Sunday 1 January 2012

Public Health Snobbery

In a piece I've been meaning to highlight for a few days, Reason's A. Barton Hinkle has gone all uncharacteristically prohibitionist, so he has. And boy does he make a good point.

Isn’t it about time America banned soccer? Not because of British hooligans or the vuvuzela that has now made it into your local dollar store, although Heaven knows soccer has plenty to answer for on both those scores. No, the question at hand is whether soccer should be banned because of the other costs it imposes on society.

This comes up thanks to a little story from a few weeks back about a new study finding that “heading” a soccer ball can lead to traumatic brain injury.

Okay, so perhaps we don’t need to ban soccer outright. Perhaps we should only require players to wear helmets. But what about sports in general? In the aggregate, they cost society a tremendous lot of money.

According to the National Center for Sports Safety, more than 3.5 million children receive medical treatment for sports injuries every year. Sports and recreation account for a fifth of traumatic brain injuries among young people, which the CDC says have increased 60 percent in the past decade. Overall injury rates for various sports are surprisingly high: 28 percent of youth football players get hurt. So do a quarter of all youth baseball players, more than a fifth of all youth soccer players, and even 15 percent of all youth basketball players. Even gymnastics is responsible for tens of thousands of injuries a year.

Obviously, this imposes huge costs on society. Those injured players who are insured drive up premiums for everybody. Those who are not insured receive charity care, which drives up hospital rates. People who play sports are engaging in risky behavior that hurts us all, for their own selfish enjoyment. Somebody needs to put a stop to this.
Very reminiscent of Joe Jackson's Dog Ban proposal, isn't it? It should be, of course, as both articles sagely lampoon the same selective hypocrisy, as Hinkle succinctly points out.

If you think the preceding paragraph is a barrel of 180-proof rot, good for you. But this is precisely the sort of argument that is being made in other areas of what is subversively known as public health.
Do go read the whole thing as it is delightfully drawn, highlighting as it does a particular inconsistency in the way different behaviours and choices are viewed by those we expect to 'serve' us.

You see, no matter the perfectly transparent nature of costs against benefits that modern statistics gathering affords us, the benefits are ignored only in areas where the state chooses to.

Sport is considered a 'win' because of the intangible benefit to the nation of enjoyment and health. This, of course, despite the fact that healthy people arguably cost every nation more than those who are unhealthy. In Jackson's article, dogs are even harder to justify except by the satisfaction factor - they are also a luxury apart from a few exceptions.

Yet satisfaction and other intangible benefits are routinely ignored where lifestyles of which the state disapproves are concerned.

They're easily measurable, too.

With alcohol harm costing us an estimated £25 billion each year, MPs must act now.
And what a delightfully made up number. However, as has been pointed out many times before, there are costs and benefits to all things. People drink because they like it, the pleasure of the booze is worth the pain purchasing it brings on in the wallet. Thus the value to the populace of booze must be higher than what the populace spends on booze. Over£50 billion then.

We get twice as much out of booze as booze gets out of us, even by your absurd and inflated figure.
So, how do we find ourselves in this position whereby one set of choices are derided as being a financial burden by way of strategic dismissal of plain benefits, while others are lauded thanks to the dismissal of all mention of costs?

Well, it helps if self-interest dictates that vast soundbite-spouting departments would be on the dole if starved of the cash handed to them by the same ideologically blinkered politicians who change the rules with every disingenuous utterance, of course.

But when you boil it all down, there is a massive dose of class condescension and snobbery involved too, as Snowdon recently identified in the case of fat taxes.

As for reducing consumption of "sugar-sweetened beverages" by 7.5ml a day, there are 400 calories in a litre of Coca-Cola, so a reduction of 7.5ml works out at 3 fewer calories per day. This, of course, assumes that people would replace their Coke with water or nothing at all. If they substituted something "healthy", like an Innocent Smoothie, they would wind up consuming more calories because a typical litre of smoothie contains more than 500 calories. (But we don't mention that because middle-class people like them.)
Y'see, the severity of sanctions against practices which 'cost' the NHS is directly correlated with how they will impact the middle class and upwards. When it comes to lifestyles identified as enjoyment for the working classes, the cost is described in terms like 'epidemic', 'crisis', disaster', and 'time bomb', whilst action to be taken against such pleasures is 'urgent', 'vital', and 'essential'. It's awful to see working class people enjoying their little sins, isn't it? Even if that very enjoyment is an intangible benefit in itself, as is the tangible monetary saving.

Whereas, if it concerns something not seen as predominantly for the 'common' or classless - like sport, for example - the same costs are either meekly accepted, or ignored altogether.

Goes some way to explaining why we have politicians of widely differing ideologies all proposing laws which dismiss verifiable evidence in favour of sentiment, myth and blatantly manipulated poppycock, doesn't it? Detached and dispassionate though they believe themselves to be, their self-control is so weak that they simply can't mask that hideous in-built bigoted snobbery.


Simon Cooke said...

Good piece - nice to see the yanks picking up on my "denormalise" sport line!

Interesting to note that, during the "people getting drunk on 'mad friday' are a terrible cost to society" debate, several callers remarked on the inconsistency between getting smashed out of your face and getting your face smashed in on the rugby pitch.

