Weekend Revelations #1 – Dr Jonathan Coleman

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2008

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In June 2008, the then-Labour government – realising that child obesity was becoming a major health and social problem – moved to reduce the availability of unhealthy foods from schools;

TDB Recommends NewzEngine.com

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What could be wrong with providing healthy food options for our children? Who could possibly object to fighting obesity in our youngest citizens, who are vulnerable to the highly-processed, addictive, sugary and fatty foods that are a plague on Western (and increasingly developing) contries?

Who indeed…

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2009

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Schools' healthy food rule scrapped

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Yes, folks, evidently ensuring that the next generation of New Zealanders do not die  prematurely from heart disease, stroke, diabetes, etc, etc, from eating processed sugar/fat/salt-laden “food” is  now officially “nanny statism“. Apparently, then-Education Minister, Anne Tolley*,  was suffering deep angst over sausage sizzles;

“There was a great deal of angst about things like, when you’re having a school gala, can you have a sausage sizzle on site, can you lay down a hangi?”

Which raised the obvious question; were schools holding sausage sizzles every single school day, and feeding charcoalled ‘bangers’ to kids?

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2011

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As National maintained a  hands-off stance to our growing obesity problem, the consequences became obvious;

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According to the Ministry of Health;

New Zealand has the third highest adult obesity rate in the OECD, and our rates are rising. Almost one in three adult New Zealanders (over 15 years) is obese, and one in ten children.

This is unsurprising. Doing nothing about obesity and refusing to act decisively on combating a torrent of cheap, unhealthy “food”, has it’s natural consequences.

What is surprising to this blogger is that National has not tried to curtail or ‘massage’ Health Ministry data-collection on this problem, as it has done with child poverty. Or Crime statistics (more on this in an up-coming blogpost).

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2015

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One of the best strategies for reducing consumption of unhealthy food such as sugary carbonated drinks is to tax the product.

Mexico implemented a 10% tax on ‘fizzy’ drinks on 1 January 2014. This was was enacted as Mexican authorities realised the gravity of growing  obesity and related problems amongst their people;

Campaigners and public health experts are watching closely to see what impact Mexico’s tax has on consumption. Mexico, where 32.8% of the population is obese, is now the country with the biggest weight problem in the world, according to the UN’s Food and Agricultural Organisation, overtaking the United States. The impact on health has been serious – 14% of the population has diabetes. Rates of high blood pressure, which can lead to stroke and heart attacks, are also high.

It worked.

A year and a half later, and the consumption of ‘fizzy’ drinks has dropped by   6% to 12% in the first year;

A tax on Coca-Cola and other sugar-sweetened drinks in Mexico has succeeded in bringing down sales, which experts hope will help curb the nation’s obesity problem.

The 10% tax was implemented on 1 January 2014 after a battle with the beverage industry. More than 30% of the Mexican population is obese and a love of Coca-Cola and other sugary drinks has been held at least partly responsible. The average Mexican drinks the equivalent of 163 litres of Coca-Cola a year, or nearly half a litre a day.

The Mexican National Institute of Public Health and the University of North Carolina have now carried out an evaluation of the impact of the tax, which shows it cut purchases by an average of 6% across 2014, and by as much as 12% in the last part of the year.

The effect was greatest on lower-income households, who cut their purchases by an average of 9% across the 12 months, and by 17% in the later months. The impact appears to be similar to that of taxes on tobacco and other goods that are hard to give up, where the drop in sales increases over time.

As with taxing tobacco products in New Zealand – a method proven to work – increasing the price of an unhealthy product reduces consumption. Especially amongst the poor, who are particularly susceptible to pernicious marketing and supply of cheap, unhealthy ‘foods’. A Parliamentary report here in New Zealand showed that obesity was especially prevalent in lower socio-economic areas;

In 2012/13, a Ministry of Health-led survey estimated that three out of ten New Zealand adults were obese (31.3%), an increase of 2.7% from 2011/12  and an increase of 18.6% in the 25 years since 1989   Obesity rates were highest amongst Pacific adults (68%) and Māori adults (48.3%).

