By Chelsea Lenhart, Staff Writer, Brief Policy Perspectives
Nicholas (Nick) Wallace will graduate in May 2016 from the Trachtenberg School of Public Policy and Public Administration at the George Washington University with a concentration in health policy. He focuses his coursework on health planning and obesity epidemiology. In addition to being a full-time student, Nick is a health policy intern with the Senate Committee on Health, Education, Labor and Pensions, as well as a personal training supervisor at GWU’s Lerner Health and Wellness Center. I chatted with Nick about his article that will be published in Volume 23 of Policy Perspectives.
Brief Policy Perspectives: Nick, tell me a little bit about yourself and your interest in health policy.
Nick Wallace: Well, that’s a great question. I have always been extremely interested in personal fitness and wellness. It is the personal passion that gets me out of bed every morning. However, I am also deeply interested in politics and have so far tuned into all of the Republican presidential debates and all but one of the Democratic debates [chuckles]. I wanted to figure out how I could mesh these two areas of my life and I realized that my personal interest in fitness can act as a catalyst for public health and health policy. I want to be able to bring the motivation that I have to get others in the community to adopt healthy lifestyles and practices. In the long-term, I want to be able to help advocate for a non-profit that focuses on fitness, health, wellness; an issue that I care about and can honestly and fully advocate for.
BPP: That’s awesome. Sounds like studying health policy was a good move then. What is your article about?
NW: It’s about the Personal Health Investment Today (PHIT) Act that was first introduced in 2007 and has been included in all sessions since its introduction without being voted on or passed. The bill introduces a scaled model of a fitness tax credit program based off a system that is already in place in Canada.
When people think about government intervention in the realms of health, they often conjure up images of Mayor Bloomberg’s sugar taxes, and the regulations that were placed on large sugary drinks in New York City. However, there is a whole other group that is focusing on incentivizing good behavior rather than taxing bad behavior—very similar to the model seen for the Earned Income Tax Credit (EITC).
The question really comes down to whether it is feasible to take this program and introduce it into the United States. Just as opponents of the soda tax decry it for being regressive, opponents of PHIT can say the same thing. It is also regressive because it is based on the individual having a health savings account. What about people that don’t have health insurance? How about people who don’t have access to the information to even know that PHIT exists? My paper analyzes all of these questions and problems with implementing PHIT.
BPP: It appears to me that the costs of this program, and the fact that it may not reach the people it needs to, make it not feasible and not worth it even?
NW: No, that’s not the way to look at it. In my opinion, the problem today is so severe that the costs of the problem outweigh any of the potential costs of the program itself. The concept and the idea behind the program is good – implementing it effectively will be the issue. Although there are probably many other solutions out there, like corporate wellness programs or personal empowerment, there isn’t enough evidence that the private sector is willing to invest to solve the problem.
BPP: Why is promoting physical activity such a big deal? What do you want your readers to take away from your article?
NW: Obesity and physical inactivity are two completely different things. Obesity is an inflammatory disease that leads to cascading negative health consequences, whereas physical inactivity is a health problem within itself. Physical inactivity is a health problem that can be fixed. All people benefit from physical activity. There are studies that show that obese individuals who exercise, even if in very small amounts, still have lower rates of hypertension compared to obese individuals who don’t move at all. The conversation about obesity shouldn’t focus on the weight, it should focus on all the positive outcomes that physical activity brings. These can include weight loss, but also range from increased cognitive ability to positive social benefits. Obesity is measured by simply looking at an individual’s BMI (body mass index) and this indicator misses the rest of the story that shows how many good things come from physical activity, things that are so important to long-term health.
BPP: Okay, you’ve sold me. Physical activity deserves our attention. Where can your readers go for more information about all of this?
NW: One of the best resources is the Trust for America’s Health website. They are a sub-group under a larger umbrella organization called the National Coalition for Promoting Physical Activity (NCPPA). I will actually be attending the national conference for NCPPA this year and hope to share with them the ideas in my article. Trust for America’s Health has information on all sorts of topics that surround health. They publish annual state obesity indexes and have numerous indicators that rank how healthy states are. Trust for America’s Health goes beyond the popular conversation that focuses on nutrition promotion and looks at the whole picture. The best thing about this resource is that everything on their website is free!
Interested in health policy and obesity? You can read Nick’s article “Behavioral Economics and Obesity: An Analysis of Fitness-Based Tax Incentives” in Volume 23 of Policy Perspectives, coming to a classroom near you on April 15th! The article appears online here.