Most of the legislation addressing obesity is developed at the state and local levels. For example, some school districts in the country are using newly implemented laws and or their existing legal authorities to improve nutrition, increase physical education programs, and monitor childhood obesity through BMI screening. A watershed year for such legislation, 2005, saw the passage of 17 state statutes relating to school-based nutrition and 21 related to physical education programs. Other legislation includes restricting access to vending machines, and introducing fresh, locally grown produce into school nutrition programs. To date, states have not imposed advertising and marketing limits on products that contribute to obesity rates, though we can anticipate such attempts in the future. In part because the laws have not yet been evaluated, they have not been widely adopted throughout the country.
Various laws and legal authorities directly and indirectly regulate many (if not most) of the factors influencing obesity rates, such as food production, distribution, eating, and exercise. Therefore, it is important for public health and health care practitioners to share information with elected officials and other policymakers to develop sound public policy to reduce the incidence and prevalence of obesity. Legislators and practitioners seeking to improve policies and programs related to obesity prevention and control must have ready access to evidence-based information to support laws and implement programs that can have a long-term impact in reducing obesity as a chronic disease.
As the lone black Member at the dawn of the 20th century, Representative defended the "right to live" in his campaign for anti-lynching legislation. Lynching—public execution by hanging or shooting, sometimes involving torture—was a particularly racially tinged form of violence that had long been a scourge of American society. Lynch mobs consisted of a handful of vigilantes, or sometimes hundreds, ranging from criminals and thugs to the leading citizens and favorite sons of local communities. Occasionally, lynchings were attended by throngs of onlookers. A disproportionate number of the victims were black men. Particularly in the South, they were accused of rape and other sexual offenses against white women (even though the vast majority of victims already under arrest were not charged with any crime of sexual violence).74 Accurate figures are impossible to obtain, but from 1882, when reliable statistics first became available, to the early 1930s, approximately 3,400 African Americans were lynched.75
Representative White called for an end to the barbarism of lynching in the South on January 20, 1900, when he introduced H.R. 6963, the first federal anti-lynching bill "for the protection of all citizens of the United States against mob violence."76 A month later, during general debate on American territorial expansion in the Caribbean and Pacific, White defended his bill on the House Floor. He provided graphic accounts of lynching atrocities and a stern rebuttal to derogatory comments made on the House and Senate floors against blacks. White noted that his goal in seeking to require lynching cases to be tried in federal courts was "that the National Government may have jurisdiction over this species of crime." But conditions in the South were such that they provoked serious questions not only about regional race relations but also about national and international policy. "Should not a nation be just to all her citizens, protect them alike in all their rights, on every foot of her soil," White asked rhetorically, "in a word, show herself capable of governing all within her domain before she undertakes to exercise sovereign authority over those of a foreign land—with foreign notions and habits not at all in harmony with our American system of government? Or, to be more explicit, should not charity first begin at home?"77 The legislation garnered no support from the William McKinley administration, stirred little enthusiasm in the House, and was met with ambivalence by an American public with scant knowledge of the magnitude of the lynching problem. White's bill died in the Judiciary Committee at the close of the 56th Congress in 1901.
In addition to campaigning for anti-lynching legislation, challenged the House to punish southern states for disfranchising blacks by calling for a reduction in their congressional delegations. White's appeal in 1899 that southern delegations to Congress ought to be limited to "the benefit of the votes that are allowed to be cast in their representation" initially fell on unsympathetic ears, despite his declaration, "It is a question that this House must deal with some time, sooner or later."78 Derived from Section 2 of the 14th Amendment, reduction legislation required Congress to penalize states that sought to disqualify eligible voters by subtracting the number of disfranchised voters from the population count used to determine the number of seats each state was allotted in the House. At the high tide of Radical Republican rule in the House, the chamber passed a measure after the 1870 Census that required Congress to enforce that provision. Section 6 of the Apportionment Act of February 2, 1872, mandated that if any state denied or abridged the voting rights of eligible male inhabitants over the age of 21, "the number of Representatives apportioned in this act to such State shall be reduced in the proportion which the number of male citizens shall have to the whole number of male citizens twenty-one years of age in such state." 79
The 1900 Census and the resultant reapportionment of U.S. House seats presented those few inclined to White's views a chance to resurrect the issue. In 1901, Congress took up its prescribed role of reapportioning House seats based on the states' population gains or declines recorded in the census.80 Among several bills addressing the process, a measure introduced by of Indiana received the most attention. The legislation sought to penalize Louisiana, Mississippi, North Carolina, and South Carolina, which had approved state constitutions disfranchising blacks. A former appellate judge and a prosecuting attorney from Valparaiso, Indiana, Crumpacker was first elected as a Republican in 1896 from a northwestern district that encompassed the industrial city of Gary. He appears to have first raised the issue of reduction in the late 1890s, as a member of the Select Committee on the Census. In that capacity he introduced H.R. 11982, requiring the director of the census to collect information on state suffrage laws relating to voter qualifications and to tabulate for each state the number of males over the voting age of 21. Armed with this information, Crumpacker hoped to enforce the reduction clause of the 14th Amendment. The committee reported the bill favorably to the House on the final day of the 55th Congress (1897–1899) when it was too late to take action.81 This failed attempt to obtain a House vote on reduction would be the first of many.