The same survey found that after adjusting for age, sex, and ethnicity, adults living in the most socioeconomically deprived areas were 1.5 more times as likely to be obese as those living in the least deprived areas.

However, our esteemed ‘Health’ Minister, Dr (!) Jonathan Coleman was/is not convinced.

On 28 June, speaking on TVNZ’s Q+A, Dr Coleman said;

Dr Jonathan Coleman: Not necessarily. No, the evidence doesn’t show that. If you look at the evidence for sugar tax, right, it shows actually it’s very low in terms of disability-adjusted life years lost, so that’s basically saying that, look, there’s no evidence that it’s going to end up with people living longer, healthier lives. What there is evidence for is actually eating less and exercising more, and so I’m focusing my efforts on education, getting people to actually live more healthy, active lifestyles. Sugar taxes get a lot of attention. No evidence that it works.

Four months later, in an interview with Dr Jonathan Coleman, on TV3’s The Nation, on 24 October;

Patrick Gower: Looking at a soft-drink tax –why not?

Dr Jonathan Coleman: Because, actually, there’s not the conclusive evidence, right? There might be a correlation in those Mexican studies, so they put a 9% tax on soft drinks.

Patrick Gower: And consumption dropped. That’s evidence, isn’t it?

Dr Jonathan Coleman: Sales decreased, but it’s not clear if that’s a correlation or a causative effect, so there were other things going on – a tanking Mexican economy, $30 billion drinking-water programme. It’s also not clear if there’s substitution to other beverages. So we’re saying, look, you know, there’s some evidence that’s being assessed – it’s going to be reported on in 2017 at Waikato University as well as the University of North Carolina – but there isn’t any direct evidence of causation that anyone can point to.

Patrick Gower: Well, the World Health Organization, which put out that major report recently, led by our own Sir Peter Gluckman, you know, that has said, and I will quote it for you, ‘The rationale and effectiveness of taxation measures to influence consumption are well supported by available evidence.’

Dr Jonathan Coleman: Well, they might be talking about a decrease in sales. But what we want to know about is – is there a link to obesity directly? So, for instance, there might be a decrease in consumption of soft drinks, but are people drinking more flavoured milk? Are they drinking beer as a substitution? What is says in that report is that, actually, there isn’t clear evidence. On balance, they recommend it, but, look, that’s the WHO, you know? You would expect that they would take a very purist view. And I met with the commissioners personally. I talked to Sir Peter Gluckman.

Patrick Gower: What about this for evidence? If a tax doesn’t work or there’s no evidence for it, what about with cigarettes? Because your own government’s putting up the price of cigarettes and saying that that is working to stop smoking.

Dr Jonathan Coleman: Well, that’s a different issue. So, yes, if you put a tax on something, it will decrease consumption, but what I’m interested in is – will that decrease obesity? So say, for instance, we tax something. You might drink less Coke, but are you drinking beer or flavoured milk instead?

This was an interesting exchange between Gower and Coleman. Note that his first contention is that sugar taxes do not work;

“Because, actually, there’s not the conclusive evidence, right? There might be a correlation in those Mexican studies, so they put a 9% tax on soft drinks […]  Sales decreased, but it’s not clear if that’s a correlation or a causative effect […] but there isn’t any direct evidence of causation that anyone can point to…

But only a few seconds later, Coleman makes this startling admission;

“So, yes, if you put a tax on something, it will decrease consumption…”

That was a slip on his part. The National Party politician in Dr Jonathan Coleman was instructed to parrot the official line: ‘there is no evidence that sugar taxes work‘ (even though that is precisely the same mechanism used to reduce tobacco consumption).

