PUBHLTH 1 Lecture Notes - Lecture 34: Paternalism
Austin Maldanado
Professor Bic
Public Health 1
Lecture
• Adolescents of lower SES status are more likely to smoke than those of higher SES (Adler et.
Al., 1994)
• People with higher SES are less likely to have most medical and psychiatric disorders (Adler et.
Al., 1994)
• Biological Factors that Contribute to Negative Health Outcomes
• Exposure to pathogens, carcinogens, & other substances – People with low SES more likely to
smoke – more likely to live near sources of pollution
• Socioeconomic Status
• SES is “a composite measure that typically incorporates economic status, measured by income;
social status, measured by education; and work status, measured by occupation”
• SES and Obesity cont. Psychological Factors:
• Low SES populations tend to consume more potatoes and soft drinks and less fruits and
vegetables than high SES populations (Hulshof et. al., 2003)
• Low SES populations favor foods with a high calorie per dollar ratio
• Social norms for attractiveness are accepted and internalized to a lesser extent by women of
low SES (Sobal & Stunkard, 1989)
• SES and Obesity cont. Environmental:
• High rates of crime in low SES communities can discourage physical activity
• A dose-response relationship can be observed between income category of a community and
the number of fast food outlets nearby (Reidpath et. al., 2002) Sources of Controversy
• Economic impact
• Individual liberty
• Moral and religious concerns
• Politics vs. science Economic Impact
• Businesses often resist public health measures because they affect profits
• Those who must pay may not be the ones who benefit
• Costs may be short-term, while benefits may be long-term
• Costs easier to calculate than benefits Economic Impact
• Milk producers resisted pasteurization
• Landlords resisted building codes,
• Automobile manufactures resisted design changes to improve safety
• Cigarette sales also are a significant income for small businesses
• Owners of bars and restaurants fought laws restricting smoking on their premises, fearing that
they would lose patronage of smokers
Economic Impact
• In times of economic difficulty, people are often unwilling to pay short-term cost in order to
obtain a benefit in the long term.
• Fishing & lumber industry – sources depleted – risk of killing all fish, cutting down all the
timber Examples :
• Companies resist tough pollution control
• Mad cow outbreak, (USA no testing, American beef banned in many countries)