On January 7, 1901, Representative Crumpacker delivered a lengthy floor speech emphasizing Congress's obligation to uphold the 14th Amendment. He urged his colleagues not to let their "coercive power" be "abrogated by passive nullification" of the Constitution. Opposing southern claims that the 15th Amendment superseded the 14th, Crumpacker declared both "active and operative" and complementary. "No state may disfranchise citizens on account of race, color, or previous condition of servitude, but they may disfranchise on any other account," Crumpacker said, taking note of state constitutional provisions for poll taxes and literacy tests. "But, sir, if they restrict the right of suffrage of male citizens 21 years of age by raising the age limit, by educational laws, by property qualifications, or by any other method within their constitutional authority, except for crime, the basis of representation [of those states in Congress] must be reduced accordingly." Crumpacker hoped to avoid a protracted struggle with southern Members over voting statistics. He proposed to reduce representation based on illiteracy rates for both whites and blacks, assuming illiterates would fail education tests that accompanied disfranchisement plans.82 Representative George White praised Crumpacker as an exemplar "who has taken occasion to stand up in his place as a man, and has said a word in defense" of African Americans.83 The House, which eventually voted to expand its membership, devoted considerable attention to Crumpacker's plan before voting—136 to 94—to table further consideration.84
The reduction debate flared again in early 1902, after of Ohio proposed to instruct the House Rules Committee to investigate the relationship between disfranchising states' congressional representation and the voting figures for congressional elections.85 Southerners responded venomously. of Mississippi, a Confederate veteran turned newspaper publisher, baldly declared that disfranchisement's "leading purpose was to eliminate the negro from the political equation." He added that the South would prefer to have no congressional representation if it could avoid a "return again to the state of affairs existing in the reconstruction period."86 Nevertheless, in a party line vote, the Republican-dominated House Rules Committee supported the Dick proposal in March 1902. However, Representative of Alabama, who had just spearheaded his state's 1901 constitutional convention disfranchising virtually all blacks, successfully sabotaged the proposed investigation by exploiting a Republican division regarding a sugar tariff. Insurgent Republicans opposed leadership efforts to strike the elimination of a tariff differential amendment and thus retain a high tariff. By joining Midwestern and insurgent Republicans on an economic issue to thwart corrective federal legislation, Democrats replayed their strategy for subverting the Federal Elections Bill of 1890. In delivering the Democratic Caucus vote to these Republicans, Underwood secured their promise to vote down the Rules Committee investigation after it came to the floor.87
When Democratic candidate Grover Cleveland won the presidential campaign in 1884, the Republican Party lost control of the White House for the first time since 1860. GOP reformers were quick to blame disfranchisement of black (and mostly Republican) voters in the South for the devastating electoral loss. Republican Senators William Chandler of New Hampshire and of Ohio—both staunch reformers with GOP careers predating the Civil War—led an attempt to roll back disfranchisement. Chandler began amassing evidence of election fraud in the South after the 1884 election, which led one African–American committee witness to call him "the greatest man in the United States."65 Sherman introduced a bill to enact federal control over national elections in January 1889; however, the bill had no chance of passing the 50th Congress (1887–1889). Republicans held a slim, two-person majority in the Senate and Democrats controlled the House. Nevertheless, the Senators captured the attention of other Republicans who, pushed and pulled by the monetary and humanitarian factions of the party, began to realize the political expedience of reasserting federal election law in the South.