But the other part of Dr Jonathan Coleman – the doctor part – knew deep in his soul that a tax on anything will affect consumer behaviour. There is a part of Jonathan Coleman that, as a doctor of medicine, wants to help people, and National’s luke-warm, ineffectual “22 initiatives” will not placate that desire in him.

As bad as those “22 initiatives” are, National has heaped insult upon injury by funding the policy  “from within existing health, sport and education budgets“.

Millions will be taken from health, sport, and education, to fund a policy of “initiatives” that are a sop to the sugar and food industry, and not designed to address the problem at it’s core; the widespread availability of cheap, unhealthy, sugar/fats/salt-laden ‘food’.

How many hip replacement operations or classroom re-builds were sacrificed or postponed, to fund this rubbish “initiative package”?

It is interesting that Dr Coleman has rejected implementing a tax on sugary drinks and other foods because of a “lack of evidence”.

In March 2009, National scrapped the previous Labour governments healthy-food-in-schools programme. This allowed school cafetarias/”tuck” shops – many run by private companies – to again return to the practice of selling unhealthy foods to children.

When Corin Dann challenged Dr Coleman on Q+A on 28 June, he said;

“You reversed the rules on the tuck shops, on the canteens at schools, so there’s sugary foods and all that sort of stuff gone back in there.”

To which Minister Coleman replied;

“That’s because they weren’t working.”

If that is the rationale used by Jonathan Coleman to justify wrecking the healthy-food-in-schools programme, then the Minister should be deeply, deeply ashamed of himself.

The policy had been in effect only nine months (see above screen-grabs, 2008 and 2009). There was simply insufficient time to assess the programme. Of course there was “no evidence” – the programme was aborted before it could be gathered!

By comparison, the Mexican sugar tax has been in effect since 1 January 2014 – nearly two years. Consumption of carbonated sugar drinks has fallen dramatically.

The evidence exists: sugar taxes, like tobacco taxes, work.

But this is not about “evidence” at all. If National was keen on gathering evidence, it would have permitted Labour’s healthy-food-in-schools programme to continue until it could be properly evaluated.

If National was interested in evidential-based policies, it would be studying the Mexican result keenly.

And if National valued the advice from it’s own science-advisor, Dr Peter Gluckman, it would listen. As Dr Gluckman pointed out on 30 July, on TV3;

“The issue around these taxes is, how much tax would you have to put in to change behaviour? I think they’re a really important signal, and it does look from the preliminary evidence from Mexico that taxes on sugary beverages do reduce consumption.

No, evidence does not factor in National’s actions.

This is about corporations; profits; and free-market ideology. As former-NZ Herald columnist, Dita De Boni wrote in her excellent piece on obesity, on 3 July;

“If we are intent on reducing health spending on obesity, it will come – but only when political ideologues like Jonathan Coleman and the food lobby are comprehensively uncoupled.”

In this instance, evidence is not only not welcome by National, it is downright embarrassing.

Parents throughout the country should be alarmed at what this government is doing. Or, more accurately; not doing.

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Postscript

Former-NZ Herald columnist, Dita De Boni wrote an incisive piece on obesity, on 3 July – “Giving us a fat chance against obesity“. Ever insightful, and a master at prose and skilled, liberal use of facts, Ms De Boni’s column was scathing of National’s do-nothing stance on our growing obesity crisis.

Further down the online page, in the Comments section, was this chilling, prophetic comment left by “Cathy”;

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Ms De Boni was dumped from NZ Herald on 10 August. “Budgetary considerations” were given as the official reason.

“Cathy” would do well with Lotto or putting bets on horses.

