A Governmental Analysis of Children ‘at Risk’ in a World ... · PDF fileA Governmental Analysis of Children ... 1992; Castel, 1991; Coveney, 1998; Dean, 1997, 1999; Giddens, 1991;

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The author is with the Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta.

Sociology of Sport Journal, 2007, 24, 302-324 © 2007 Human Kinetics, Inc.

A Governmental Analysis of Children ‘at Risk’ in a World of Physical Inactivity

and Obesity Epidemics

Lisa McDermottUniversity of Alberta

A number of scholars have noted the increased social currency that a risk vocabu-lary has come to assume in late modernity. This vocabulary has been deployed in discourses of physical inactivity and obesity, wherein children have increasingly been identified as an ‘at-risk’ population leading a sedentary lifestyle, which is culturally represented as a primary risk factor for obesity and ultimately ill health. This article explores the usefulness of Foucault’s governmental perspective in problematizing the function served and effects produced by a risk vocabulary within discourses and practices directed at intervening in the childhood inactivity and obesity epidemics with a specific focus on the Canadian context.

Plusieurs chercheurs ont noté l’utilisation croissante d’un vocabulaire de risque vers la fin de la modernité. Ce vocabulaire a été déployé au sein des discours sur l’inactivité physique et l’obésité ; discours au sein desquels les enfants ont été de plus en plus identifiés en tant que population à risque qui possède un style de vie sédentaire (ce dernier étant représenté culturellement comme un facteur de risque pour l’obésité et, ultimement, la maladie). Cet article explore l’utilité de la perspec-tive gouvernementale de Foucault pour problématiser les effets du vocabulaire de risque retrouvé dans les pratiques et discours d’intervention dans la soi-disant « épidémie » d’inactivité et d’obésité enfantines au Canada.

The Canadian Paediatric Society and the Canadian Teachers’ Federation . . . called on parents, politicians, and policy makers to take action to increase the physical activity levels of children and teenagers. The call for action comes only weeks after two national studies . . . found that the health of 63 per cent of Canadian children is threatened due to high levels of physical inactivity. (Canadian Paediatric Society, 1998)

Considerable public and scholarly discussion in Canada is devoted to physical inactivity and obesity. Within the discourses and practices of groups and institutions (governmental, medical, health promotion, academic) whose efforts are directed at “stemming the tide” (Canadian Fitness and Lifestyle Research Institute [CFLRI],

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2001) of the obesity and inactivity ‘epidemics,’ physical inactivity and obesity are positioned as risks to both the individual body’s health and to the social body. Increasingly, however, some scholars have begun to problematize our contemporary disquiet with obesity in particular and inactivity to a lesser extent (Aprhamors, 2005; Burrows & Wright, 2004; Evans, 2003; Evans & Davies, 2004; Gard & Wright, 2001, 2005; Rich & Evans, 2005; Saguy & Riley, 2005; Tinning & Glasby, 2002). Saguy and Riley (2005) label this group “obesity skeptics.”

Health concerns about obesity and physical inactivity are not new: Gard and Wright (2001) point out that as early as the 1950s biomedical research linked physi-cal inactivity with cardiovascular disease (CVD). Two things in particular, however, distinguish these earlier health promotion efforts from contemporary ones. First, since the mid-1990s, there has been an intensification in governmental, academic, medical, and popular interest in the ‘obesity epidemic’ (Saguy & Riley, 2005) and what is assumed to be its cause, the physical inactivity epidemic. Assumed is used here to signify the increasingly contested nature, among obesity skeptics, of the way in which obesity is constructed as simply an issue of an imbalance between consumed and expended energy. Contemporary health promotion’s other distinguishing characteristic is its positioning of inactivity and obesity within a vocabulary of risk, which conveys its own bodily self-responsibility and self-control imperatives that are deployed so as to accomplish the normative ‘healthy citizen.’ Of interest for this article is the increasing focus on children, who are identified as an ‘at-risk’ population and are represented as succumbing to an inactive lifestyle leading to obesity and other illnesses:

As parents, it is imperative to start teaching our kids about heart health at an early age. . . . The evidence suggests that an unhealthy lifestyle is putting our children at serious risk . . . [of] developing risk factors of heart disease includ-ing obesity, type II diabetes and processes that lead to high blood pressure and atherosclerosis. Previous generations typically didn’t experience these condi-tions until mid-life or later. (Canadian Heart and Stroke Foundation, 2005)

While the concept of children ‘at risk’ has roots in the medical and public health traditions (Swadener & Lubeck, 1995), their identification as an ‘at-risk’ population in terms of inactivity and obesity, and resulting ill health, is a more recent phenomenon that sociologists of physical education (PE) have only begun to examine (Burrows & Wright, 2004; Evans, 2003; Evans & Davies, 2004; Evans, Rich, & Davies, 2004; Gard & Wright, 2001, 2005; Leahy & Harrison, 2004; Rich & Evans, 2005; Tinning & Glasby, 2002; Wright & Burrows, 2004).

Scholars have noted the salience of the term risk in late modernity and have problematized its contemporary social and cultural currency on a variety of fronts, including health (Beck, 1992; Castel, 1991; Coveney, 1998; Dean, 1997, 1999; Giddens, 1991; Lupton, 1995, 1999a, 1999b; Nettleton, 1997; O’Malley, 1996; Petersen, 1997; Skolbekken, 1995). Lupton (1995) notes that late modernity can be characterized through its deployment of a risk discourse in health concerns whereby particular segments of the population are categorized as ‘high risk’ as a result of epidemiological analyses:

Epidemiologists calculate measures of ‘relative risk’ to compare the likeli-hood that populations exposed to a ‘risk factor’ will develop an illness. . . .

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In response to epidemiological predictions of risk, public health and health promotional texts identify discrete groups in the population requiring specific attention. (p. 81)

The discourses surrounding childhood inactivity and obesity illustrate these pro-cesses, as demonstrated in a CFLRI report providing justifications for identifying children as an ‘at-risk’ population and for intervening in this situation:

Given the rapidly rising levels of childhood obesity, the increase in chronic conditions and diseases in adulthood that now are tracking in early childhood, and the increase in life expectancy, children are justifiably becoming an increas-ing focus for research and intervention. People in Canada are living longer, and becoming sicker at an earlier age,1 and the latter trend is largely related to lifestyle-related factors beginning in early childhood, not the least of which is sedentary living. (Craig, Cameron, Russell, & Beaulieu, 2001)

Giddens’ (1991) work on risk helps to make sense of the logic deployed by Craig and colleagues (2001) when Giddens explains, “the concept of risk becomes fun-damental to the way both lay actors and technical specialists organise the social world. Under conditions of modernity, the future is continually drawn into the present by means of the reflexive organisation of knowledge environments” (p. 3). In other words, the logic underlying children’s being identified as ‘at risk’ is both epidemiologically based statistical knowledge and a belief that in knowing the risks associated with inactivity, we can take corrective action (i.e., increasing one’s physical activity) and avoid becoming an overweight or obese adult and a future, economically liable heart-attack victim. Central to this logic is a discourse of “immediacy and proximity . . . here and now, on the doorstep of disease” (Evans, 2003, p. 95). Certainly, the comments by Craig and colleagues (2001) and the Cana-dian Heart and Stroke Foundation along with a resounding chorus within the active living2 and obesity literatures (see Andersen, 2000; Basrur, 2003; Cole, Bellizzi, Flegal, & Dietz, 2000; Tremblay & Willms, 2000) echo this assumption that child-hood obesity poses future risks to the health of the individual and the nation.3

This article critically examines the contemporary construction of childhood inactivity and obesity in terms of the notion of risk, focusing specifically on the Canadian context. A textual analysis was undertaken to examine the discourses emanating from four main constituencies that are central to the representation of Canadian children as being ‘at risk’ of succumbing to inactivity and obesity: scholars, the government, nongovernmental organizations, and the media.4 Using a sociocultural perspective on risk that draws on Foucault’s work, I examine these discourses from a governmental perspective to elucidate how and why childhood inactivity and obesity are positioned as risk objects, that is things “to which harm-ful consequences are conceptually attached” (Lupton, 1999b, p. 30). The social and cultural production of such representations is examined to elucidate both the function and produced effects a risk discourse serves in discourses of childhood inactivity and obesity.

