The extent to which the public health ‘war on obesity’ reflects the ethical values and principles of critical health promotion: a multimedia critical discourse analysis
Lily O’Hara A D , Jane Taylor B and Margaret Barnes C
+ Author Affiliations
- Author Affiliations
A Emirates College for Advanced Education, PO Box 126662, Abu Dhabi, United Arab Emirates.
B School of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs Drive, Sippy Downs, Qld 4556, Australia.
C School of Nursing and Midwifery, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs Drive, Sippy Downs, Qld 4556, Australia.
D Corresponding author. Email: lilyohara@ecae.ac.ae
Health Promotion Journal of Australia 26(3) 246-254 https://doi.org/10.1071/HE15046
Submitted: 28 May 2015 Accepted: 18 October 2015 Published: 26 November 2015
Abstract
Issue addressed: The discipline of health promotion is responsible for implementing strategies within weight-related public health initiatives (WR-PHI). It is imperative that such initiatives be subjected to critical analysis through a health promotion ethics lens to help ensure ethical health promotion practice.
Methods: Multimedia critical discourse analysis was used to examine the claims, values, assumptions, power relationships and ideologies within Australian WR-PHI. The Health Promotion Values and Principles Continuum was used as a heuristic to evaluate the extent to which the WR-PHI reflected the ethical values of critical health promotion: active participation of people in the initiative; respect for personal autonomy; beneficence; non-maleficence; and strong evidential and theoretical basis for practice.
Results: Ten initiatives were analysed. There was some discourse about the need for participation of people in the WR-PHI, but people were routinely labelled as ‘target groups’ requiring ‘intervention’. Strong evidence of a coercive and paternalistic discourse about choice was identified, with minimal attention to respect for personal autonomy. There was significant emphasis on the beneficiaries of the WR-PHI but minimal attention to the health benefits, and nothing about the potential for harm. Discourse about the evidence of need was objectivist, and there was no discussion about the theoretical foundations of the WR-PHI.
Conclusion: The WR-PHI were not reflective of the ethical values and principles of critical health promotion.
So what?: Health promotion researchers and practitioners engaged in WR-PHI should critically reflect on the extent to which they are consistent with the ethical aspects of critical health promotion practice.
Key words: best practice, critical health promotion, critical weight studies, ethics, fat studies.
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