In 1888, Republican presidential candidate Benjamin Harrison added election reform to his campaign platform. Born in Ohio and hailing from Indiana, Harrison was a Civil War veteran who had declared in 1876 that the U.S. government had "an obligation solemn as a covenant with God to save [freedmen] from the dastardly outrages that their rebel masters are committing upon them in the South." During his campaign, he refused to "purchase the Presidency by a compact of silence" regarding black voting rights in the South.66 Riding the coattails of Harrison's victory, the Republican Party gained a majority in both houses for the first time in eight years at the start of the 51st Congress. Led by the influential Massachusetts duo of Representative and Senator , the GOP made one last attempt at reinforcing the 15th Amendment and combating disfranchisement in the South.
George Hoar had been a leading GOP House Member and an ally to abolitionist-turned-freedmen's advocate Senator Charles Sumner of Massachusetts during the Reconstruction Era. When Senator Chandler fell ill just before the opening of the 51st Congress, Hoar drafted a new bill to place national elections under federal control. Representative Lodge, however, soon convinced Hoar that since the bill affected only the lower chamber (Senators were not directly elected until 1913) the legislation should originate there. A Boston native of Puritan stock, Lodge earned one of the first history Ph.D. degrees awarded by Harvard University. Described as a "self-righteous humanitarian," he was abrasive and blunt with friends and enemies alike.67 Unlike Hoar, who died in 1904, Lodge enjoyed a long and storied career in the Republican Party well into the 20th century. In 1893, he moved to the Senate, where he remained for more than 30 years, chairing five committees, serving as chairman of the Republican Conference, and becoming a spokesman for the party's foreign policy initiatives.
Lodge submitted the Federal Elections Bill to the House on June 14, 1890. The legislation was a conglomerate of several measures, including Hoar's and those of other House and Senate Members. Exceeding 70 pages, the bill allowed a small number of constituents in any given precinct to petition a federal judge to take charge of a national election rather than leaving the process in the hands of local—and, in the South, usually Democratic—officials. The federal government also would appoint supervisors to oversee all phases of federal elections, from voter registration to the certification of the results. The bill reaffirmed the President's prerogative to send federal troops to monitor violent or chaotic elections. On June 26, Lodge opened the debate to support the bill with what one historian describes as a "racial sermon."68 "The first step…toward the settlement of the negro problem and toward the elevation and protection of the race is to take it out of national party politics," Lodge asserted. "This can be done in but one way. The United States must extend to every citizen equal rights." Addressing southern Congressmen's tendency to call forth the specter of "negro domination," he continued, "This bitter appeal to race supremacy, which is always ringing in our ears, is made a convenient stalking horse to defraud white men as well as black men their rights. It is an evil which must be dealt with, and if we fail to deal with it we shall suffer for our failure."69 Opponents in the South soon labeled the Federal Elections Bill the "Force Bill" and recalled the chaos caused by federal regulation during the Reconstruction Era. "If you could only realize as we do how this measure is destined to retard our progress, destroy confidence, impair development, engender strife, revive bitterness, relegate us to the dark and deplorable conditions of reconstruction, and produce only evil," Representative of Texas declared.70
The Federal Elections Bill barely passed the House on July 2, 1890, 155 to 149. It then languished in the Senate, where the debate over circulating silver bullion eventually killed it. Western Republicans dismissed the bill, hoping the coinage of silver—a policy beneficial to their mining states—would come before the Senate first. When the Senate finally took up the Federal Elections Bill, angry Silver Republicans joined Democrats in a week-long filibuster that defeated the legislation in February 1891. Most notably, Nevada Senator William Stewart—a principal architect of the 15th Amendment and the floor manager during debate on the Ku Klux Klan bills—joined the filibuster.
In many ways, the GOP reformers' efforts paralleled those of the Radical Republicans, who steered the 1875 Civil Rights Bill through Congress. Both pieces of legislation were carefully whittled into the form that was deemed most palatable to the competing factions of the Republican Party. Both bills were partially blamed for and threatened by GOP losses in midterm elections. Much as in the 1874 elections, the Republican Party was devastated in 1890. In the House, the 17-seat majority in the 51st Congress gave way to a whopping 152-seat deficit in the 52nd Congress (1891–1893). Though Senate Republicans maintained their majority, they lost four seats.
