The Social Construction of Obesity in an Australian Preventive Health Policy

In Australia obesity is constructed by governments as a leading risk factor for major, preventable, non-communicable chronic disease. To investigate the failure of obesity policy to stop or reverse the prevalence of obesity in Australia over the last two decades calls have been made to better theorise obesity as a problem. Social constructionism is identified as a useful theoretical approach to analyse entrenched and socially complex policy problems. Based on social constructionism a Critical Social Constructionism methodology is created for use in this thesis and is based on aspects of Bacchi’s critical policy analysis methodology, ‘What’s the problem represented to be?’. The Critical Social Constructionism methodology is a practical and effective tool to critically analyse the policy problem representation of obesity. A specific example of obesity policy, the Australian Government Measure Up campaign along with the historical and broader policy context of that campaign are analysed. This analysis is assisted by the production of a schema of obesity representations that differentiates biomedical and social representations of obesity and by interviews with experts in obesity and preventive health issues. It is widely agreed in critical literature that the biomedical paradigm which was developed in response to acute and infectious diseases constructs health problems in a reductionist and individualistic way. The first major conclusion of this thesis is that the current dominant obesity problem for policy is constructed in a biomedical model with important underexplored effects. A second major conclusion holds that changing what the problem is represented to be from a biomedical representation of obesity to a social health representation faces extraordinary barriers that make such a project both impractical and improbable. Therefore this work explores the possibility of a radical disruption of the representation of the problem as obesity in policy. Alternative, ‘weightless’ representations of the problem within current research, public programs and medical practice are described and proposed for consideration in future policy making aimed at more effectively reducing the rates of major, preventable, non-communicable chronic diseases in Australia

Management of Childhood Fever by Parents: Literature Review

Having a sick child is an anxious time for parents who are frequently very concerned about their child and have difficulty assessing the severity of the illness (Kai 1996a). One of the main indicators of an illness is fever. Many parents consider fever to be harmful (Crocetti et al. 2001) and a disease in itself (Singhi et al. 1991). Parents often feel disempowered when their child is ill and that they are not caring appropriately for their child if they do not treat the fever (Kai 1996a). A number of articles describing parents’ concern about and inappropriate management of fever have been published in the medical literature over the past few decades. Educational programs developed to assist parents manage childhood fever have proven effective. (Casey et al. 1984, Crocetti et al. 2001, Sarrell & Kahan, 2003). Yet, parents remain concerned about and mismanage fever. They seek information about fever management and reassurance for their management practices from family, friends, health professionals, books, magazines and the Internet (eg., Impicciatore et al. 1998, Crocetti et al. 2001, Allen et al. 2002, Karwowska et al. 2002). Medical literature interest in parents’ management of fever appears to have originated from an article written by Schmitt in 1980 (1980) where he coined the phrase ‘fever phobia’ to describe parents’ unrealistic fears about fever. Since this time parents’ fever phobia, confirmed by their overuse of medical practitioners for minor febrile illnesses, has been the impetus for the majority of research in this area. Studies conducted in the 1980s were descriptive and undertaken predominantly in the United States with some in Canada and Saudi Arabia. During this decade only two controlled intervention studies were reported from the United Sates. The 1990s saw an international interest in fever phobia. Descriptive studies from the United Kingdom, Italy, India and Israel and intervention studies from the United States and United Kingdom were published. The quest to understand and enhance parents’ management of fever continues into the 21st Century as researchers continue their search to understand parents’ fever management concerns and trial new methods of improving parents’ management of childhood fever. However, no studies report Australian data