PoPulationand Public HealtH etHics

esearch
Case discussion in response to
obesity surveillance in scHool cHilDren
Michael J. Selgelid, Ph.D.
Director, Centre for Human Bioethics
Monash University, Melbourne, Australia
MICHael.selgelID@MonasH.eDu
Introduction
Given the growing obesity problem in children and adults — and apparent
links between obesity and illness — the need for more research and surveillance
regarding obesity can presumably be taken as a given. Assuming that
the general need for obesity surveillance should be considered uncontroversial,
the case described by Dilworth et al. raises questions regarding (1)
whether such surveillance should be conducted at elementary schools and,
if so, (2) the conditions under which such surveillance should be conducted.
An important purpose of surveillance is to identify the prevalence of diseases
and/or risk factors. When surveillance reveals that such rates are sufficiently
high, public health authorities and policy makers can take action to respond
to them. Establishing accurate estimates of prevalence rates requires study
of representative populations. Dilworth et al. make a convincing case that elementary
schools would provide an ideal representative sample of the study
group in question (i.e., young children). The surveillance program they describe
would “reach virtually all [young] children” (assuming not many parents will
choose to opt out). It is hard to imagine a better, more representative, sample.
Assuming that data regarding obesity prevalence rates in young children will
provide useful information, the surveillance program described could have
important benefits. This partly depends, however, on what exactly will be
done with the data obtained. Analysis of surveillance ethics, to date, has been
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