The first section of this article offers an overview of the literature on children, risk, physical inactivity, and obesity. The second section encapsulates the governmentality literature, highlighting the roles of experts and the dominant political rationality within late modernity, while demonstrating their workings


in childhood active living and obesity discourses. The focus then narrows to elucidate the notion of risk from a governmental perspective and its relevance to contemporary discourses and practices directed at intervening in the ‘epidemics’ of childhood inactivity and obesity. The final section considers one specific form of risk rationality: epidemiological risk. Epidemiology has assumed the role of an ‘objective’ arbitrator defining the normative measures used to distinguish the ‘healthy’ from the ‘unhealthy.’ When obesity and physical inactivity are constructed as epidemics, the logic of epidemiological diagnosis and prevention shifts health care from a focus on individual symptoms to a focus on the risk profile of a potentially ‘sick’ population in which an ever-increasing number of risks must be managed (Castel, 1991). This discourse facilitates the management of populations and the promotion of normative behaviors for self-regulated adoption so as to procure the identity of both healthy children and citizens.

Children, Risk, Physical Inactivity, and Obesity: An Overview

A clear relationship between negative health outcomes and morbid obesity has been consistently shown in the biomedical literature; however, the evidence is much more complex and uncertain regarding the health effects of overweight and nonmorbid obesity (Aprhamors, 2005; Evans, 2003; Gard & Wright, 2001, 2005). Similarly, despite the certainty with which physical activity is represented as positively affecting health, the science underpinning this assertion is far from unequivocal. Gard and Wright (2005) note that scientific opinion is mixed regard-ing physical activity’s role in preventing and treating a range of diseases. Boreham and Riddoch’s (2003) review of the health benefits of physical activity for children and youth concludes that “there is surprisingly little empirical evidence to support this notion” (p. 17). Just as measurement of population levels of obesity has been contested (Evans, 2003; Gard & Wright, 2001, 2005), the assumption that children are more inactive today compared to the past is also increasingly critiqued (Gard & Wright, 2005; McDermott, 2007). For example, McDermott (2007) queries the veracity of representations of an inactivity epidemic among children. Canadian statistics for children aged 12 to 14 indicate that only 24% are inactive; the remain-ing 76% range across a spectrum of activity levels, from moderate to meeting the “international guidelines for optimal growth and development” (Cameron, Craig, & Paolin, 2005). But the contemporary public representation of children is one of being overwhelmingly inactive since only children who reach these international standards of energy expenditure are defined as being “active,” despite a lack of both robust findings regarding childhood activity and health outcomes, due to methodological concerns,5 and a deficiency of clarity around terms such as opti-mal. These points are critical as contemporary levels of childhood inactivity and obesity, which are reported with an air of certainty, are central to the construction of children as ‘at risk.’

A few scholars have explored the notion of risk in the study of inactivity and obesity. For the purpose of this discussion, the works of Gard and Wright (2001), Burrows and Wright (2004), Tinning and Glasby (2002), and Leahy and Harrison (2004) are most relevant. These discussions focus on the increasing degree to

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which school PE programs are being reshaped and delivered though health issues and implicitly connected to the ‘cult of the body.’ Central to all these discussions is a consideration of ‘risk’ discourses. Gard and Wright (2001), for example, trace the process by which the debates surrounding obesity in biomedical research come to be erased through that knowledge’s recontextualization into a secondary field of knowledge production—PE research. This, they argue, limits how health is conceived and practiced in PE. Specifically, health is conceived through a focus on obesity, which the authors argue is dangerous given the glorification of slender-ness and the concomitant disdain for obesity in Westernized cultures.6 Burrows and Wright (2004) also take up the theme of uncertainty and risk and provide a textual analysis of media representations of the relationships among health, weight, and physical activity in children, which, they argue, through a risk discourse has engendered a sense of panic regarding children’s health. Their particular interest is examining the effects produced through the construction of the ‘healthy child’ identity, chiefly when it becomes articulated to the ‘cult of the body.’

Tinning and Glasby (2002) and Leahy and Harrison (2004) take a governmental perspective not only on risk in relation to health and PE curriculum and practice but also on the ‘cult of the body.’ Both articles provide an overview of governmentality and are interested in questions of identity, whether of the ‘at-risk’ self (Leahy & Harrison, 2004) or of the ‘healthy citizen’ (Tinning & Glasby, 2002). Leahy and Harrison provide a qualitative analysis of a grade 10 girls’ health unit while Tinning and Glasby examine the health and PE curriculum in its role as a technology of governance and the pedagogical work it performs regarding the ‘cult of the body.’ The present article adds to these discussions of risk by offering a more compre-hensive theoretical examination of the governmental perspective, extending it into a discussion of the rationale of epidemiological risk.

Governmentality

Governmentality, based on Foucault’s (1991) notion of the “art of govern-ment,” represents a rationality and strategy of governing that emerged in the West in the 18th century, the focus of which is to manage populations in such a way that simultaneously individualizes and totalizes, in terms of each and all:

Government has as its purpose not the act of government itself, but the welfare of the population, the improvement of its condition, the increase of its wealth, longevity, health, etc. . . . The population is the subject of needs, of aspirations, but it is also the object in the hands of the government. . . . Interest at the level of the consciousness of each individual who goes to make up the population, and interest considered as the interest of the population regardless of what the particular interests and aspirations may be of the individuals who compose it, this is the new target and the fundamental instrument of the government of population. (Foucault, 1991, p. 100)

Foucault (1984) argues a new regime of power, biopower, takes shape with this broadening of the state’s interests to that of population welfare. Central to its func-tioning is the administration of life, which “brought life and its mechanisms into the realm of explicit calculations and made knowledge-power an agent of transformation of human life”; it was “taking charge of life . . . that gave power its access . . . to the


body” (p. 265), operating around two poles: an anatomo-politics of the human body (i.e., disciplining it, optimizing its capabilities, usefulness, efficiency, and docility); and a biopolitics of the population (i.e., regulatory control of and interventions into the biological processes of life). The individualizing and totalizing effects of governmentality clearly map onto these two poles of biopower.

In contrast to conventional thinking about government, which positions the state as an all-embracing authority circumscribing individual autonomy (Lupton, 1995), Foucault understood governance in a more wide-ranging way to signify “a form of activity aiming to shape, guide or affect the conduct” (Gordon, 1991, p. 2; see also Dean, 1999) of people in the “best” way, which for Foucault (1991) meant in the “most economical” or efficient way (see also Rabinow, 1984). In this way, government is concerned with:

men [sic] in their relations . . . with those other things which are wealth, resources, means of subsistence . . .; men in their relation to that other kind of things, customs, habits, ways of acting and thinking, etc.; lastly, men in their relation to that other kind of things, accidents and misfortunes such as famine, epidemics, death, etc. (Foucault, 1991, p. 93)

Turner (1997) suggests Foucault’s understanding of governmentality should be positioned within his theory of power, in which government combines his histori-cal concern with disciplinary regimens and his later work on the production of the self. From Foucault’s perspective, power operates in localized and diffuse ways throughout the social system rather than simply in a unidirectional manner from the state. Governmentality operates both through traditional notions of external government (e.g., state regulatory and surveillance practices) and through internal government (i.e., self-government) (Lupton, 1995, 1999b). Thus, “‘the character-istic outcome of power is not a relationship of domination but the probability that the normalized subject will habitually obey’” (Johnson, 1993, cited in Lupton, 1995, pp. 9–10). Government is consequently “a ‘contact point’ where techniques of domination—or power—and techniques of the self ‘interact’ … [and] where techniques of the self are integrated into structures of coercion’ (Foucault, 1980)” (Burchell, 1996, p. 20). Foucault thus understands government as practice rather than just an institution.

The usefulness of governmentality lies in its analytical incorporation of both the coercive and noncoercive strategies that “the state and other institutions urge on individuals for the sake of their own interests” (Lupton, 1995, p. 9). Turner (1997) speaks to these noncoercive strategies through the concept of “normative coercion,” which operates to normalize behaviors in particular ways. While he uses this term to describe legal, medical, and religious institutions, it could apply equally to active living ones, whose effects over everyday life are not only disciplinary and surveillant but also voluntarily consented to as legitimate and normative rather than authoritarian:

These institutions of normative coercion exercise a moral authority over the individual by explaining individual “problems” and providing solutions for them. In this sense we could say . . . [they] exercise a hegemonic authority because their coercive character is often disguised and masked by their normative involvement in the troubles and problems of individuals. They are coercive, normative and also voluntary. (p. xiv)

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This is particularly the case in health matters, which have become a critical contact point between government and population in late modernity (Gastaldo, 1997) and is an area where “one is largely self-policed” with no force being necessary (Lupton, 1995, p. 10). The success of active living and obesity discourses, and their associ-ated practices, lies in their ability to induce people to comply voluntarily “in the interests of their health” (p. 11).

