People who have a poor diet, smoke or are physically inactive are generally most opposed to public health authorities imposing preventive health measures. Photo: Shutterstock, NTB Scanpix

People who need health care advice the most like it the least

Most people think it’s a good thing that public health authorities propose preventive health measures. The greatest resistance is found among individuals who need these measures the most – such as smokers, people with unhealthy diets or who don’t exercise.

Lifestyle diseases affect a lot of us. The obesity epidemic, tobacco, alcohol and inactive lifestyles are straining health care systems in many parts of the world. That has led authorities in several countries to take preventive health measures.

What do people in Norway think about the authorities imposing preventive measures to help us live more healthy lives? That question has remained unanswered – until recently.

Targeted population the most negative

Telling me what to do? Many people say thanks, but no thanks. Photo: Shutterstock, NTB Scanpix

People who have a poor diet, smoke or are physically inactive are generally those most against the authorities taking such initiatives, says PhD candidate Gloria Traina at the University of Oslo’s (UiO) Department of Health and Society.

In other words, the targeted population for these measures are the most negatively oriented towards them.

A research team from the University of Oslo and NTNU analysed data from a study conducted by the Norwegian Heart and Lung Patient Organisation (LHL) in 2015. In the study, 2689 people were asked about their own health and lifestyle, their attitudes towards personal responsibility for their own health and the authorities’ responsibility for health promotion measures. The sample of respondents represented an approximate cross-section of the adult Norwegian population.

Traina, Associate Professor Eli Feiring at UiO’s Department of Health and Society and Professor Pål Erling Martinussen at NTNU’s Department of Sociology and Political Science collaborated on the article.

Patient co-pay unconnected to lifestyle

To date, Norway’s health care system takes care of people when they get sick, regardless of their lifestyle choices.  But in several other countries, it’s been suggested that lifestyle choices should be linked to how much a person has to pay to receive treatment.

The idea that we all have personal responsibility for our own health is supported across the board as a kind of ideal. But only one-third of the survey respondents wanted people who chose an unhealthy lifestyle to be charged a higher co-pay for treatment.

Women are somewhat more supportive of the authorities sharing preventive health advice than men are. People over 60 are on average the most negative towards this work.

Both a personal and a societal responsibility

Norway’s Minister for the Elderly and Public Health, Sylvi Listhaug, was criticized for saying that people should be allowed to “smoke, drink and eat as much red meat as they want. The authorities are happy to inform people, but I think most people know what’s healthy and what’s not.” Now it seems that most voters still want the authorities to continue offering advice. This sentiment applies regardless of the respondent’s political positions, Martinussen says.

The study shows support for society taking responsibility for the health of the population.

“But this view doesn’t preclude simultaneous strong support for individual responsibility for one’s own health,” says Martinussen.

Source: Being Healthy, Being Sick, Being Responsible: Attitudes towards Responsibility for Health in a Public Healthcare System. Gloria Traina, Pål E Martinussen, Eli Feiring. Public Health Ethics, Volume 12, Issue 2, July 2019, Pages 145–157, Published: 24 June 2019. https://doi.org/10.1093/phe/phz009