Several other obstacles doomed the passage of the Federal Elections Bill. Foremost, it landed low on the congressional priority list. Republican leaders in both chambers saw to it that commercial legislation was dispensed with before taking up the Lodge Bill. Congress spent half of the first session debating the McKinley Tariff—which raised duties on imports almost 50 percent to protect domestic agricultural and industrial products—before taking up the Federal Elections Bill. Once debate commenced, few Members put a human face on the legislation, despite ample evidence of black suffering in the South. Lodge was one of the few supporters of the bill who emphasized African-American rights. In contrast to the debate on the Civil Rights Bill, which was permeated by talk of "equality" and "humanity," debate on the Federal Elections Bill emphasized the need to defend "republicanism"—abstractly defined as the "right to vote."71
Finally, in contrast to the firsthand testimony of black Members during the Civil Rights Bill debate in 1874 and 1875, black Representatives had very little input on the 1890 Federal Elections Bill. Henry Cheatham, the only black Member serving in the House while that chamber considered the bill, never gave a speech on the topic. and , who joined Cheatham in the next session after winning their contested election cases, could only encourage Senate consideration of the bill. "It does not matter how black we are; it does not matter how ignorant we are; it does not matter what our race may be," Langston declared in January 1891. "The question presented here to-day under our amended Constitution…is shall every freeman, shall every American citizen, shall every American elector…be permitted to wield a free ballot?"72 Miller noted that southern blacks lacked necessities whose absence overshadowed their lack of voting rights. "Ah, gentlemen," he lamented, "what we need in this land is not so many [political] offices. Offices are only emblems of what we need and what we ought to have. We need protection at home in our rights, the chiefest of which is the right to live."73
To address the limited nutritional information available to consumers at the point of purchase, states and localities have proposed labeling and caloriecount requirements in restaurants. But only one state (California) and a handful of localities (King County, Washington; San Francisco and Santa Clara County, California; and New York City) have succeeded in passing such legislation. After overcoming the state restaurant association's challenge in court in May 2008, the New York City Health Department started issuing citations to chain restaurants that were not posting calorie counts on their menus. New York and other cities, including Boston, have approved local trans fat bans. Studies have shown that a high intake of trans fat is associated with the risk of weight gain and gain in abdominal fatness. While evaluation studies of these programs are under way, they have not yet resulted in widespread knowledge of the impact these legal strategies may have on obesity prevention and control.
To be sure, lawmakers cannot easily wait for full evaluation results before taking action. But just doing something is not necessarily a better alternative. It is not likely that legislators will continue to enact new laws if obesity rates continue to escalate and doing so may come at the expense of implementing superior alternatives.
Information sharing and the methods used to share best practices are components of the fourth core element of public health legal preparedness. The way public health practitioners, health care providers, attorneys, and legislators share information or have access to information is critical for ensuring that laws and legal authority support best practices that address the complex public health issue of obesity.
Assignment: Unit 13, 14, 16 & 17: Legislation regarding SOVA, outcome based practice and person-centred care.
Skills for Care and Development QCF Assessment
1. 2 (Unit 13) Critically review approaches to outcome based practice
1.3 (Unit 13) Analyse the effect of legislation and policy on outcome based Practice.
4.1 (Unit 13) Explain the necessary steps in order for individuals to have choice and control over decisions.
5.1 (Unit 13) Analyse the importance of effective working relatioships with carers, families and significant others for achievement of positive outcomes.
5.4 ( Unit 13) Explain how legislation and regulation influence working relationship with carers, families and significant others.
1.2 (Unit 14) Evaluate the impact of policy development on approaches to safeguarding vulnerable adults in own service setting.
1.1 (Unit 16) explain the policies, procedures and practices for safe working with children and young people.
1.1 Explain person-centred practice. (Unit 17)
1.2 Critically review approaches to person-centred practice. ( Unit 17)
1.3 Analyse the effect of legislation and policy on person-centred practice. (Unit 17)
1.4 Analyse how person-centred practice informs the way in which consent is established with individuals. (Unit 17)
1.5 Explain how person-centred practice can result in positive changes in individuals’ lives. (Unit 17)