Turner’s (1997) normative coercion is evident in the feedback documented on the CIHR (2004) web site detailing its efforts at combating obesity. Under the heading “Adrian’s story,” feedback from doctor, child, and parent is recorded. The doctor, who is studying appetite control among children, “has enrolled Adrian in a series of classes to teach him how to assess fat content in foods; exercise to improve his sense of well-being and make the right choices when it comes to snacks.” The parent reports her delight at her son’s progress: “He’s definitely learned to choose the right foods,” and she “does her part by emphasizing the importance of physical activity with Adrian.” Adrian himself is reported as saying that “the classes serve everyone’s best interests” (emphasis added). Discerned through this narrative are a variety of cultural impulses, including an anathema of obesity; the positioning of Dr. Berall as the hero and expert who will help ‘save’ Adrian from himself; the reduction of good health to a matter of the active, responsible subject making the right choices; and the implicit normative coercion urged on Adrian so that “every-one’s best interests” are served.

The Role of Experts in Governance

Population management relies on experts and the knowledge they produce, which comes to be accepted as ‘truth’; such knowledge is central not only to governmentality, as it both constitutes and defines the activities of governance and monitors its advancement (Lupton, 1995), but also to the production of late-modern identities. Expert-based knowledge of the population, both collectively and individually, is produced through data gathering, monitoring, establishing norms and developing population-based interventions “to ensure that the government is effective and capable in achieving the ends of establishing a healthy, happy, and productive population” (Nettleton, 1997, p. 211).

Within the Canadian population health context, a number of government-funded active living agencies (e.g., CFLRI,7 Alberta Centre for Active Living) and research activities measure and monitor Canadians’ health-related habits.8 More recently and innovatively, the Canada on the Move web-based research project has been organized through partnerships among the CIHR, nongovernmental organizations, and for-profit companies in the food, information technology, and health promotions sectors (Rose, 2005) to track individuals’ activity levels using pedometers.9 To date, more than 3,000 Canadians “completed online surveys and submitted their step data” (Canada on the Move, n.d.) providing an exemplar of Foucault’s point of government as a contact point between technologies of domination and technologies of the self. All of these various studies, regardless of their methodology, and institutions (e.g., CFLRI) represent technologies of power through their surveillance and normative effects, as this scientific expertise is used both to define ‘normal’ body weight and activity levels and to monitor and evaluate actual obesity and physical activity levels in light of these norms. This knowledge, in turn, is crucial to the rhetorical process


of representing childhood inactivity and obesity as being of ‘epidemic’ proportions, posing risks to ‘each and all’ children. In this way, experts play a critical role in deter-mining what aspects of people’s lives require guidance to ensure population welfare.

Central to these activities is the power of science: its effects are forms of social control, not through violence or authoritarianism but rather through surveillance and regulation. Coveney’s (1998) observations regarding the ‘scientific’ strategies adopted by experts in the nutrition field are useful here as a similar logic fuels the efforts of active living experts:

. . . a population is encouraged to adopt specific concerns based upon assump-tions that it is a ‘sick population’ and, as such, everyone is in need of dietary reform. These assumptions are based on dietary surveys which indicate that the population is not following dietary recommendations. Diagnosed as ‘sick’ and ‘non-compliant,’ the population is subjected to rational, scientific, dietary modifications through mass education strategies. (p. 462-463)

Statistics are central to this scientific expertise and thus a primary technology of governance, as Foucault (1991) has observed. Through epidemiology’s statistical measuring and monitoring of populations, not only do a potent set of ideas about ‘risk factors’ and ‘risky behavior’ (Benson, 1997) come to be constructed, but also health norms (e.g., physical activity levels) come to be established and individual compliance (and implicitly negligence) is measured against them. Thus, for exam-ple, the Public Health Agency of Canada (PHAC) mobilizes children’s normative energy expenditure statistics to justify intervening in their health habits:

The Public Health Agency of Canada recognized that the rapid increase in overweight and obesity, combined with low levels of physical activity, represent a serious threat to the health of Canada’s children and youth. In response to this crisis, the Public Health Agency of Canada, and the Canadian Society for Exercise Physiology initiated the development of Guides that were recently launched in April 2002. (PHAC, 2005)

As in Coveney’s (1998) analysis of the way nutrition discourse mobilizes a sense of crisis in order to increase the regulatory power of government regarding the food people choose to eat, so, as this passage demonstrates, the PHAC and other health organizations use statistical information and norms in the service of governance to define Canadian children as a ‘sick population’ in need of remediation.

Foucault, however, would argue that such impulses to educate the masses on what constitutes ‘good’ physical activity habits amounts to an extension of power due to the inextricability of knowledge-power. The public identification of what is considered ‘good’ is at the heart of governing given that its focus is “facilitating the development of certain characteristics considered ‘good’ and ‘desirable’ and of eliminating or minimising others” (Evans & Davies, 2004, p. 44). It is ultimately through education that “we learn to know what kind of good citizen in body and health we are and ought to be” (p. 44), which are the effects the physical activity guides, as part of the discursive formations of active living, seek to produce; they encourage individuals to “become [their] ‘subjects’ by ‘subjecting’ [them]selves to [their] meanings, that is power and regulation” (Hall, 1997, p. 56).

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Political Rationality of GovernanceThe dominant political rationality associated with governmentality in late

modernity is that of neoliberalism, which is premised on a number of principles, including state recoil from collective social provisions and a modern subject conceived as a disciplined, autonomous, rational, choosing individual who is positioned as a calculating entrepreneur (Burchell, 1996; Dean, 1999; Lupton, 1995). This neoliberal subject is understood to be free and to have the capacity to take care of and improve oneself “through processes of endless self-examination, self-care and self-improvement” (Petersen, 1997, p. 194). Within the context of active living discourses and practices, this mandate of self-care is applied regardless of age, better serving the long-term interests of neoliberalism when the principles of self-governance and self-responsibility are learned as a child. For example, in Alberta, Canada, where health and PE are taught as two separate core subjects, students receive a double dose of learning about self-responsibility regarding their health, starting in kindergarten:

Wellness Choices [health curriculum] Students will make responsible and informed choices to maintain health and to promote safety for self and others. (Alberta Learning, 2002, emphasis in original)

General Outcomes [PE curriculum] Students will assume responsibility to lead an active way of life. (Alberta Learning, 2000, emphasis in original)

Tinning and Glasby (2002) observe that from its inception, PE has been a site of governance, but its form has changed considerably from earlier periods. Whereas in the past governance occurred through face-to-face interventions by PE professionals, that has come to be replaced by governance through key learning outcomes that educatively operate “to create self-regulating healthy citizens” (p. 114). The net effect is the production of active rather than passive subjects of governance who “exercise power upon themselves as normalized subjects who are in pursuit of their own best interests” (Lupton, 1999b, p. 88); such self-governing subjects ultimately buttress the objective of a political rationale justifying the movement away from publicly funded, collective social provisions. Governance thus occurs “not through society but through the responsible and prudential choices and action of individuals on behalf of themselves” (Dean, 1999, pp. 133-134). Active living discourses and practices, with their focus on changing individual lifestyle factors rather than addressing the structural factors affecting health (e.g., class, race, gender, sexuality, etc.), are a governmental apparatus serving such a political rationale. Education, a primary technique of knowledge dissemination, becomes a governmental technology through the role it plays in this process of self-care, thereby serving a regulatory function that operates through a variety of sites including the media, the school, and the family (Burrows & Wright, 2004; Evans, 2003; Gard & Wright, 2001; Leahy & Harrison, 2004; Tinning & Glasby, 2002). As illustrated previously, children are actively governed to make the ‘choice’ to become a ‘healthy child.’

The synergies between a neoliberal political rationality and self-governing imposed through technologies of the self are obvious. This synergy is rooted in


an inherent principle of neoliberal systems, which animates and regulates what Osborne (1997) terms responsibilisation.10

It is not only . . . that people are made responsible for their own health; with all the ‘victim-blaming’ consequences this implies. Rather, the principle of responsibilisation works . . . throughout the whole system, giving it coherence as its principle of functioning. So . . . potential patients are to be responsible for being entrepreneurs of their own health. (pp. 185-186)

This moralistic principle of responsibilisation is deployed in government active living and obesity discourses, as seen in comments made by former Alberta Minister of Health and Wellness Gary Mar: “The prevalence of chronic disease can be directly linked to diet and physical exercise. Knowing this, it disturbs me that so many Albertans are inactive and may not be eating well” (Government of Alberta, 2003, emphasis added). Implicit in this concept of responsibilisation is that of rationality, a defining feature of risk discourses wherein engaging in risky behaviors (e.g., sedentarianism) is seen to be irrational (Lupton, 1999b). Such logic also individualizes one’s responsibility for one’s health; as Benson (1997) observes, this implies “that good health is something within our power to achieve if only we exercise prudence, discipline, and control of our impulses” (p. 123), illustrating this convergence of responsibilisation and rationality. In this way, the subject position of the healthy citizen is seen to be readily available, and ‘each and all,’ including children, are encouraged to take it up, regardless of the social context in which one lives.

