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An Ounce for Prevention… Germany’s Public Policy on Health Promotion and Disease Prevention

Published online by Cambridge University Press:  20 January 2017

Kathrin Loer*
Affiliation:
Fern-Universität Hagen

Abstract

This section discusses the regulation of “lifestyle risks” a term that can apply to both substances and behaviours. Lifestyle risks take place along the line of “abstinence - consumption - abuse - addiction”. This can concern substances such as food, alcohol or drugs, as well as behaviours such as gambling or sports. The section also addresses the question of the appropriate point of equilibrium between free choice and state intervention (regulation), as well as the question of when risks can be considered to be acceptable or tolerable. In line with the interdisciplinary scope of the journal, the section aims at updating readers on both the regulatory and the scientific developments in the field. It analyses legislative initiatives and judicial decisions and at the same time it provides insight into recent empirical studies on lifestyle risks.

Type
Reports
Copyright
Copyright © Cambridge University Press 2016

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References

1- “Act on enhancing health promotion and prevention”.

2- BGBl.I S. 1368.

3- There are many useful studies in public health on that. For comprehensive overviews see especially for the U.S. Freudenberg, Nicholas, Lethal but legal: corporations, consumption, and protecting public health (New York: Oxford University Press, 2014) Google Scholar, and for Europe and the US Vogel, David, The Politics of Precaution. Regulating Health, Safety, and Environmental Risks in Europe and the United States (Princeton: Princeton University Press, 2012)CrossRefGoogle Scholar.

4- Overview: Roberto, Christina A. and Kawachi, Ichiro, Behavioral Economics and Public Health (New York: Oxford University Press, 2016)Google Scholar, Alemanno, Alberto and Garde, Amadine, Regulating lifestyle risks: the EU, alcohol, tobacco and unhealthy diets (Cambridge: Cambridge University Press, 2015)Google Scholar.

5- Thaler, Richard H. and Sunstein, Cass R., Nudge. Improving Decisions About health, wealth and happiness, 13rd ed. (London: Penguin Books, 2009)Google Scholar.

6- For examples see Plickert, Philipp and Beck, Hanno, „Kanzlerin sucht Verhaltensforscher”, 26 August 2014, available on the Internet at <http://www.faz.net/aktuell/wirtschaft/wirtschaftspolitik/kanzlerin-angela-merkel-sucht-verhaltensforscher-13118345.html> (last accessed on 14 September 2015)+(last+accessed+on+14+September+2015)>Google Scholar.

7- This does not mean that there were no academic efforts to analyse public health policy (promotion and prevention), something that can be observed. However, these approaches at least “played the second fiddle” in practical health (care) policy and in policy research on health systems.

8- Resolution A/RES/66/2. Political declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. In: Resolutions adopted by the General Assembly at its 66th session. New York: United Nations; 2012. Available on the Internet at <http://www.un.org/Depts/dhl/resguide/r66.shtml> (last accessed 16 May 2016). See for example WHO’s programme to “reduce the exposure of populations and individuals to the risk factors for NCDs” <http://www.who.int/nmh/resource_centre/strategic_objective1/en/> (last accessed 16 May 2016), or the diversity of EU policies tackling chronic diseases http://ec.europa.eu/health/major_chronic_diseases/policy/index_en.htm (last accessed 16 May 2016)

9- Cited in: Kiel, Daniel, “An ounce of prevention is worth a pound of cure: Reframing the debate about law school affirmative action88, Denver University Law Review (2011), p. 791 Google Scholar.

10- For an overview of early research on obesity see Sobal, Jeffrey and Stunkard, Albert J., “Socioeconomic status and obesity: A review of the literature105, Psychological Bulletin (1989), pp. 260275 CrossRefGoogle ScholarPubMed. For a global comprehensive survey see Di Cesare, Mariachiara, Khang, Young-Ho, Asaria, Perviz et al. “Inequalities in non-communicable diseases and effective responses”, 981, The Lancet (2013), pp. 585597 CrossRefGoogle Scholar.

11- In the tradition of Immergut, Ellen M., Health politics interests and institutions in Western Europe, 1st ed. (Cambridge u.a.: Cambridge University Press, 1992)Google Scholar, Bandelow, Nils C., Gesundheitspolitik -Der Staat in der Hand einzelner Interessengruppen? Probleme, Erklärungen, Reformen, 1st ed. (Opladen: Leske + Budrich, 1992)Google Scholar.

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13- Formerly known as Gib Aids keine Chance (https://www.gib-aids-keine-chance.de), and in April 2016 established as LIEBESLEBEN due to the spread of different sexually transmitted diseases.

14- For an overview see Stoeckel, Sigrid and Hirschberg, Irene, Prävention und Gesundheitsförderung - welche Rolle spielt die Gesundheitspolitik? Ein historischer Rück- und Ausblick, 72 Gesundheitswesen (2010), pp. 3540 CrossRefGoogle Scholar.

15- In 2013 (election campaign) the German Green Party suggested the introduction of a “Veggie Day”. Thus, lunchrooms and cafeterias should start to offer only meatless meals once a week (see: Knus, Thorsten, “Der Speiseplan im Wahlkampf”, 6 August 2013, available on the Internet at <http://www.fr-online.de/politik/veggie-day-der-speiseplan-im-wahlkampf,1472596,23924102.html> (last accessed on 14 September 2015)+(last+accessed+on+14+September+2015)>Google Scholar.

16- A comparison of the German Länder shows a clear east-west divide, where public health institutions in East Germany are more accepted due to the history of the public health system of the GDR.

17- Hall, Peter, “Policy paradigms, social learning, and the state25 Comparative Politics, (1993), 275296 CrossRefGoogle Scholar.

18- Ibid. at 278f.

19- The following concentrates on qualitative characteristics. For information purposes: with the PrävG the budget for prevention policy has been increased by 35 million Euro.