Obesity is a public health problem influenced by behavioral patterns that span an ecological spectrum of individual-level factors, social network factors and environmental factors. Both individual and environmental approaches necessarily include significant influences from social networks, but how and under what conditions social networks influence behavior change is often not clearly mapped out either in the obesity literature or in many intervention designs. In this paper, we provide an analysis of recent empirical work in obesity research that explicates social network (...) influences on eating behaviors. We argue that a relational rather than individualistic view of personhood should help us better understand the content and context of social network relations that inform health behavior choices. We introduce the concept of ‘identity-constitutive affiliations’ as the glue that binds these social relationships together. Finally, we outline the implications for public health ethics in the development of effective interventions to address overweight and obesity, leveraging the content and context of social network ties to reinforce healthy (or alter unhealthy) eating. More complex treatment of positive and negative behaviors stemming from social network connections should lead to more comprehensive theoretical models of health behavior change and more effective public health interventions. (shrink)

Experimental philosophers advocate expansion of philosophical methods to include empirical investigation into the concepts used by ordinary people in reasoning and action. We propose also including methods of qualitative social science, which we argue serve both moral and epistemic goals. Philosophical analytical tools applied to interdisciplinary research designs can provide ways to extract rich contextual information from subjects. We argue that this approach has important implications for bioethics; it provides both epistemic and moral reasons to use the experiences and perspectives (...) of diverse populations to better identify underlying concepts as well as to develop effective interventions within particular communities. (shrink)

Calorie labeling on menus is one of the more recent public health responses to calls for increased access to nutrition information. The goal is to encourage consumers to make more healthy food choices. In this commentary on ‘Equity in Public Health Ethics: The Case of Menu Labelling Policy at the Local Level’, I focus first on research supporting health equity-directed goals for menu labeling policies; then I turn to the issue of challenges and opportunities for menu labeling as a part (...) of local food policy and food activism. I argue that, while there is some evidence that changes in menu labeling may help to promote health equity, other moves are needed at all levels of political organization. In particular, effecting shifts in attitudes and consumption will require changing our relationships with the food sources in our neighborhoods, and changing those food sources themselves. Leveraging our knowledge of behavioral economics and social marketing, using social networks and developing programs to transform eating patterns; all of these require participation and coordination among many stakeholders. Menu labeling is one tool, but many others are needed to effect change in communities. (shrink)

Understanding the relationship between obesity and fast food consumption encompasses a broad range of individual level and environmental factors. One theoretical approach, the health capability framework, focuses on the complex set of conditions allowing individuals to be healthy. This qualitative study aimed to identify factors that influence individual level health agency with respect to healthy eating choices in uniformly constrained environments. We used an inductive qualitative research design to develop an interview guide, conduct open-ended interviews with a purposive sample of (...) 14 student fast food workers, and analyze the data. Data analysis was conducted iteratively during the study with multiple coders to identify themes. Emergent themes included environmental influences on eating behaviors and internal psychological factors. A localized, embedded approach to analyzing the factors driving the obesity epidemic is needed. Addressing contextual interactions between internal psychological and external environmental factors responds to social justice and public health concerns, and may yield more relevant and effective interventions for vulnerable communities. (shrink)

Obesity is defined and identified in a number of ways, depending on whether it is in a medical, social, public health, or other context. After a brief primer on obesity, its causes and effects (and in particular its gender-based effects), this entry will examine weight stigmatization in more detail, giving an overview of some of the major results of studies across social science and public health fields. Next will be a discussion of two main approaches from which to understand and (...) address effects of weight stigmatization. Two common approaches – those pursued by public health ethicists and by various feminist scholars – overlap in some ways but differ substantively about the nature and medical status of obesity. Finally, this entry summarizes responses to issues of obesity and gender from the standpoints of both ethical approaches. There is a growing consensus across disparate groups about how to understand obesity as a social phenomenon, how to address it, and even how to reconceive health and fitness in ways that underplay the importance of body weight. (shrink)

This chapter contains sections titled: The Start Line Lap One, Where Cycling Practice Meets Feminist Ethics Lap Two, Words from Our Teammates or The Dirt Documentaries Lap Three, Different Lines, Same Course Last Lap, How Women Cyclists Transform Cycling.

Arguments for and against direct-to-consumer drug advertising (DTCA) center on two issues: (1) the epistemic effects on patients through access to information provided by the ads; and (2) the effects of such information on patients’ abilities to make good choices in the healthcare marketplace. Advocates argue that DTCA provides useful information for patients as consumers, including information connecting symptoms to particular medical conditions, information about new drug therapies for those conditions. Opponents of DTCA point out substantial omissions in information provided (...) by the ads and argue that the framing of the ads may mislead patients about the indications, uses, and effectiveness of the drugs advertised. They also suggest that DTCA has a number of potentially negative effects on the doctor–patient relationship. The standard arguments appear to assume a simplistic correlation—more information means more agency for patients. However, empirical studies on medical decision making suggest that this relationship is much more complex and nuanced. I examine recent research on ways in which patients are vulnerable with respect to DTCA. In order to address the complex issues of information acquisition and consumer decision-making in the health care marketplace, the focus should not be simply on what information patients need in order to make medical decisions, but also on the conditions under which patients actually are able to make medical decisions requiring complex medication information. This requires examining both the cognitive limitations of patients with respect to drug information and investigating patients’ preferences and needs in a variety of medical contexts. (shrink)