Childhood in a Risky World of Inactivity and Obesity: A Governmental Perspective

The risk vocabulary deployed within active living and obesity discourses is representative of a techno-scientific approach (Lupton, 1999a, 1999b) centered on the belief that risk is an objective phenomenon that stands outside of social and cultural contexts and processes. Juxtaposed to this is a governmental perspective that sees risk in its social, cultural, and historical dimensions; what is defined as a risk is understood to be socially constructed, performing particular functions socially, culturally, and politically (Lupton, 1999b). As Dean (1999) posits, “risk is a way . . . of ordering reality, of rendering it into a calculable form. It is a way of representing events so they might be made governable in particular ways, with particular techniques, and for particular goals” (p. 131). Accordingly, risk is a strategy, a rationality and a technique of governing. It plays a fundamental role in rationalist ontologies that assume unwelcome events, such as ill health, are not only predictable, but ultimately avoidable (Dean, 1999; Lupton, 1995). A risk vocabulary works effectively in tandem with an epidemic discourse (see Saguy & Riley, 2005). This strategy defines contemporary representations of childhood inactivity and obesity.

Across the variety of texts and comments on childhood inactivity and obesity, the consensus regarding the ‘epidemic’ proportion of these issues is clear.11 For example, in support of the federal government’s releasing physical activity guide-lines, Claire LeBlanc, head of paediatric rheumatology at the Children’s Hospital of

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Eastern Ontario, asserted, “There is an epidemic of inactivity among our children, and we have to start tackling this problem like an epidemic. . . . It’s not just a good idea to be active, it’s essential to their health” (Picard, 2002, p. A13).12 Martin and Martin-Granel’s (2006) etymology of the term epidemic identifies its use in the context of infectious diseases dating back to the 19th century; only over the last half of the 20th century has it come to be deployed in the context of noninfectious conditions such as obesity and inactivity. Boero (2006) refers to this latter usage as a “postmodern epidemic” (p. 2), which divorces the term from its biomedical roots and carries an inherent risk concern to which everyone is subject. Saguy and Riley (2005) argue the term epidemic has increasingly been used by policy makers and the media as an emotionally laden metaphor in speaking to an array of social ills (e.g., drug and alcohol addictions, teenage pregnancies).

By definition, an epidemic is the appearance of new cases of a disease in a given population and period at a rate that “exceeds [the] expected level for a given time” (Wheeler, n.d., emphasis added). The use of epidemic in the context of child-hood inactivity and obesity is interesting on two fronts. First, categorizing physical inactivity and obesity as diseases, in the way this term is traditionally understood within epidemiology, signals their medicalization (Conrad, 1992; Gard & Wright, 2005),13 a representation that is increasingly critiqued (Aprhamors, 2005; Gard & Wright, 2005; McDermott, 2007; Saguy & Riley, 2005). Saguy and Riley (2005) argue that positioning obesity as an epidemic conflates the term’s literal and meta-phorical meanings, whereby the latter signals anxiety about the spread of immoral behavior; arguably, a similar process of meaning operates within the context of active-living discourses. Childhood obesity and inactivity are thus associated not only with health risks but also with moral choices. This is particularly the case given the cultural currency of self-responsibility in late modernity. This leads to the second point: the literal meaning of epidemic, as occurrences exceeding the expected rate, is also problematic. What is expected in terms of the number of ‘cases’ used to designate an epidemic? How are these expectations defined and by whom? For example, in the United States, the lowering of BMI guidelines by the National Institutes of Health in 1998 from 27.3 (female) and 27.8 (male) to 25 resulted in 50 million Americans’ being (seemingly randomly) defined as overweight at the stroke of a pen, clearly contributing to the identification of an epidemic (Boero, 2006; see also Marsh, 2005). These critical questions speak to the issue of power arbitrarily deployed through the use of an epidemic vocabulary.

Lupton (1995) explains the semantic function served by labeling particular conditions as epidemics:

‘Epidemic’ suggests the potential for sudden, exponential spread, for societal disorder, the need for harsh and decisive measure to be taken to keep the disease in check. An ‘epidemic logic’ takes over, which seeks immediate action to the threat, including the proliferation of regulatory practices which both construct and seek to contain the object of fear. (p. 65)

Flegal (1999) adds the term epidemic serves as a rhetorical device to marshal action when deployed in noninfectious contexts. With its connotative assault on public order, the term induces what Strong (1990) calls an epidemic psychology (the psy-chosocial dynamics of an epidemic) and also signals the fact that those dynamics can spread like an epidemic rapidly from individual to individual. Central to these


dynamics are fear, explanation and moralization, and action, all of which are readily evident within the discourses of physical inactivity and obesity.14

An epidemic logic has clearly taken hold within the health industry concerned with childhood inactivity and obesity. Moreover, within this logic particular actions and interventions, directed particularly at the individual, can be legitimized. First, there has been a push from a variety of sectors (e.g., government, PE advocates, academics, doctors) to undertake actions with regulatory effects, ranging from implementing daily PE classes to banning the sale of junk food in schools.15 Second, research dollars have been assigned: the CIHR, the federal government agency responsible for funding health research in Canada, has to date channeled $32 million toward obesity research; since 2003 approximately $2.3 million has been directed at addressing the inactivity ‘epidemic’ (CIHR, 2006). Such high levels of spending on research represent the creation of more expert knowledge that both “construct[s] and seek[s] to contain the object[s] of fear” (Lupton, 1995, p. 65), which is ultimately used to manage individuals’ health habits. Media coverage of such expert knowledge in turn serves to engender a public discourse that functions as a barometer that is read by politicians and funding bodies as being indicative of public concern about an issue (Gard & Wright, 2001). This speaks to the circuitry of research funding and the production of more knowledge to be put in the service of health governance, with the public becoming an apparatus of such circuitry.

Miah’s (2005) examination of scientific journalism’s mediating role regarding the public’s understanding of science posits that depending on the type of under-standing desired, various kinds of experts (i.e., scientific versus ethical) should be sought by the media. Miah is especially critical of the practice of relying on scientific experts as moral experts because of both the limited range of ethical positions presented for making sense of scientific implications and the potential for a scientist’s personal moral view regarding the subject to be seen “as a matter of fact rather than judgement” (p. 413). This is particularly relevant in the area of obesity science where moral and ideological arguments often intersect with scientific opinion (Aprhamors, 2005; Gard & Wright, 2005; Rich & Evans, 2005). I would add that increasingly such moralism is also found in inactivity discourses where assumed sedentary children are labeled with the morally imbued term of couch potato (see Gard & Wright, 2005; McDermott, 2007). Given the media’s central role in manufacturing moral panic through scientific journalism (Gard & Wright, 2005; Miah, 2005; Monaghan, 2005; Rich & Evans, 2005), this raises concerns regarding the circuitry of research funding. When the public is potentially unable to separate fact from judgment, due to scientific experts’ being given the task of speaking to the implications of morally charged issues such as obesity and inactivity, the grounds for funding become questionable. Scientific journalism thus functions as an apparatus of governance as it acts as conduit through which an epidemic vocabulary not only comes to be cemented to particular conditions (e.g., inactivity, obesity) in the public imagination but also facilitates a health issue being identified as of great consequence to population welfare, and thus requiring intervention and funding.

The strategic representation of childhood inactivity and obesity as epidemics thus invokes a discourse of risk and creates a sociopolitical climate that legitimizes mobilizations, intervention, and modes of regulation by active living and obesity experts, which represent various forms of Turner’s (1997) normative coercion (see

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also Evans & Davies, 2004). The relationship between epidemic and risk discourses is thus twofold. First, an epidemic vocabulary serves as a technology of governance as it operates to intensify the perceived sense of risk attached to inactivity and obesity as having ill effects for each (individual) and all (society), thereby shoring up the certainty of such expert-based arguments. Second, if, as Dean (1999) and others (Castel, 1991; Lupton, 1999a, 1999b) have argued, labeling something a risk is an attempt to manage and tame disorder and uncertainty, then the deployment of a risk vocabulary becomes an obvious way of “ordering” the disorder manufactured through an epidemic discourse.

