A phosphate mine in Nauru
In detailing his travels across the Pacific islands in 1521, Magellan described the men as “well formed,” and the women as “slender and beautiful.” Five hundred year later, the top seven most obese countries, as well as eight of the top 10, are all Pacific islands. At the top of this list is the Republic of Nauru, with an overall obesity rate of 71.7 percent for its 10,000 residents and a staggering average BMI of 34-35. 40 percent of the adult population is diabetic, dragging the life expectancy down to 63.
The obesity crisis in Nauru stems from the intersection of numerous unique historical, economic, and cultural factors. Although the government and various interest groups have taken measures to address the issue, their efforts have, thus far, been largely ineffective. Despite its relatively small size, influence, and population, Nauru presents one of the most concerning public health cases anywhere in the world.
The Takeoff
For many years, the economy of Nauru was driven by exports of phosphate, the product of thousands of years of accumulated bird droppings. First discovered in the early days of European colonialism, the mineral became the most significant revenue source for the nation following its independence in 1968, eventually leading to an enormous economic boom that lasted throughout the ’80s. At one point, Nauru had the second highest GDP per capita of any country in the world, second only to the United Arab Emirates. This allowed the government to develop a vast welfare state, including universal health care and compulsory education, without imposing any taxes on its citizens.
Knowing that the phosphate supplies would eventually run out, the government initially placed profits from the industry into the Nauru Phosphate Royalties Trust, which sought to invest the commodities earnings in order to provide a sustainable source of income for the growing nation. While a sound premise, the money was sapped away by a number of poor investments, including an international airline, so-called “prime banknotes,” and a London-based musical about the romantic affairs of Leonardo da Vinci.
Left with few other options, the nation transformed itself into a tax haven for illicit banking activities. At one point, any individual could start a bank in Nauru with a one-time investment of $25,000. Although this initially brought modest economic success to the island, the country was eventually labeled by the G7 as one of the world’s “uncooperative nations” in the fight against money laundering. This led many of the country’s investors to pull out and crippled the island’s economy until the policies were reversed in 2004.
Today, Nauru is a poster child for economic dysfunction: its unemployment rate stands at 90 percent, with 95 percent of workers employed by the government. The country still maintains the welfare state established during times of prosperity yet has virtually no domestic industry to sustain it. Only 5 percent of Nauruans have a college degree. The country depends heavily on foreign aid from Australia, and avenues for future growth are few.
Staggering levels of obesity are just one of the concrete implications of this economic paralysis. Phosphate mining stripped Naura of all arable land, destroying virtually all domestic agriculture on the island. This has eliminated traditional diets of coconuts and other fresh vegetables, leaving fishing as one of the island’s only methods of food production. As a result, the country now depends almost entirely on food imports for sustenance.
The foods coming into Nauru tend not to be particularly favorable to public health. According to MIT’s Observatory for Economic Complexity, only about 5 percent of Nauru’s food imports are “vegetable products,” while 12 percent are “other foodstuff,” consisting of artificial, sugary foods. In other words, Nauru imports almost twice as much artificial foodstuff as it does healthy vegetables, to replace food that can no longer grow on the island. Furthermore, the plurality of this foodstuff are categorized as “other edible preparations,” a euphemism for processed foods, fatty sauces, seasonings, and other flavorings. This is followed by “baked goods,” referring primarily to sugary desserts.
Nauru faces two economic trends that have converged to the current obesity crisis. Environmental degradation, as a result of earlier resource exploitation, has forced the country to import the majority of its food, and economic stagnation has required it to buy the cheapest food available—which is inevitably unhealthy.
Obesity as Tradition
Nauruan cultural tendencies serve to further compound the island’s weight problem. Attitudes towards obesity are colored by the interplay between Nauru’s economic history and the emergence of a post-tribal and postcolonial national identity. In general, as the economy of the island has grown in its ability to provide adequate calories to each individual, traditional culture has been slow to reflect this change, resulting in a general public health imbalance.
In the Western world, body image is one of the most salient expressions of an individual’s identity, more or less distinct from society at large. Nauruan culture, however, views obesity in a vastly different light. Instead of a reflection of the individual, body image is viewed as a reflection of the society within which the individual resides. This phenomenon is described by Alexandra Brewis, an anthropologist at Arizona State University, in her book Obesity: Cultural and Biocultural Perspectives. She argues that “the body is seen as an expression of how the community is faring, and hence as a collective achievement or failure.” A plump community, then, is a successful one, able to provide for all of its members.
