Is nudge an effective public health strategy to tackle obesity? NoBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d2177 (Published 14 April 2011) Cite this as: BMJ 2011;342:d2177
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Salary Wages Globalization, Compulsory Education in Health and Radical Lifestyle Changes are the True Clues.
Practice in the health sector has shown us that pushing people gently
is not a good strategic method to achieve evolutionary success in
solving the great current problems in people health around the world.
The Colombian health service has created and even now creates several
nonprofessional figures of health manpower to nudge people into
tackling problems related to malnutrition, and not only are there not
solutions, but there are also an increasing number of overweight people and a
higher morbidity and mortality rate from diabetes, hypertension, cardio
and brain vascular diseases. This kind of nudge has created more
corruption, nepotism, bad use of health economics resources and new forms
of dirty business.
After the sixties of the last century the Colombian Association of Medical
Faculties promoted a new educational dynamic and we passed from the
traditional Flexner medical educational system to another which focuses on
social dynamics as a strategy to bring students of nursing and
medicine to the most depressed suburbs and quarters to solve
the health problems of poor communities. The result was to fill the
medical and nursing curricula with a lot of subjects typical for students
from sociological careers.
In Colombia malnutrition is mainly the result of people's inability to buy
adequate foods rich in essential nutrients. As a second factor we can name
the people's failure to understand the importance of proper nutrition in
growth and development. A third factor is related to the coming of new
technologies, which are producing radical and critical changes in dynamics
of all societies around the world. A fourth factor is advertising and
permission of distribution and selling of dangerous street foods.
The correction of these situations requires:
To increase workers' salary wages, to a globalized economical level.
People don't have the necessary money for eating and living well.
We are living a similar time to that lived by people during the eighteenth
century when new engines and industrial procedures appeared, but with a
big difference, nowadays' machines are more powerful and productive than
those of the industrial revolution. For this reason it's necessary to
create a wide social security system for poorest people and to decrease
the big gap between riches and poor people.
To educate people at a primary humanitarian compulsory school (in Colombia
we have a basic primary one), in aspects related with the importance of
nutrition in human life and social behavior.
It's urgent and indispensable to prohibit and to eradicate forever
distribution and selling of rambler street foods.
Don't permit the official opening of restaurants, better called
"degradants", where people eat bad quality products, which don't have
indispensable nutrients for living and restoring our body. At street level it's
necessary to rule with a rod of iron.
To promote a new living culture characterized by a permanent daily
physical activity. It's necessary to move the people.
Competing interests: No competing interests