ELF – Engelsk läsförståelse (HPHOST2016P4)

In the following text, there are gaps which indicate that something has been left out. Look at the four alternatives that correspond to each gap and decide which one best fits the gap. Ten mark your choice on your answer sheet.

Taxing Fat

Alternatives Te purpose of food taxes is to reduce sales of the products concerned. By introducing its fat tax in 2011, which was dropped after only a year, the Danish government also wanted to __1__ revenue, reduce costs associated with obesity-related diseases, and increase health and longevity. A year is hardly time to assess its impact on health, but the tax did bring in $216 million. Danes will now face higher income taxes to make up for the loss of the fat tax.

Business groups insist that the tax had no effect on the amount of fat that Danes ate.__2__, economists at the University of Copenhagen say Danish fat consumption fell by 10 to 20 percent in the first three months after the tax went into effect. However, it is not possible to know whether it fell because of the tax or because of the slump that hit the Danish economy.

Is a saturated-fat tax good public policy? All food fats are a mix of unsaturated and saturated fatty acids. Saturated fats raise the risk of coronary heart disease, although not by much. Trans fats, banned in Denmark since 2003, are a greater risk factor. Because the different fatty acids __3__ in their risk, imposing a single tax on them as if they are indistinguishable is difficult to support scientifically.

For these reasons, anti-obesity tax measures in other countries have tended to avoid targeting broad nutrient groups. __4__, they focus on processed foods, fast food, or sugary drinks – all major sources of calories. Taxing them seems like a more promising strategy.

What else should governments be doing? That they have a role in addressing the health problems caused by obesity is beyond __5__, not least because they bear much of the cost of dealing with such problems. In the US, economists estimate the cost of obesity-related healthcare and lost productivity at between $147 billion and $190 billion a year. Thus, the need to act is urgent. But how?

Marion Nestle, New Scientist

Preventive Medicine

A Review of Vaccine by Arthur Allen

n 1796, an English country doctor named Edward Jenner successfully immunized a child against smallpox, the world’s deadliest infectious disease. News of Jenner’s stunning achievement led millions throughout Europe to roll up their sleeves. Yet, as Arthur Allen makes clear in Vaccine, a timely, fair-minded, and crisply written account of “medicine’s greatest lifesaver,” not everyone welcomed Jenner’s feat. Criticism came quickly, often in apocalyptic terms. The economist Tomas Malthus wrote that vaccination might lead to dangerous population increases. Ministers warned against interfering with the Lord’s grand design. Others, meanwhile, objected to a process that injected foreign, perhaps poisonous, matter into the body. What possible good could come from polluting the bloodstream of a child?

Antivaccine sentiment found fertile soil in the United States, where the ethos of individual responsibility often clashed with public health programs based on collective norms. What kept vaccine opponents on the defensive, however, were the rapid breakthroughs in medicine and public health. Jenner’s triumph was followed by a procession of other vaccines, for rabies, tetanus, yellow fever, diphtheria, and more. A healthier diet advances in sanitation and surgery, and the development of antibiotics and DDT – all combined to increase American life expectancy to 70 years from 47 between 1900 and 1955.

World War II made vaccination fashionable. Polio turned it into a national crusade. No disease drew as much attention in postwar America or created as much fear. Primarily striking children, polio killed some of its victims and paralyzed others, leaving behind vivid reminders for all to see: wheelchairs, leg braces, iron lungs, and deformed limbs. The quest for a means of prevention led to the largest public health experiment in American history, involving nearly two million school-age volunteers. When Jonas Salk’s virus vaccine was declared “safe, effective, and potent” in 1955, the nation celebrated as if a war had ended – and, indeed, one had.

As late as the 1950s, parents had been encouraged to expose their children to diseases like measles and mumps in order to get them over with before adulthood, when the dangers increased. Vaccines for these illnesses have been around since the 1970s. More were on the way and some researchers spoke openly about a future without infectious disease. In our current age of AIDS, one marvels at the arrogance of such a belief. Nature remains a full step ahead.

Allen is sympathetic to parental fears regarding the dangers of various vaccines, though he remains skeptical that scientific studies of these dangers will open many minds. At this point, he writes, much of the “antivaccinist” leadership is composed of countercultural types who view life through the prism of conspiracy theory: the government lies, the drug companies are evil, the medical profession is corrupt; trust the Internet instead. A fair number oppose traditional medicine in favor of homeopathy, believing that vaccines weaken the immune system and that sickness is a natural part of life.

To a large extent, says Allen, this antivaccination impulse is fueled by an ignorance of the past. Vaccines have done their job so well that most parents today are blissfully unaware of the diseases their children are inoculated against. The end result is a culture that has become increasingly risk-averse regarding vaccination because people have greater trouble grasping the reward.

The problem appears to be growing. As more children go unvaccinated in the United States, there has been a rise in vaccine-preventable diseases. Meanwhile, fewer pharmaceutical companies are now producing vaccines, citing the high cost of testing, diminishing markets, and a fear of litigation. For Allen, a reversal of these trends will require something long overdue: a frank national discussion about the risks and benefits of vaccination. His splendid book is a smart place to begin.

David Oshinsky, The New York Times Book Review