The Pharmaceutical Journal
Vol 273 No 7322 p622
23 October 2004

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Addiction to the goggle box more
Global health and moral values interact more
Grim warnings about the prospect of disastrous climatic warming more

Addiction to the goggle box

Two articles published in The Lancet for 17 July draw attention to the unhealthy aspects of too much television watching by children and adolescents.

The first article, from a group of investigators in New Zealand, examines the amount and type of television viewing indulged in by individuals between the ages of five and 21 years. The authors comment that in developed countries the time spent in front of the box during childhood and adolescence may even exceed the time spent in school, provoking concern that such a habit might have adverse effects on health both of the child and of the adult. Not only might it displace more energetic activities but it might also encourage poor eating habits, violent behaviour and substance abuse.

Previous studies have linked television viewing to obesity, poor physical fitness, lipid abnormalities and the smoking habit, but the long-term outcome in terms of later adult health seems not to have been addressed. Between the ages of five and 15 years the amount of viewing correlated with lower socioeconomic status, increase in parental smoking, higher maternal and paternal body-mass indices and body-mass index at age five.

Although television viewing went hand in hand with excessive weight, poor cardiorespiratory function, raised serum cholesterol and adolescent cigarette smoking, no significant association was discovered with blood pressure. Television advertising in New Zealand tends to promote an unhealthy diet and influence other behaviours such as cigarette smoking by offering undesirable examples, and this effect is independent of the family’s habits. Viewing habits established in childhood may persist into early adulthood and adults should lead by example by reaching for the off-switch. This should be a health priority.

In the second article, a commentary by investigators at Harvard University, it is stated that a typical child in the US watches television for 2.5 hours daily, which is more than 10 times the average time spent in vigorous physical activity. Mental health experts are also worried about television programmes encouraging violence. Other undesirable effects are weight gain caused by the neglect of physical activity, the depression of metabolic rate and the encouragement of unhealthy eating and drinking by food advertisements.

The food industry spends enormous amounts of money in advertising high-calorie poor-quality foods to children, making it more likely that they will request such foods from their parents. Unfortunately, television viewing during childhood tends to affect health later in life, by encouraging unhealthy choices.

Ultimately, “parents must reclaim from television the responsibility for educating and entertaining their young children”. There is a case for a ban on food advertisements aimed at children. Otherwise there is a distinct danger that another generation will be programmed to become obese.

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Global health and moral values interact

The prospects for human health in a world under increasing threat from AIDS, terrorism, environmental destruction and political indifference are problematical.

In October last year a meeting at Trinity College, Cambridge, discussed the effect of moral values and some of the points raised have been described by two experts in the 18 September issue of The Lancet. Programmes of public health launched by the World Health Organization have been directed towards controlling malaria, tuberculosis, poliomyelitis and tobacco use and, to achieve advances, here calls for the support of ethical and moral values. Technical excellence and political commitment are valueless unless there is an ethically sound purpose behind them. New global health programmes would be facilitated by applying common moral values. An approach based on rights or equity might be expected to differ from one that was utilitarian or humanitarian in nature. The moral soundness of a programme has in practice to be balanced against the imperative of achieving consensus among people who hold many different moral views.

Four major divisions of moral values commonly applied to global health matters are humanitarianism, utilitarianism, equity and rights. The essence of humanitarianism is embedded in nearly all religions. Compassion, empathy or altruism dictate action. This is the primary ethical basis of voluntary action undertaken by non-governmental organisations. Utilitarianism involves the happiness, pleasure or satisfaction of desires created in an individual by health measures. Improving health in deprived people is in everybody’s interest. Equity means the fairer distribution of health facilities and means, for example, the removal of discrimination by gender. Human rights are an intensely argued field of thought.

Then there is the interaction between the right to affordable access to drugs and the idea of international intellectual property rights which may favour commerce over human health. This and the foregoing considerations make important matters for argument when global health is on the agenda.

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Grim warnings about the prospect of disastrous climatic warming

Some progress is being reported in agreements over the many climate studies carried out for several decades. Researchers are in fair agreement that our world has risen in temperature by about 0.6C during the past century, most of the effect being thought to be attributable to human activity in burning fossil fuels to produce carbon dioxide. However, assessments of climate science have been vague in respect of future warming. Extreme calculations have yielded figures between 1.5 and 4.5 degrees.

A news item by Richard Carr in Science for 13 August describes advances reported by a panel on climate sensitivity which met in Paris at the end of July. Almost all the evidence, it was found, indicates a temperature rise of 3C and a doubling of atmospheric carbon dioxide by the end of this century. This would be potentially disastrous. The three leading climate models produced in the US suggest a temperature rise of 2.5 to 3.0C, but clouds might affect the energy budget as carbon dioxide increases. Clouds tend to reflect more shorter wavelength radiation, but the overall effect might be an increase or a decrease in rainfall.

The general opinion after the conference was that a temperature rise of around 3C, with a margin a half a degree either way, is more likely than one of the lowest estimate of 1.5C. The likelihood appears to be that climatic warming by the end of the present century will present hazards to the earth’s flora and fauna, including its human population. Details of precisely what those hazards may be remain vague, but the distant future looks decidedly grim.

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