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References

NZ Herald: Greasy school tuckshop food on way out

World Health Organisation: Healthy diet

Fairfax media: Schools’ healthy food rule scrapped

Radio NZ: More weight loss surgery funded

Ministry of Health: Obesity

Scoop media: Combating poverty more important than measuring it

NZ Herald: ‘Ghost crime’ stats may be probed

The Guardian: Mexico enacts soda tax in effort to combat world’s highest obesity rate

The Guardian: Mexican soda tax cuts sales of sugary soft drinks by 6% in first year

NZ Treasury: Increase in Tobacco Excise and Equivalent Duties

Parliament: Research papers – Obesity and diabetes in New Zealand

Fight the Obesity Epidemic (FOE): NZ: National reversal on healthy food in schools “incredible”

TVNZ Q+A: Coleman – We’ll tackle obesity but no tax or legislation

TV3 The Nation: Health Minister Jonathan Coleman

National Party: Dr Jonathan Coleman

Facebook: Dr Jonathan Coleman – 22 health initiatives

TV3: Don’t rule out sugar tax – PM’s chief scientist

Additional

NZ Herald: Dita De Boni – Giving us a fat chance against obesity

Other Blogs

The Pundit: Children’s Commissioner fronts for Nats on food in schools: Corporate agenda rules

The Daily Blog: Has the Government manipulated Corrections statistics as well?

Brooking Blog: Corrections cuts crime with the selective use of statistics

Previous related blogposts

Can we afford to have “a chat on food in schools”?

10 August: Unhealthy Health Cuts

When is ‘Nanny State’ not a ‘Nanny State’?

From “Nanny” State to “Natzi” State?

You’ll have a free market – even if it KILLS you!

Why did the fat kiwi cross the road?

*Also on Anne Tolley

Anne Tolley’s psycopathy – public for all to see

The law as a plaything

A fitting response to National MP’s recent personal attacks on Metiria Turei

On ‘The Nation’ – Anne Tolley Revealed

“I don’t know the details of that particular family” – Social Development Minister Anne Tolley

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16 COMMENTS

  1. How can Health Minister Jonathan Coleman, as a former medical practitioner, deny internationally accepted evidence-based research that shows taxes on sugary food and drinks, limiting junk food advertising, and provision of free, healthy food in schools are three significant ways to improve children’s health and reduce obesity? Provision of healthy food in schools for breakfast and lunch would reduce children’s craving for junk food and improve their ability to concentrate and learn, having long-term health and social benefits by reducing long-term negative costs to the State, of people who were not able to learn due to socioeconomic deprivation. Provision of healthy food in schools would enable parents and guardians on low incomes to have more money to spend on accommodation costs and essentials such as power, water, clothing and other requirements.

    As a doctor, Jonathan Coleman would have taken the Hippocratic Oath that includes the statement, “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.” It is therefore bewildering that Coleman is part of the National Government, whose policies disadvantage the majority of the population, and in particular, the most vulnerable members of society, including people on low incomes, beneficiaries, State house tenants, people with disabilities, mentally ill people and elderly people.

    No doubt, most people who view themselves as “middle New Zealand” and consider people should take responsibility for themselves, including their health, would be outraged if their taxes contributed to helping others via healthy food in schools. This view is ironic, given that many “middle New Zealanders” are beneficiaries via the tax credit “Working for Families” and via their speculation and/or investment properties, which they rent out at very high costs to tenants who receive the accommodation supplement, funded by the taxpayer. Housing costs and property speculation are topics for another discussion.

    It seems that unless many “middle” New Zealanders are impacted directly by a serious health problem, in which case they are most likely to be treated in the taxpayer-funded public health system, or lose their jobs or property, in which case they will expect taxpayer funded support, they are unlikely to show any concern or compassion for people, including children, who experience socioeconomic deprivation and its consequences, which include major health problems.

    • +100 Vivie.

      Excellent article Frank and an equally excellent response Vivie. You explain everything so clearly, especially the short-term and long-term benefits of healthy food in schools, and the rationales for having a sugar tax and limiting junk food ads.

      As a doctor (and as a human being), Jonathan Coleman should be ashamed of himself for denying evidence-based truths, propping up his corporate mates, and further disadvantaging the most vulnerable people in society. Very reptilian of him.

