“If we let these kinds of people have their way, we will not be allowed or able to do anything anymore!!”

New health measures were recently proposed by the Dutch National Institute for Public Health and Environment (RIVM), including increasing taxes on sugar-sweetened beverages and unhealthy food. While the health benefits of such interventions are clear, the legitimacy among citizens – especially less-educated ones – is uncertain.

One of the main reasons for increasing the price of sugar-sweetened beverages and unhealthy food is to diminish the health gap between less- and more-educated individuals. The former more often consume these unhealthy products, and thus form the ideal beneficiaries of the newly proposed interventions from a health perspective. Yet, as extant research shows, less-educated individuals also report more aversion to institutions from which these interventions originate. This endangers support for those interventions among those who need them most.

Semi-systematic social media observations

That the anti-institutionalism that is most often found among less-educated citizens manifests itself as aversion to (governmental) health promotion is perhaps most visible at today’s biggest public forum: social media websites like Facebook and Twitter. Comments on posts from Dutch news media offer a window on citizens’ opinions on many societal issues, including proposed health interventions. In comments on posts about the new RIVM measures, users, for example, call them the “ultimate form of meddling”, exclaim how “all that is fun will be forbidden” and worry about unhealthy products becoming “products of luxury only for the elite”, signaling not only anti-institutionalism, but also concern about growing social inequality as a result of the health measures.

Feelings of misrecognition

Granted, price interventions that directly affect the ability to consume certain products, do not have to lean on public support to be effective, as opposed to, for example, information interventions. Yet, the pushback against price interventions by less-educated citizens may also be cause for worry, because it may create a feedback loop that negatively affects public health efforts. Less-educated individuals can see the proposed health measures as an attack on their lifestyle and feel like their choices are looked down upon. In their eyes, drinking a can of Coke or eating fried snacks will essentially be forbidden, while lifestyles of others remain untouched. By feeding into these feelings of misrecognition, the proposed measures may increase the perception that the responsible institutions primarily target lower social strata. Ultimately, this may not only incentivize them to oppose the price interventions, but also other measures taken by public health institutions. Well-meant health interventions might thus alienate those that need them most, and that can never be their intention.

Tim van Meurs is a PhD candidate at the Department of Public Administration and Sociology of the Erasmus University Rotterdam. His main focus is on educational differences in the receptiveness of informational and structural nutrition interventions. You can contact him via email: vanmeurs@essb.eur.nl

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