Several months ago now, I responded to a snarky tweet about celebrity chefs and, in particular, Jamie Oliver. The tweet wasn’t meant to be mean, but Oliver gets a hard time. Yes, his larger-than-life Essex wide boy image invites ridicule. But he has been tremendously successful, initially as a TV chef and then, perhaps inevitably to a lesser extent, in drawing attention to the importance of the quality of our food. Personal success is something many in the UK and elsewhere often regard with jealousy or resentment. Those who criticize Oliver often seem to have overlooked or dismissed the difficulty and significance of his achievements (in particular his positive influence on school meals). I have a knee-jerk reaction against people who knock Oliver, and on this occasion, I found myself defending him again.
Instead of arguing, @movito offered to buy me a copy of the book that had prompted his tweet. What a generous gesture, and what better way to frame a thought limited by 140 characters than to place it in the context of the book that provoked it? But I was secretly reluctant to accept the gift, because doing so would obligate me to actually read the book. Though I currently read as much or, likely, more than I ever have, I have become very bad at finishing long-form pieces. I suspect many of us suffer somewhat from this; the thing that did for me was studying for a PhD, which had the unforeseen effect of making non-academic reading a source of guilt. (My wife, who I met when we were both doctoral students, experienced the same thing.) By the time I was ready to start reading for pleasure again, the Internet had exploded, and I had a smartphone and an academic career. So, hello even more journal papers, Twitter, listacles, and liberal-baiting churnalism.
But one can’t receive a gift in this way and not read it — that would be rude. I finished the book several months ago now and wanted to write about it. (No good deed goes unpunished, @movito!)
The book is The Wellness Syndrome by Carl Cederström and André Spicer. The authors use wellbeing as a lens to examine modern life. They are interested in the relationships between the individual and societal bodies such as governments and employers, and in how those relationships are often framed in terms of health and wellness. These relationships are examined from the perspective of the individual, who is subordinate to those bodies, under the premise that those bodies position societal and organizational ills as a result of individual ills (whether physical, mental, or moral), thereby displacing the responsibility and agency for fixing systemic and societal ills onto the individual. The tools for achieving individual wellness are then, therefore, the tools for achieving societal and organizational wellness.
I’m afraid I disliked the first half of the book for two reasons. First, the authors reexamine accepted health risks such as obesity and smoking by linking their well-established deleterious effects on health with the moral judgements society now often makes about the behaviours of those at risk. But Cederström and Spicer then question these moral judgements in a way that seems to cast doubt on the veracity of the health risks themselves — a potentially dangerous rhetorical backflip. While it’s always reasonable to reexamine our understanding in the presence of new data and as our standards of scientific practice improve over time — indeed, science requires us to do this — here Cederström and Spicer seem to be trying to create false evidence through argument alone.
My second complaint is that much of The Wellness Syndrome is justified by citing writers who have made supporting arguments, rather than by presenting new — or explaining existing — evidence. (Ideally the authors would also consider contradictory evidence, but do not.) Perhaps I’m used to reading original research, but I find that pointing to other people who agree with you is a poor way to support a thesis, but an effective way to make uncritical readers agree with you (see for example the bandwagon effect). The authors’ examination of smoking bans and organizations with policies of not hiring smokers is particularly irritating. The earliest smoking ban is traced to Nazi Germany and its treatment of smokers as second-class citizens. The authors’ trick here, that the Nazis were bad and banned smoking, and therefore perhaps smoking bans are bad, is so naïve that I wonder if even the authors believe what they have written, or if I am taking them far too seriously. The book is, after all, laden with comical hyperbole. At one point, Cederström and Spicer describe Jamie Oliver as a middle class reformer who thinks he can transform organic focaccia “into something which might save the neglected children in deprived communities across the world”.
Lack of reliance on primary evidence is Cederström and Spicer’s undoing. Their already weak moral examination of smoking is, to me, entirely neutered by the strong evidence that modern smoking bans have succeeded in improving short-term health and reasonable proxy measures of long-term outcomes. For example, after Scotland banned smoking in public places in 2006, studies of the ban’s effects found that hospital admissions for heart attacks had decreased by 17%, that secondhand smoke exposure had decreased by 39% in schoolchildren and 49% in adult non-smokers, and that saliva nicotine levels in non-smoking bar staff had decreased by 89%. There are interesting debates to be had about the merits and demerits of population-level health interventions such as smoking bans and water fluoridation, and whether organizations should be allowed to discriminate in their hiring practices against people who engage in unhealthy but legal behaviors, but I think those debates need to be rooted in evidence, not rhetoric.
While I have some complaints about the book, I did ultimately take something useful away from reading The Wellness Syndrome. It made me think about my own and society’s moral judgements about wellness. None of us are perfect in our health choices or moralizing, and we could benefit from thinking more carefully about both. I sometimes now spot myself making unfair moral judgements when I see someone obese and clearly unwell, eating something that is only going to make their situation worse. I’m not comfortable that I (and presumably we as a society) do this. Ultimately, I think the book presents a reasonable hypothesis: that by associating personal ills and personally deleterious health behaviors with poor morality, we create a convenient class of scapegoat for societal and organizational ills.
On the now infamous Turkey Twizzlers served in British schools, the book points out that while such foods can be blamed for poor educational outcomes among lower-working class British children, the food those children are fed at school is determined by “broader government education policy, by deeply entrenched class structures in British society, by systemic unemployment, or even by the vagaries of global capitalism.” I recently spoke with a British school-leaver about how their school tuck shop was replaced by a Starbucks concession, from which pupils bought thousand-calorie Frappuccinos before returning to class just in time for the sugar crash. If education policy, class structures, and market forces represent a serious influence on our children’s diets and educational outcomes, we need reformers like Oliver more than ever.