And the original bog posts are:

Happy New Year and keep up the good work!

Anonymous said...

Funny thing about 'costs to society',comparisons are never made.

Smoking,in America, is claimed to 'cost' society about $97 billion per year in lost productivity.

How does that compare to other factors?

Lost Productivity

Poor management planning and control $880 billion

Worker interruptions $588 billion

Employees wasting time on the job $544 billion

Workers who don't feel "engaged" in their work $350 billion

Employers who don't adapt to the needs of working parents $300 billion

Traffic crashes $230 billion

Illiteracy $225 billion

Heart disease due to death and disability $152 billion

Presenteeism" $150 billion

Hangovers $148 billion

Crime $130 billion

Poor power quality and reliability $120 billion

Untreated and mistreated mental illnesses $105 billion

Poor web designing $100 billion

Roadway congestion $100 billion

Stress-related ailments $100 billion

Gary K.

Mick Turatian said...

Happy New Year, DP.

Good piece but I'm not quite sure about the working/middle class divide.

I doubt whether this is a thing that divides on traditional lines of social class but more of the bien-pensant righteous in one corner versus those who aren't progressively enlightened in the other.

I imagine that aristos enjoy the hedonism of fags, booze and scoff as much as any other social class.

Anonymous said...

"Whereas, if it concerns something not seen as predominantly for the 'common' or classless - like sport, for example - the same costs are either meekly accepted, or ignored altogether"

Case in point, the one everyone - well the BBC and other medja outlets seem to believe it is everyone - are all pants wettingly excited about - London 2012.

Mark Wadsworth said...

Yes, agreed, of course, seeing as it is time for me to wish you Happy New Year, let me remind you that we've a whole 'nother year of this to look forward to, and then after that a whole 'nother year and so on for ever.

Good list by Gary K.

Anonymous said...

“It's awful to see working class people enjoying their little sins, isn't it?”

I’ve often wondered whether that’s why there is an admittedly, (thank goodness) small but irritatingly opportunistic lobby which seeks to ban boxing – traditionally a working-class sport – whereas there is absolutely no such lobby demanding an end to rugby – traditionally an upper middle-class one.

Also, Mick,

I imagine that aristos enjoy the hedonism of fags, booze and scoff as much as any other social class.

Yes they do – very much so. But it’s the middle classes who are doing most of the complaining and who form the majority of the Healthist movement, that’s one of the reasons why they hate smoking (and, now, drinking) so much. If there’s one thing that a middle-class I-wish-I-was-upper-class snob hates more than anything else, it’s seeing the local landed gentry rubbing friendly shoulders over a beer and a cigarette with the “peasants” – something which used to happen a lot in country pubs before the ban, and yet another reason for the push for the ban with no exceptions.

the prog said...

Anon, rugby is often followed by extreme binge drinking. Always has been - when I was a university (73-77), certain student bars were often best avoided post match days (apart from when strippers were on the bill*). Thing is, the resulting animal behaviour was usually done in relative privacy and thus never witnessed by Joe Public (I recall one individual taking a shit in front of the bar).

*=Live sex show (minus erections...)

Anonymous said...


Absolutely. Rugby players have always been known for their big drinking bouts post-games, at all levels – it’s even part of the tradition for the teams to buy each other a huge jug of beer after the game which in and of itself must surely be what Healthists would delight in calling “encouraging” binge drinking if they weren’t busy turning a blind eye. It would be considered most odd if you went to a rugby game and there was no alcohol available - spectators are allowed to visit the bar during the game and bring drinks into the stadium at any time, even at Twickenham (irritatingly, in a typically middle-class way, they have banned smoking, which is one reason why I don’t go to see as many matches as I used to).

And yet there’s not a peep about this from the embryonic anti-alcohol brigade because, as you say, all the unpleasantness associated with drinking too much is kept well behind closed doors so that rugby supporters maintain this jolly-hockey-sticks image that when they get drunk all that happens is that they tell a few bawdy jokes, slap each other on the back in a manly way and sing a few rude songs.

It seems that, just like in some sections of the anti-smoking movement (CAMRA springs to mind) whereby some smokers are seen as “better” than others (i.e. the comment by one of their members about people who smoke “good” tobacco as opposed to those who smoke nasty, smelly “cheap” tobacco), there is a subtle form of snobbery already at work in the anti-alcohol movement also, whereby some drunken antics are deemed unacceptable whereas others are seen as just “harmless fooling around after a few drinks.”

And hypocrisy at this level is a very, very middle-class trait.

Anonymous said...

Dear Mr Puddlecote

Has any thought of the children?

Consider the costs of having children: pre-natal care, peri-natal care, natal care, post-natal care, baby health costs, child health costs, education, more health costs, dental costs, more education; plus food, clothes, birthday presents, parties, Christmas presents, parties, holidays, parties, Mum's taxi service to all manner of extra-curricular activities which may or may not involve vet's fees and special clothing, parties, iPhones, iPads, iChings – especially the cash registers – Xboxes, Yboxes and – next year – Zboxes.

The list is endless; the costs also.

I say children should be banned.

The costs to society are unbearable.

Need I say more?


J Bonington Jagworth said...

"heading a soccer ball can lead to traumatic brain injury"

Judging from the standard of most post-match interviews, I think perhaps it's the other way round...