Social and Educational Factors of Obesity

[Speaking in the Seanad during Statements on Tackling Obesity in Ireland]

I welcome the Minister and I am sorry I was not in the House for his opening address.

I welcome the priority he and the Government will give to this problem. Many of his medical school classmates, younger women and men than me, will be spending long careers dealing with the consequences if we do not tackle this problem now. There has been an incredible explosion in knowledge about the true nature of the problems caused by obesity, reaching into areas we never would have thought were relevant at the time when I was in medical school. In my own area of expertise, we now recognise obesity as being one of the principal avoidable causes of cancer.

Before Senator Hayden leaves, I must compliment her on the tour de force she gave us on insulin metabolism. I think I am going to record it as I believe I may have qualified for some continuing professional development points in listening to her presentation. It was excellent.

It will be obvious to people who work in the health system that there is a very close correlation between several unhealthy behaviours and social and educational class. There is no doubt about that. The reasons are complex and need to be approached with an open mind. Smoking has become a more common problem in people who have lower educational achievement and economic access. This provides a double level of tragedy for those people – of course, none of us should be smoking in the first place – as the power of the addiction can rob resources where they are most scarce.

Counter-intuitively, there is a definite phenomenon of obesity becoming a problem of poorer people. This has become very obvious in the United States. Senator Hayden mentioned the role of relatively cheap access to processed food, which, although part of the problem, is clearly not its sole cause. I firmly believe that a big part of the problem revolves around education. We will find that people who have a higher level of educational achievement are more likely to be susceptible to messages about important health modifications for themselves and their families. It is important that, when we look at the strategy, we focus on the disproportionate toll which the scourge of obesity will bring to those who can least afford the illnesses.

I would like to take advantage of the Minister’s presence in the House to mention that we in the oncology community have all come back recently from the American Society of Clinical Oncology. By common consent, it was the most epoch-making meeting in the history of the society, certainly in the past 20 years. There is a torrent of new data for new treatments, many in the area of immunotherapy. There are very promising data in some types of breast cancer and bowel cancer. However, the drugs are going to be extraordinarily expensive. There will be a colossal battle over the next four to five years about the health-economic implications of some of these new treatments. I would like the Minister to commit to the idea of putting a ring-fenced additional tax of €5 on a packet of cigarettes, which can be used only for the purchase of treatments for smoking-related illnesses, including cancers, cardiovascular diseases and chronic lung disease. It would be groundbreaking for a Minister to ring-fence a specific tax for one purpose, so that the sticky fingers of the Exchequer could not use it for paying off financial burdens incurred by others, bank debts, pension funds or anything else. We would still charge the good old Revenue tax on cigarettes, which would help with our financial obligations and pension funds. This is relevant to today’s discussion because several of the illnesses which are consequences of obesity are also consequences of smoking.

On the issue of specific financial disincentives, that is, forms of tax for dietary supplements, etc., I saw today that several jurisdictions in the US are moving towards a complete ban on trans fats. They intend phasing them out completely over the next three years, as other speakers may already have mentioned. That may well be something we should consider here.

I wish the Minister well in his various undertakings. We can still do a little bit of work on the smoking space. I am sorry to cross outside the remit of today’s debate but I have the Minister captive here. We are not allowed to propose Bills on taxes in the Seanad so I cannot do it, but I want to put the thought into the Minister’s head that he might. I also ask him to look critically at the social and educational factors, which need to be addressed if we are going to tackle the obesity scourge.

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