Epidemiology Risk Rationality

Dean (1997) argues essential to any understanding of risk are the political rationalities that deploy it, which in late modernity include a neoliberal rationale committed to a retraction of social rights and the principles of welfare capitalism. Such rationality individualizes risk through “an emphasis on individuals, families, households and communities taking responsibility for their own risks,” including that of ill health (Dean, 1999, p. 145). Dean (1997, 1999) identifies three common risk rationalities operating within neoliberal societies: insurantial, epidemiological, and clinical. For this discussion, I limit my focus to epidemiological risk rationality because of its overall relevance to health promotion, including inactivity and obesity.

Epidemiological risk is a pervasive and long-standing form of risk rational-ity (Dean, 1999). Risk calculation is accomplished through “the observation of patterns in anonymous populations of disease and the identification of associ-ated risk factors” (Lupton, 1999c, p. 63). Its techniques include tracing diseases within populations through screening techniques, and statistical and probability measurements, and connecting these illnesses with their causal factors to predict population health outcomes and develop better prevention and control (Lupton, 1999b). Epidemiology’s mapping of an ever-expanding range of risk factors results in patterned predictability such that conditions like obesity are represented as “the deliberate negligence of known risks” (Green, 1995, p. 117).

Epidemiologists’ work has been pivotal to the success of active living and obesity experts’ contemporary representation of children ‘at risk’ of inactivity and obesity, as it has cemented these issues to a vocabulary of risk through the statistical mining of national population health surveys, which include measures dealing with BMI, the primary technique used to define obesity, and participation and energy expenditure rates in physical activity. Often unrecognized, however, are the risks associated with how this representation of children gets deployed. When the technologies of governance are directed at each and all, they can be taken up in disquieting ways; the public discourses surrounding inactivity and obesity, for example, have been found to contribute to the development of eating disorders in young women (Evans, Rich, & Davies, 2004; Rich & Evans, 2005). Evans’ (2003) reminder that epidemiological knowledge is not deterministic but rather probabi-listic, speaking to population trends rather than an individual’s activity and weight status, is particularly relevant here, although it is often lost as epidemiological knowledge is disseminated for individual practice.


In contrast to insurantial risk, where risk is borne collectively, epidemiological risk represents a strategy used to administer populations; here, risk is both preventa-tive and individualistic (Dean, 1997, 1999). This strategy “dissolves the notion of the subject or a concrete individual, and put[s] in its place a combinatory of factors, the factors of risk” (Castel, 1991, p. 281). Health-related care, Castel argues, comes to be directed at individuals’ risk profiles rather than their symptoms. Epidemiological risk factors therefore become mobilized in the service of governance as they are used to urge individuals to engage in self-regulatory ‘lifestyle choices,’ which serve not only to individualize risk but also to buttress the dominant neoliberal rationality. For example, Lupton (1999b) notes statistics identify a population as being “at ‘high risk’” (p. 97); then, often via targeted media educational campaigns, individuals within that group are encouraged to self-identify (or parents to identify their chil-dren) as being ‘at risk,’ and to choose to self-regulate to decrease their exposure to such risk factors. Thus epidemiology operates as a central strategy of governance ‘at a distance,’ premised on voluntary self-surveillance and self-regulation.

A variety of collated risk factors have been delineated within active living dis-courses that are unquestioningly accepted as culminating in an unhealthy lifestyle for children (often initially identified through bodily appearance as ‘overweight’ or ‘obese’), including poor eating habits, physical inactivity, smoking, television watching and playing video games, and having inactive or obese parents (CIHR, 2004). The identification of parents as a risk factor is emblematic of Burrows and Wright’s (2004) observation that “the proliferation of health risks associated with childhood has contributed to a burgeoning attachment of discourses of blame and responsibility to families” (p. 90); parents are positioned as apparatus for control and surveillance of their children’s health habits. Such expectations begin shortly after birth. One newspaper article discussing parental concerns about baby fat notes that although “doctors urge parents not to panic [about baby fat], they [doctors] also encourage them [parents] to watch for warning signs” (Elliott, 2006). The collation of these ‘risk factors’ of unhealthy living in children ultimately operates within the public imagination to ratchet up a child’s perceived level of risk.

Castel (1991) elaborates on the implications of this shift from a focus on the individual to that of “statistical correlations of heterogeneous elements . . . [which] deconstruct the concrete subject of intervention, and reconstruct a combination of factors liable to produce risk” (p. 288). This preventive strategy ultimately represents a new level of surveillance, a “systematic predetection” designed to anticipate and prevent an “undesirable event” (p. 288). Such surveillance, Castel argues, is a subtle and powerful regulatory method because when the focus becomes risk factors, the possibilities for preventive action are endless. Skolbekken (1995) illustrates the effects of such epidemiological logic in the case of CVD, where more than 300 risk factors (including inactivity and obesity) have now been identified. Such minute splintering of risk factors serves the ever-expanding field of influence of the health and medical professions, including active living. The individual, however, is increasingly subject to and held responsible for attending to the escalating number of risk factors, in relation not just to one chronic disease (e.g., coronary heart dis-ease) but to all of them. For example, the Canadian Heart and Stroke Foundation (2005) advocates activity thus:

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. . . physical activity boosts health in every way! It helps prevent conditions like heart disease and stroke, diabetes and osteoporosis. It reduces stress and helps people relax. It can prevent and reverse obesity. An active life promotes self-esteem, confidence and social skills, all of which are linked to better academic performance in children. Evidence shows that individuals who are physically active are more likely to be smoke-free. (emphasis in original)

Within such discourses, physical activity is positioned as the modern preventative panacea (e.g., Tremblay & Willms, 2003). The excerpt suggests that people who are physically active never develop CVD, osteoporosis, or diabetes; that all stressful situations can be ameliorated through physical activity; and that if one is obese one must not be physically active. Despite existing evidence that casts doubt on all of these ‘certainties’ (see Gard & Wright, 2001, 2005; Evans, 2003), physical activity functions within this discourse as a technology of health and governance.

Playing a fundamental role in this process is the PE epistemic community, which has ultimately embraced its role as an apparatus of health governance. Ing-ham’s (1985) earlier critique of PE’s initial embracement of healthism is relevant here as he drew attention to the “intellectual apartheid” emerging in that context, whereby “the triple tendencies of behaviorism, empiricism, and voluntarism combine[d] to produce discrete responses to holistic problems” (p. 51) rather than attend to their social, political, and cultural dimensions. Here he recognized the potential of PE to function in the service of governance that has clearly come to pass. Unforeseen was at least one effect of this engagement between healthism and the PE epistemic community: the supplanting of sport research with health research and the reinventing of university PE (an increasingly anachronistic term) programs through a health lens (e.g., psychology of exercise morphing into behavioral medi-cine), the dots of which can be connected to epidemiological risk rationality, the endlessly increasing risk factors it induces that are linked to physical activity, and the ‘sick population’ (despite living longer) it imagines.

Castel (1991) concludes that within such preventive “hyperrationalism,” everything can potentially be identified as a risk, but contained within this logic is a contradictory impulse: in an effort to eliminate risk, new risks are constructed and become the target of preventive intervention, resulting in further surveillance and regulation. For example, while inactivity is identified as a risk factor for various diseases and obesity, physical inactivity is itself positioned as the result of other risk factors that are therefore of increasing regulatory concern for active living proponents, including urban design (suburbia’s replacement of walking with car travel), parental anxieties regarding unsupervised children’s play; energy-saving technological innovations, and so-called sedentary activities (e.g., television, com-puter games; see also Gard & Wright, 2001).

But once a risk vocabulary is put in play, controlling how it gets deployed becomes a complicated affair. The often publicly cited research of Tremblay, Barnes, Copeland, and Esliger (2005), which compares the health of Old Order Mennonite children to that of rural and urban non-Mennonite Canadian children, epitomizes this point. Tremblay and colleagues’ (2005) finding that Mennonite children are leaner, stronger, and more active than their non-Mennonite contemporaries leads these inactivity experts to conclude the irrelevancy of class: “It has been shown that socio-economic status is inversely related to the risk of overweight and physical


inactivity. However, the present results demonstrate that Old Order Mennonite children tend to be more active and physically fit than children living a contem-porary lifestyle despite having a very low socio-economic status” (p. 1192). The study does not note that Mennonites’ agrarian culture and communal approach to life result in a very different experience than that of other low-income Canadians; therefore, the implicit dismissal of class in relation to obesity and inactivity is problematic. Further, the use of a risk vocabulary in Tremblay and colleagues’ conclusions demonstrates that as some things (inactivity, obesity) can be unhesi-tatingly constructed as risk factors for ill health, other things (class) can be just as readily dismissed or ignored.

