Nanny or canny? Community perceptions of government intervention for preventive health

By Dr Anne Grunseit

The paper

Grunseit A, Rowbotham S, Crane M, Indig D, Bauman A, Wilson A. Nanny or canny? Community perceptions of government intervention for preventive health. Crit Public Health. 2018. doi: org/10.1080/09581596.2018.1468020

AUSPOPS – AUStralian Perceptions of Prevention Survey

Why we studied this topic

Public opinion is an important driver of government action in prevention. However, population-level interventions are often branded as ‘nanny state’. What is unclear is what the Australian community’s attitudes to prevention really are, or whether the idea of the nanny state truly reflects community attitudes.

What this paper adds

This research shows the public’s thinking about government intervention is more nuanced than the simplistic idea of a nanny state that contrasts personal freedom with paternalism. People can hold differing views at the same time about how far governments should intervene, depending on the target, the risk factor and the intervention. For example, while people believed that individuals were responsible for their own health, the research found they also felt that the government had a responsibility to protect population health and to invest taxpayers’ money wisely.

What was surprising

Contrary to the view proposed by proponents of the nanny state, most people were supportive of government regulation and incentives to support better health – including taxes, especially if the revenue raised is directed towards other health initiatives. They see good population health as a shared responsibility and but had mixed views about individuals who continued to act in unhealthy ways despite knowing the risks and consequences.

What it means for policy

The message for policymakers and politicians is that the public is more supportive of government intervention for prevention than perhaps they think. It is important not to let debate about new policy and legislation to be hijacked by nanny state arguments which pit individual rights vs paternalism. Rather, to align better with community perceptions of prevention, it would be more helpful to reframe the debate to focus on the cost benefit, equity, the influence of vested interests and the likely effects of both action and inaction.