Herrick, C.B.; (2008) Governing the "obesity epidemic": putting preventative public health to work in London and Austin. Doctoral thesis , University of London.

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Abstract

Recent calls for a critical geographical approach to public health have facilitated an engagement with a new range of research topics and methodologies, of which obesity is a particularly prescient example. This thesis aims to first, examine and compare obesity's historical emergence in the UK and US through three conceptual spheres: governmentality the political economy of food and cultural anthropologies of consumption. Second, this work questions what obesity, as both a biomedical epidemic and one of meanings, reveals about the tensions inherent within neo-liberal governance in the two countries through examples of obesity prevention measures in London and Austin, Texas. This work charts and critically interrogates the emergence of a global epidemic of obesity in the last two decades with reference to the 'obesity studies' literature. This discussion then backgrounds an analysis of relevant policy documents and newspaper coverage showing how the biomedical epidemic has been rhetorically employed to create an "epidemic of signification", legitimating public health intervention. The UK Labour government has recently promised to "support informed choice", while in the US, the doctrine of "personal responsibility" with regards to health has been at the fore of obesity prevention policy. These epistemological differences are explored through findings from semi-structured stakeholder interviews, health survey data, censuses and market research. In the light of such discussions, the three conceptual spheres are revisited to compare and contrast the case study findings and investigate the tensions at work within UK and US neo-liberal governance. The thesis concludes that obesity is not a universal or generalisable global epidemic, but exhibits distinct and localised risk factors, health outcomes and costs that are inextricable from the wider systems of governance that both frame and manage the condition.

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