This reveals not only the socially constructed nature of risk but also the power dynamics at play in terms of who gets to define what a risk is, particularly when conceivably everything can be defined as a risk (Castel, 1991), and how risk is defined, which functions to regulate how childhood inactivity and obesity are made thinkable. Shifting the analysis away from complex social factors affect-ing childhood inactivity and obesity (such as class) to risk factors for which the individual is responsible serves the objectives of neoliberalism, its commitment to the privatization of risk, and the “heterogeneous network of interactive actors, institutions, knowledges and practices” (Lupton, 1999b, p. 87) that have emerged to shape the conduct of children to pursue active, healthy living. Accordingly, epidemiological risk rationality presents inactivity and obesity as lifestyle choices that are under one’s complete control while simultaneously expunging alternative ways of understanding these issues, which ultimately shores up the contemporary dominant political rationality of neoliberalism.

Conclusion

Canadian children (as elsewhere) are increasingly represented as being ‘at risk’ of succumbing to physical inactivity and obesity, which are themselves posi-tioned within late modernity as risk factors for poor health. This article has used a governmental perspective to problematize the social and cultural production of such representations and their effects on the social administration of populations, particularly children. I close with two questions: what does a governmental perspec-tive offer in making sense of contemporary representations of childhood inactivity and obesity as risky? And what function does a risk discourse serve within the discourses of childhood inactivity and obesity?

In responding to the first question, from a governmental perspective, risk discourses are a strategy, a rationale, and a technique deployed to govern a population. Foucault (1991) has argued that the purpose of governance is ensuring the welfare of ‘each and all’ in a population, which is itself conceived through a lens of neoliberalism whereby subjectivity is framed through discourses of responsibilisation, choice, autonomy, self-governance, and self-improvement, in contrast to a population envisioned through a prism of collective responsibility. At the same time, health has become an increasingly critical contact point between government and population. When a population is conceived through a discourse of collective responsibility and welfare, health concerns are addressed in a social way in order to understand the class, racial, gender, and other dimensions of,

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for example, childhood inactivity and obesity. However, when a population is understood through discourses of responsibilisation, choice, and self-governance, health concerns are managed in an individualistic way, whereby physical inactivity and obesity are understood as due to an individual’s inability to make the “right” choices to commit to a healthy lifestyle. Risk discourses are thus moral technologies. They serve as a medium through which the regulatory practices seeking to shape and guide people’s conduct are deployed.

A governmental perspective offers a unique viewpoint on the interconnections among politics, the social and power, and on the role of risk discourses in the way power is deployed in the service of governance. Power, operating through discipline, regulation, and systematic preventive surveillance, shapes the bodily conduct of a nation’s citizenry, including its children, as their bodies have become a site of intervention and a target of regulatory and surveillance practices. This discussion demonstrates that the regulatory and surveillance activities related to curbing child-hood inactivity and obesity operate diffusely and normatively throughout society; various groups (e.g., scholars, active living proponents, physicians, media, parents, schools) become apparatuses of governing, as the conduct of each and all is guided to “assume responsibility to lead an active way of life” (Alberta Learning, 2000) from a very young age. A governmental perspective is particularly relevant here regarding matters of health because it critically attends to both the coercive and the normatively coercive strategies that individuals are urged to adopt for their own health. While a governmental analysis allows the workings of power to be discerned, what remains to be understood is how these governmental efforts are actually taken up by children in all of their diversity, an area of research that cur-rently is yet to be cultivated.16

What function does a risk vocabulary serve within childhood inactivity and obesity discourses? In a world where obesity is now conceived “according to the U.S. Surgeon-General … [as] ‘a greater threat than weapons of mass destruction’” (Wente, 2005, p. A15) and its primary risk factor is identified as physical inactiv-ity, which is itself represented as being of epidemic proportions, a cultural battle is being waged at the rhetorical level. At stake within this landscape are the minds of and the identities available to children whose bodies are ultimately the future medium of society’s constitution. Simplistically, these childhood identities are made meaningful through the healthy/unhealthy binary. If governing for health is about the production of a healthy citizenry that is educated to choose behaviors culturally defined as ‘healthy’ while simultaneously rejecting other ‘risky’ behaviors, then a risk discourse becomes a key strategy: it represents children’s health in a particular way, facilitating their governance in a particular way, with the specific objective of producing the ‘healthy child’ in a manner that aligns with the political rationality of late modernity, neoliberalism. In this way, a risk discourse increases the perceived sense of crisis, but also induces a sense of moral panic about the health of its children that can be ‘ordered’ only through the expert knowledge and practices that have been deployed to define and contain these risk objects (i.e., inactivity and obesity) in the first place. Moreover, positioning children as being ‘at risk’ legitimizes the mobilization of efforts aimed at “shap[ing], guid[ing], or affect[ing] the conduct” (Gordon, 1991, p. 2) of children so that neoliberal principles of responsibilization, discipline, rationality, and self-governance are learned and habitualized from a very young age, which ultimately serve the long-term interests of neoliberalism.


Enmeshing childhood inactivity and obesity discourses within a risk discourse for the purpose of health governance is, however, fraught with its own risks. Because governance operates through a principle of ‘each and all,’ the strategic deployment of a risk discourse precludes a precise targeting of only those children who are ‘physically inactive’ or ‘obese.’ Accordingly, the risk-informed representation of childhood inactivity and obesity as being of epidemic proportion operates from a blanket premise that each and all children are members of a ‘sick’ population that is inactive or obese, requiring physical activity reform. Such a premise emanates from the epidemiological risk rationality of systematic predetection whereby what is cast as a risk, particularly at a symbolic level, is eradicated in an endeavor to control it. But, as Castel (1991) astutely observes:

The modern ideologies of prevention are overarched by a grandiose technocratic rationalizing dream of absolute control. . . . Yet throughout the multiple current expressions of this tranquil preventive conscience . . . one finds not a trace of any reflection on the social and human cost of this new witch-hunt. (p. 289)

Inevitably, in an effort to produce ‘healthy citizens/children,’ there will be collateral damage whereby some children will engage in behaviors about which Rich and Evans (2005) and Evans (2003) express concern, such as anorexia and bulimia. Within our contemporary symbolic and cultural landscape, whether childhood physical inactivity and obesity are indeed ‘epidemics’ and the collateral damage incurred through efforts to contain them become a moot point from the perspec-tive of governance. As Rabinow (1984) notes, “the end of good government is the correct disposition of things—even when these things have to be invented so as to be well governed” (p. 21).

Acknowledgments

The insightful comments provided by the SSJ reviewers and editor on earlier drafts are gratefully appreciated and acknowledged.

ReferencesAlberta Learning. (2000). Physical education. Retrieved July 10, 2006, from www.education.

gov.ab.ca/k_12/curriculum/bySubject/physed/phys2000.pdf.Alberta Learning. (2002). Health and life skills kindergarten to grade 9. Retrieved July 10,

2006, from http://education.gov.ab.ca/k_12/curriculum/bySubject/healthpls/health.pdf.Andersen, R. (2000). The spread of the childhood obesity epidemic. Canadian Medical

Association Journal, 163, 1461-1462.Aprhamors, L. (2005). Is a weight-centred health framework salutogenic? Some thoughts

on unhinging certain dietary ideologies. Social Theory and Health, 3, 315-340.Bartky, S. (1990). Femininity and domination: Studies in the phenomenology of oppression.

New York: Routledge.Basrur, S. (2003, June 4). Physical activity and public health: A call to action. Report to

the Board of Health. Retrieved June 4, 2004, from www.city.toronto.on.ca/health/pa_calltoaction_report_boh.htm.

Beck, U. (1992). Risk society: Towards a new modernity. London: Sage.Benson, S. (1997). The body, health and eating disorders. In K. Woodward (Ed.), Identity

and difference (pp. 121-182). Thousand Oaks: Sage.

320 McDermott

Bercovitz, K. (1998). Canada’s active living policy: A critical analysis. Health Promotion International, 13, 319-328.

Boero, N. (2006). All the news that’s fat to print: The American “obesity epidemic” and the media. Qualitative Sociology (online). Retrieved December 5, 2006, from www.springerlink.com.login.ezproxy.library.ualberta.ca/content/k72481766376k5x1/?p=64d3f19ddeb04b919ba7a2178eb75c3d&pi=0.

Bordo, S. (1993). Introduction: Feminism, western culture, and the body. In Unbearable weight. Feminism, western culture, and the body (pp. 1-42). Berkeley: University of California Press.

Boreham, C., & Riddoch, C. (2003). Physical activity and health through the lifespan. In J. McKenna and C. Riddoch (Eds.), Perspectives on health and exercise (pp. 9-30). Basingstoke: Palgrave Macmillan.

