Childhood obesity, play and critical thinking

One of the most important functions of critical thinking is to go 'against' the prevailing wisdom: to go against convention; to think the impossible or the unreasonable; to entertain the possibility that our present way of thinking is neither the best or most appropriate way.  One way to do this is to look back to a time when people thought otherwise and to ask whether we are necessarily smarter today, or just different. This is not easy to do.  Thinking against conventional wisdom immediately puts you in a minority position and opens you up to the easy dismissal of the comfortably popular.  But that's exactly why critical thinking is so important, because it is directed at tomorrow, not today. So as Karl Popper argued with his theory of falsificationism, we should pay attention to those arguments that challenge and maybe even contradict our present way of thinking, not seek to bolster that which is taken-for-granted and obvious. There are lots of examples of quotidian thinking in health care at the moment.  Things like 'evidence based practice is vital,' 'people should exercise for 30 minutes three times a week,' 'sitting down for long periods is bad for you,' and possibly the most pernicious 'obesity is a silent epidemic threatening the present and future health of the population.' The power of such discourses creates the possibility for equally powerful counter-narratives - or countervailing powers, as Donald Light called them (Light, 1993) - and the authors of a recent article in Sociology of Health & Illness have certainly attempted this in their paper 'You have to do 60 minutes of physical activity per day … I saw it on TV’: Children's constructions of play in the context of Canadian public health discourse of playing for health (Alexander, Fusco & Frohlich, 2015). Abstract Public health institutions in many industrialised countries have been launching calls to address childhood obesity. As part of these efforts, Canadian physical activity campaigns have recently introduced children's play as a critical component of obesity prevention strategies. We consider this approach problematic as it may reshape the meanings and affective experiences of play for children. Drawing on the analytical concept of biopedagogies, we place Canadian public health discourse on play in dialogue with children's constructions of play to examine first, how play is promoted within obesity prevention strategies and second, whether children take up this public health discourse. Our findings suggest that: (i) the public health discourse on active play is taken up and reproduced by some children. However, for other children sedentary play is important for their social and emotional wellbeing; (ii) while active play is deemed to be a solution to the risk of obesity, it also embodies contradictions over risk in play, which children have to negotiate. We argue that the active play discourse, which valorises some representations of play (that is, active) while obscuring others (that is, sedentary), is reshaping meanings of play for children, and that this may have unintended consequences for children's wellbeing.

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What's interesting to me about this paper is how physiotherapists are being pulled into this debate about children's health and wellbeing.  These arguments create some real tensions for our profession, and they're not something we're particularly good at grappling with.  How do we see ourselves helping these children best?  Do we see ourselves competing with physical activity campaigners and practitioners in order to secure the government funding that often accompanies these kinds of panic?  Are we targeting our action at the children and their families, which is easier and fits in nicely with a dominant blaming culture, or are we looking at the deeper and more complex social determinants of these problems? Whatever our response, we should not be afraid to think against convention wisdom and ask critical questions about our role in future health care.  Indeed our own future health may depend on it. References Alexander, S. A., Fusco, C., & Frohlich, K. L. (2015). ‘You have to do 60 minutes of physical activity per day … I saw it on TV’: Children's constructions of play in the context of canadian public health discourse of playing for health. Sociology of Health & Illness, 37(2), 227-240. doi:10.1111/1467-9566.12179. Light, D. W. (1993). Countervailing power: The changing character of the medical profession in the united states. In F. W. Hafferty & J. B. McInlay (Eds.), The changing medical profession: An international perspective (pp. 69-79). Oxford: Oxford University Press.