    • Colman has no morals again he fits NatZ corrupt lot as business champions of whatever they sell even if it is bad for our health Government will gladly endorse those toxic food stuffs just to appease the business community at the expense of public health.

      They are criminally liable for the damage they are knowingly causing the public without providing adequate warnings and legislation.

  2. Sugar = addiction = obesity = likely ongoing health issues throughout life.

    Sugar tax = decreased sales = less profits.

    Less profits for junk food manufacturers/outlets = reduction in donations for NatzKEY.

    Bottom line = keeping the corporate cronies in business = to hell with the Hippocratic Oath!

    See where the ‘good’ Dr Coleman is coming from here?

  3. Well, to be fair, NZders in general over over-sugared, so there is something to be said for making it harder for kids to guzzle that fizzy down like water as though dying of thirst. I think it’s safe to say that relying on parents to do the work isn’t going to do the trick when pretty much everything is over-sugared already. It’s a complex issue that does very much need to be addressed nationally just as much as locally, and it’ll require public and private measures both.

    Still, the particular way this guy Colman wants to go about it? Not very smart. Also…I’ll be honest; it’s hard to take Colman the GP seriously, when he excepts invites from British American tobacco to watch Bono.

  4. As always, well researched and logically argued.

    Coleman should indeed be ashamed of his actions. If, as a doctor of medicine, he does not understand the link between increasing sugar consumption and obesity, and the positive influence of a sugar tax, then he is not fit to hold a practicing certificate.

    • He understands. I doubt the man’s that obtuse. But he’s a Tory politician, and as such expected to tow the party line, ethics be damned. If you start pointing out awkward facts, upsetting National Party donors and generally embarrassing people in high places, well… then you end up like Judith Collins — ostracised and no longer permitted to hang out with the cool kids. (It’s been a long road back for the Wicked Witch of the Eastern Suburbs.) Given the venal nature of these people, I suspect they’d have a penchant for holding grudges, and Dr Coleman could find his future job prospects looking somewhat bleaker than he’d like. Always looking out for number one — it’s the Tory way.

  5. those nats, eh? Just when you think they’d plumbed the depths, they find a new low. Its just embarrassing.

  6. One of the best strategies for reducing consumption of unhealthy food such as sugary carbonated drinks is to tax the product.

    Well, that’s one way and it does have an effect. The other way is to regulate how much sugar can be added to processed food. Keep it somewhere near zero.

    If National was interested in evidential-based policies, it would be studying the Mexican result keenly.

    National are only interested in boosting the profits of the private sector. Actual facts get in the way of that.

    • Even the zero sugar options, like Coke Zero and Pepsi Max, induce an insulin response. The brain notices the sugar substitute, it tastes sweet, and produces insulin as a natural response. Too much over too long a time will still assist in development of diabetes, a major problem in NZ.

      The whole lot should be taxed to hell. If we’re going to use taxes to change consumption behaviour. But I’m pretty sure the big multi national corporations that make the stuff have the governments ear.

  7. Having worked in the supermarket trade, you realise how much shit New Zealanders are eating when you see the truck loads of snack foods and fizzy drinks going through the stores.

    New Zealanders are drinking Coke as it is cheaper than bottled water, and eating junk food because it is cheaper than fresh fruit and vegetables.

    Coleman is an idiot and obviously got his medical qualifications out of a Weetbix Packet.

  8. Coleman is playing politics with children’s lives. There is no other way to describe his appalling lack of action.

    By the way, Frank, I showed your blogpost to my neighbour who has been a National voter since 2008. She was disgusted and will be voting Green party next time. I’ve sent her the link to the Daily Blog to keep an eye on your future articles, which she’ll be sharing with her playgroup parents.

  9. When a household product like tomato sauce is roughly one third sugar, you know there is a serous problem.

    Jonathan Coleman is engaging in harm-trivialisation and is not fit to be a doctor of medicine.

  10. The guy should have his doctors licence revoked, thank god he is no a practicing medical practitioner at the moment.

Comments are closed.