Branswell, H. (2000). Canadian kids getting fat at a staggering rate. Standard [St. Cath-erines], 27 November, A1.

Burchell, G. (1996). Liberal government and techniques of the self. In A. Barry, T. Osborne, & N. Rose (Eds.), Foucault and political reason (pp. 19-36). Chicago: University of Chicago Press.

Burrows, L., & Wright, J. (2004). The discursive production of childhood, identity and health. In J. Evans, B. Davies, & J. Wright (Eds.), Body knowledge and control. Studies in the sociology of physical education and health (pp. 83-95). New York: Routledge.

Cameron, C., Craig, C., & Paolin, S. (2005). Local opportunities for physical activity and sport: Trends from 1999-2004. Retrieved October 17, 2006, from www.cflri.ca/eng/statistics/surveys/documents/PAM_SPORT_2004.pdf.

Canada on the Move. (n.d.). The Canada on the Move research project is complete. Retrieved August 3, 2006, from www.canadaonthemove.ca/complete/index_en.htm.

Canadian Fitness and Lifestyle Research Institute. (n.d.). About us. Retrieved June 3, 2004, from www.cflri.ca/cflri/about/l_mission.html.

Canadian Fitness and Lifestyle Research Institute. (2001). Childhood obesity: Stemming the tide. The Research File. Retrieved June 20, 2004, from www.cflri.ca/pdf/e/rf0107.pdf.

Canadian Health Network. (2006). What is active living? Retrieved April 8, 2007, from www.canadian-health-network.ca/servlet/ContentServer?cid=1001752&pagename=CHN-RCS%2FCHNResource%2FFAQCHNResourceTemplate&lang=En&repGroupTopic=Active±Living±FAQ&parentid=1048540759782&c=CHNResource.

Canadian Heart and Stroke Foundation. (2005). Healthy hearts at home. Pamphlet. Ottawa, ON: Heart and Stroke Foundation of Canada.

Canadian Heart and Stroke Foundation. (2005). Heart and stroke jump rope for heart. Pamphlet. Ottawa, ON: Heart and Stroke Foundation of Canada.

Canadian Institutes of Health Research. (2004). Obesity. Retrieved June 1, 2006, from www.cihr-irsc.gc.ca/e/24942.html.

Canadian Institutes of Health Research. (2006). CIHR funding database. Retrieved July 12, 2006, from http://webapps.cihr-irsc.gc.ca/funding/run_search.

Canadian Paediatric Society. (1998, March 4). Canadian Paediatric Society and Canadian Teachers’ Federation call for action to boost physical activity levels in children. Retrieved August 8, 2006, from www.cps.ca/english/media/NewsReleases/activity.htm.

Castel, R. (1991). From dangerousness to risk. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (pp. 281-297). London: Harvester Wheatsheaf.

Cole, T., Bellizzi, M., Flegal, K., & Dietz, W. (2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal, 320, 1240.

Conrad, P. (1992). Medicalization and social control. Annual Review of Sociology, 18, 209-232.


Coveney, J. (1998). The government and ethics of health promotion: The importance of Michel Foucault. Health Education Research, 13, 459-468.

Craig, C., Cameron, C., Russell, S., & Beaulieu, A. (2001). Increasing physical activity. Supporting children’s participation. A CFLRI project initiated in partnership with the Physical Activity Unit, Health Canada, and the Interprovincial Sport and Recreation Council. Retrieved May 10, 2004, from www.cflri.ca/pdf/e/2000pam.pdf.

Dean, M. (1997). Sociology after society. In D. Owen (Ed.), Sociology after postmodernism (pp. 205-228). Thousand Oaks, CA: Sage.

Dean, M. (1999). Risk, calculable, and incalculable. In D. Lupton (Ed.), Risk and sociocul-tural theory: New directions and perspectives (pp. 131-159). New York: Cambridge University Press.

Elliott, C. (2006, August 3). When “baby fat” becomes too much of a good thing. The Globe and Mail, p. A11.

Evans, J. (2003). Physical education and health: A polemic or “let them eat cake!” European Physical Education Review, 9, 87-101.

Evans, J., & Davies, B. (2004). Sociology, the body and health in a risk society. In J. Evans, B. Davies & J. Wright (Eds.), Body knowledge and control. Studies in the sociology of physical education and health (pp. 35-51). New York: Routledge.

Evans, J., Rich, E., & Davies, B. (2004). The emperor’s new clothes: Fat, thin, and over-weight. The social fabrication of risk and ill health. Journal of Teaching in Physical Education, 23, 372-391.

Feldman, W., & Beagen, B. (1994). Screening for childhood obesity. In Canadian Task Force on the Periodic Health Examination. Canadian Guide to Clinical Preventive Health Care. Ottawa: Health Canada.

Flegal, K. (1999). The obesity epidemic in children and adults: Current evidence and research issues. Medicine and Science in Sports and Exercise, 31(Suppl.), S509-S514.

Foucault, M. (1984). Right of death and power over life. In P. Rabinow (Ed.), The Foucault Reader (pp. 258-272). New York: Pantheon.

Foucault, M. (1991). Governmentality. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect. Studies in Governmentality (pp.87-104). London: Harvester Wheat-sheaf.

Gard, M. & Wright, J. (2001). Managing uncertainty: Obesity discourses and physical educa-tion in a risk society. Studies in Philosophy and Education, 20, 535-549.

Gard, M., & Wright, J. (2005). The obesity epidemic. Science, morality and ideology. New York: Routledge.

Gastaldo, D. (1997). Is health education good for you? Re-thinking health education through the concept of bio-power. In A. Petersen & R. Bunton (Eds.), Foucault, health and medicine (pp. 113-133). New York: Routledge.

Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Palo Alto, CA: Stanford University Press.

Gordon, C. (1991). Governmental rationality: An introduction. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect. Studies in governmentality (pp. 1-51). London: Harvester Wheatsheaf.

Government of Alberta. (2003, January 31). Albertans’ attitudes about health need improve-ment. Retrieved May 19, 2004, from www.gov.ab.ca/acn/200301/13818.html.

Green, J. (1995). Accidents and the risk society. Some problems with prevention. In R. Bunton, R. Burrows, & S. Nettleton (Eds.), The sociology of health promotion (pp. 116-132). New York: Routledge.

Hall, S. (1997). The work of representation. In S. Hall (Ed.), Representation. Cultural rep-resentations and signifying practices (pp. 13-74). Milton Keynes: Sage.

Ingham, A. (1985). From public issue to personal trouble: Well-being and the fiscal crisis of the state. Sociology of Sport Journal, 2, 43-55.

322 McDermott

Leahy, D., & Harrison, L. (2004). Health and physical education and the production of the ‘at risk self.’ In J. Evans, B. Davies, & J. Wright (Eds.), Body knowledge and control. Studies in the sociology of physical education and health (pp. 130-139). New York: Routledge.

Lupton, D. (1995). The imperative of health. Public health and the regulated body. Thousand Oaks: Sage.

Lupton, D. (1999a). Introduction: Risk and sociocultural theory. In D. Lupton (Ed.), Risk and sociocultural theory: New directions and perspectives (pp. 1-11). New York: Cambridge University Press.

Lupton, D. (1999b). Risk. New York: Routledge.Lupton, D. (1999c). Risk and the ontology of pregnant embodiment. In D. Lupton (Ed.),

Risk and sociocultural theory: New directions and perspectives (pp. 59-85). New York: Cambridge University Press.

Marsh, P. (2005). An epidemic of confusion. Social Issues Research Centre. Retrieved December 7, 2006, from www.sirc.org/obesity/epidemic_of_confusion.shtml.

Martin, P., & Martin-Granel, E. (2006). 2,500-year evolution of the term epidemic. Emerg-ing Infectious Diseases. Retrieved December 1, 2006, from www.cdc.gov/ncidod/eid/vol12no06/05-1263.htm#cit.

McDermott, L. (2007). Weighing in on the discourses of physical inactivity and obesity: Back to the future. Manuscript submitted for publication.

Miah, A. (2005). Genetics, cyberspace and bioethics: Why not a public engagement with ethics? Public Understanding of Science, 14, 409-421.

Monaghan, L. (2005). Discussion piece: A critical take on the obesity debate. Social Theory and Health, 3, 302-314.

Monaghan, L. (2006). Weighty words: Expanding and embodying the accounts framework. Social Theory and Health, 4, 128-167.

Nettleton, S. (1997). Governing the risky self: How to become healthy, wealthy and wise. In A. Petersen, & R. Bunton (Eds.), Foucault, health and medicine (pp. 207-222). New York: Routledge.

