Physicians are obliged to report instances of certain diseases and suspected child abuse to state agencies.  Child victims of suspected unhealthy diet and inactivity should be brought to the attention of the proper authorities for intervention.



6.            Wrongful Lifestyle: Wrongful acts result in harm from negligence or other liability.  A child injured through unhealthy diet and inactivity by those responsible for the minor’s care can bring this new cause of action.  As children tend to be influenced by adult behavior, those adjudicated as responsible for wrongful lifestyle should be required to set a proper example to the children, if their own physical conditions reflect unhealthy diet and inactivity.



7.            Oversight of Government Programs: Governments already impose limits on the use of our dollars.  An example is the restriction of ethanol from those items which can be purchased with food stamps.  Another program, WIC, is designed to provide “proper nutrition” for certain segments of the population.  Computerized checkout technologies can help promote healthier eating by preventing certain foods or combinations of foods from being purchased.



8.         Media Disclosure: The media like to pride themselves on truthful reporting.  As more correspondents appear on “infotainment” shows, the capacity in which they speak becomes blurred.  The public frequently relies on the presumed trustworthiness of these individuals.  When these shows present health-related segments that can be related to children, they should be required to disclose the rigor of the research behind the piece, stating whether it is of the same caliber as their news investigations or merely “fluff.”  Networks and other media publicizing health-related products that might be used by children can honestly and prominently disclose “None of the information in the following commercial has been proven true by any health authority.”



9.            Manufacturers: Labeling requirements are frequently controversial.  That is because they often warn of dangers.  To help the children, “educating labels” should be placed on food items to assist both children and their caregivers in making sound food choices.



10.       Adult Responsibility for the Acts of Children: Adults have been held responsible for societal harm caused by the minors for whom they are responsible.  There can be little doubt that unhealthy eating and inactivity among children result in harm to society.  Those adults responsible should face accountability.



11.       After School Fitness Programs: Joint efforts between health plans and community/private facilities that will offer employees responsible for children and employers discounted costs of coverage for documented attendance and improvement in the children.



By initiating some or all of the preceding we should be able to prevent a next generation from developing the scope and scale of illnesses that are so costly in terms of dollars, lives, function and happiness.