On March 11, New York City’s new ban on selling jumbo-sized portions of sugar-sweetened drinks was struck down by the New York State Supreme Court, a decision the city plans to appeal. In a New England Journal of Medicine Perspective article, Amy Fairchild, PhD, professor of Sociomedical Sciences at Columbia University Mailman School of Public Health, assesses the merits of the policy and situates it in an historic context. On the one hand, the ban is seen as an affront to individual choice or, because it sets a limit on just a single behavior, “a drop in the bucket,” far short of what’s needed to address the obesity problem. On the other hand, the policy represents a challenge to corporate behaviors: “If we see supersized drinks not in terms of the individual’s freedom to be foolish but instead as a kind of industrial pollution that is super-concentrated in impoverished neighborhoods, limits on drink size become a far different kind of regulatory measure,” writes Dr. Fairchild.
These bifurcated takes on the soda-size measure mirror an historic shift in the role of public health policy from a focus on social reform and industrial regulation to a focus on individual behavior, argues Dr. Fairchild. Continuing debate over the role of public health, particularly relating to behavior involving a hazardous product like tobacco, often orbits around questions of individual liberty, not the target of regulation, which is corporate behavior. While the New York City policy is weak from the standpoint of changing individual behaviors, it could open new avenues to changing corporate behavior that puts profits ahead of people’s health. If we embrace a challenge to businesses that profit from oversized portions, Dr. Fairchild concludes, “perhaps we can take on other corporate enterprises that similarly contaminate our social environment.”