Osborne, T. (1997). Of health and statecraft. In A. Petersen & R. Bunton (Eds.), Foucault, health and medicine (pp. 173-188). New York: Routledge.

O’Malley, P. (1996). Risk and responsibility. In A. Barry, T. Osborne, & N. Rose (Eds.), Foucault and political reason (pp. 189-207). Chicago: University of Chicago Press.

Petersen, A. (1997). Risk, governance and the new public health. In A. Petersen & R. Bunton (Eds.), Foucault, health and medicine (pp. 189-206). New York: Routledge.

Picard, A. (2002, April 5). Most children dangerously sedentary, report shows. The Globe and Mail, p. A13.

Public Health Agency of Canada. (2005). Welcome to the online edition of Canada’s physical activity guide for children. Retrieved August 8, 2006, www.phac-aspc.gc.ca/pau-uap/paguide/child_youth/children/index.html,

Rabinow. P. (1984). Introduction. The Foucault reader (pp. 3-29). New York: Pantheon.Rich, E., & Evans, J. (2005). “Fat ethics”—The obesity discourse and body politics. Social

Theory and Health, 3, 341-358.Rissanen, A., & Fogelholm, M. (1999). Physical activity in the prevention and treatment of

other morbid conditions and impairments associated with obesity: Current evidence and research issues. Medicine and Science in Sports and Exercise 31 (Suppl.): S635-645. http://gateway.ut.ovid.com/gw1/ovidweb.cgi.

Rose, A. (2005). Canada on the move: Research, evaluation, and partnership. WellSpring, 16. Retrieved August 3, 2006, from www.centre4activeliving.ca/publications/well-spring/2005/JunArticle.html.

Saguy, A., & Riley, K. (2005). Weighing both sides: Morality, mortality, and framing contests over obesity. Journal of Health Politics, Policy and Law, 30, 869-921.


Skolbekken, J. (1995). The risk epidemic in medical journals. Social Science and Medicine, 40, 291-305.

Spitzack, C. (1990). Confessing excess. Women and the politics of body reduction. Albany: State University of New York Press.

Strong, P. (1990). Epidemic sociology: A model. Sociology of Health and Illness, 12, 249-259.

Swadener, B., & Lubeck, S. (1995). Children and families “at promise”: Deconstructing the discourse of risk. New York: State University of New York Press.

Tinning, R., & Glasby, T. (2002). Pedagogical work and the “cult of the body.” Consider-ing the role of HPE in the context of the “new public health.” Sport, Education and Society, 7, 109-121.

Tremblay, M., & Willms, J.D. (2000). Secular trends in the body mass index of Canadian children. Canadian Medical Association Journal, 163, 1429-1433.

Tremblay, M., & Willms, J.D. (2003). Is the Canadian childhood obesity epidemic related to physical inactivity? International Journal of Obesity and Related Metabolic Disorders, 27, 1100-1105.

Tremblay, M., Barnes, J., Copeland, J., & Esliger, D. (2005). Conquering childhood inac-tivity: Is the answer in the past? Medicine and Science in Sports and Exercise, 37, 1187-1194.

Turner, B. (1997). Forward: From governmentality to risk, some reflections on Foucault’s contribution to medical sociology. In A. Petersen & R. Bunton (Eds.), Foucault, health and medicine (pp. ix-xxi). New York: Routledge.

Vail, S. (2001). The physical inactivity epidemic: The preventative role of active school communities. A discussion paper. Retrieved June 10, 2004, from www.yorku.ca/suevail/asc/ASCdiscussion.doc.

Wente, M. (2005, July 23). Kids are casualties of the adult war on fat. The Globe and Mail. Retrieved November 25, 2005, from www.theglobeandmail.com/servlet/story/RTGAM.20050723.COWENT23_COPY/BNStory.

Wheeler, F. (n.d.). Population health for health professionals. Retrieved January 14, 2007, from www.scahec.net/courses/PH%20Modules/Module2a.pdf.

World Health Organization. (2003). Controlling the global obesity epidemic. Retrieved May 27, 2004, from www.who.int/nut/obs.htm.

Wright, J., & Burrows, L. (2004). “Being healthy”: The discursive construction of health in New Zealand children’s responses to the National Education Monitoring Project. Discourse: Studies in the Cultural Politics of Education, 25, 211-230.

Notes

1. See Evans (2003) for a discussion of this contradiction.

2. Active living is a concept and initiative developed by the federal government that dates back to 1987 (Bercovitz, 1998) and is “an approach to life that values and includes physical activity in everyday living.” It is a broad concept envisioned to encompass exercise, physical fitness, physical activity, and sport (Canadian Health Network, 2006). Bercovitz (1998) notes the conspicuous resemblance between this discourse and that of health promotion.

3. Obesity sceptics dispute this received wisdom (e.g., Aprhamors, 2005; Evans, 2003; Feld-man & Beagen, 1994; Gard & Wright, 2001, 2005; Monaghan, 2005).

4. The academic constituency was examined through research primarily emanating from PE and kinesiology. Governmental texts originated from both provincial and federal education and health ministries. Positioned as having one foot in the academy and one in the government are two significant stakeholders in Canadian discussions of physical inactivity and obesity: the CFLRI

324 McDermott

and the Canadian Institutes of Health Research (CIHR), government-funded research agencies. Nongovernmental organizations include professional health and medical organizations (e.g., the Canadian Medical Association, the Canadian Paediatric Society), non-Canadian health organiza-tions (e.g., WHO), and Canadian-based physical activity organizations (e.g., Canadian Association for Health, Physical Education and Dance). Media sources were limited to two national media outlets: The Globe and Mail newspaper and the Canadian Broadcasting Corporation online.

5. See Boreham and Riddoch (2003), Gard and Wright (2005), and Rissanen and Fogelholm (1999) for an elucidation of such concerns.

6. Feminist research detailing the gendered politics of appearance (e.g., Bartky, 1990; Bordo, 1993; Spitzack, 1990) has been central to critiques of the cult of the body. See also Gard and Wright (2001, 2005), Evans, Rich, and Davies (2004), and Rich and Evans (2005), who demonstrate the deleterious effects recontextualized health discourses, as delivered through the educational context, can have on young people’s subjectivities, particularly in relation to contributing to eating disorders.

7. The CFLRI, in particular, is a central apparatus in the governance of Canadians’ healthy living practices. This nonprofit agency, founded in 1980, monitors population changes in physi-cal activity and health status, develops research priorities and strategies, assists in government policy development, educates individuals about the benefits of active living, and helps agencies promoting health and fitness (CFLRI, n.d.).

8. The CFLRI has conducted 11 national surveys on physical activity; 9 are contained in its Physical Activity Monitor reports (1995-2004); the other two are the 1981 Canada Fitness Survey and the 1988 Campbell Survey on Well-Being in Canada.

9. Kellogg’s Canada has been pivotal to this research project’s success as it inserted step counters in 800,000 cereal boxes, facilitating Canadians’ ability to track their steps, illustrating how issues of governance meld well with corporate interests within neoliberal societies.

10. Other scholars (e.g., Dean, 1999; Gordon, 1991; O’Malley, 1996) use the term prudential-ism in a similar manner.

11. Discussions of obesity as an epidemic date back to 1994 in the Journal of the American Medical Association (Saguy & Riley, 2005). While research does not indicate when physical inactivity became enmeshed within such a vocabulary, a Canadian newspaper database search found the first public occurrence linking these terms in 1997.

12. See Tremblay and colleagues (2005), Tremblay and Willms (2003), and Vail (2001) for further illustrations of this representation of childhood inactivity and obesity as being of epidemic proportions.

13. Conrad (1992) suggests the medicalization of obesity is representative of what he terms the medicalization of deviant behavior.

14. Branswell (2000) and WHO (2003) demonstrate this culture of fear; Gard and Wright (2005) and others (Aprhamors, 2005; Evans, 2003; Monaghan, 2005; Rich and Evans, 2005; Saguy and Riley, 2005) deconstruct ideologically and moralistically informed explanations conveyed through the “health industry.” Rich and Evans (2005) use the term health industry as shorthand to refer to health education experts, government agencies, and academics.

15. Ironically, junk food sales provide schools with revenues, funding such things as sport pro-grams, to offset reductions in public education funding under the implementation of a neoliberal political agenda.

16. See, for example, Monaghan’s (2006) analysis of adult men in relation to obesity and risk discourses, demonstrating how this process is shaped by gender and class.

Documents

A Governmental Analysis of Children ‘at Risk’ in a World ... · PDF fileA Governmental Analysis of Children ... 1992; Castel, 1991; Coveney, 1998; Dean, 1997, 1999; Giddens, 1991;