To the extent that individuals’ body images do reflect their own identities, weight is seen as a status symbol, instead of a source of shame. This trend is historically common in societies that find themselves struggling to provide adequate nutrition—even when calories are readily available, rotundness remains symbolic of prosperity.
Nauru’s economic development has further exacerbated the country’s weight issue by contributing to the creation of a markedly sedentary lifestyle. Calories once burned through farming and fishing now go unused, as both arable land and jobs have disappeared. A mantra of consumerism, developed in times of plenty, means that sports and fishing have been replaced by drinking and watching television as the nation’s most common pastimes.
Colonialism and its lingering effects may also shoulder some responsibility for the island’s problems. Some believe that the introduction of market concepts to the island has helped develop materialistic values, along with an expectation of immediate gratification. According to this line of reasoning, commercial forces create a culture that values quick, easy goods throughout society—whether those take the form of unhealthy snack foods, a mediocre education system, or short-term fulfillment. This postcolonial glitch helps explain both the skyrocketing obesity and economic stagnation that has accompanied dwindling industry.
There is perhaps no better example of the confluence of these factors than the islanders’ reverence of Spam. With its high sodium and saturated fat content, Spam today serves as one of the primary symbols of wealth in many of the Pacific islands, including Nauru. Pork has traditionally been considered a delicacy in the region—so when Spam was first introduced during the colonial era, it was hailed as a cheap alternative that tasted almost the same, and was occasionally brought as a delicacy by cargo cults. Today, shelves in Nauru are filled with rows and rows of Spam—an emblem of cultural and material prosperity.
Slimming Nauru
Efforts to curb obesity on the island have, as of yet, been largely ineffective. In 2005, the Pacific Obesity Prevention in Communities Project provided a number of direct action plans to curb obesity throughout Oceania. For islands comparable to Nauru, these recommendations included regular breakfasts and meals throughout the day, along with increased physical activity. These action plans have formed the basis for the response by the Nauruan government to the growing epidemic.
Interestingly, beyond promoting healthy eating and exercise, the OPIC also recommended that efforts to curb obesity in the Pacific islands focus on building on existing religious groups in the region. The motivation behind this is to directly address the cultural factors currently creating a Nauru conducive to an obese population and to build a new health culture from the ground up. By appealing to existing institutions with meaningful social heft, the program has substantial potential in a country of Nauru’s size.
The Nauruan government itself has attempted to encourage healthier lifestyles through a variety of methods. In the late 2000s, the president implemented a national walk every Friday around Nauru’s International Airport. Perhaps more significant than any tangible effect on obesity in the nation—round-trip, the walk is a total of five kilometers—is the deep symbolic value that the walks have had as concrete steps taken by the government geared toward public health.
Indeed, the first taxes ever implemented by the Nauruan government were more a mechanism of fighting obesity than of filling public coffers. In 2014, the nation implemented a sugar tax of 30 percent on imported sugar, confectionaries, carbonated soft drinks, cordials, flavored milk, and drink mixes. It also lifted the levy on bottled water, making it almost as cheap as soda. However, every few steps forward are accompanied by one in the other direction. Nauru’s Olympic Day Run, another attempt to promote fitness, was sponsored by Coca-Cola.
Potential solutions to curb obesity in Nauru might follow existing protocols established in the United States—a country with an obesity epidemic of its own. In an interview with the HPR, Jenna Seymour, a senior scientist at the Center for Disease Control, spoke of her efforts working on the Healthy Hunger-Free Kids Act with First Lady Michelle Obama. When asked about the hallmarks of effective measures to curb obesity, she gave two primary answers: comprehensive research and sufficient funding. The Healthy Hunger-Free Kids Act implements this by increasing the federal reimbursement rate for some school lunch programs. The Pacific Obesity Prevention in Communities project provides Nauru with the research to put the wheels for this in motion.
The lack of adequate funds due to a decaying economy (and thus dwindling tax base), however, leaves Nauru unable to implement virtually any lasting obesity legislation. It seems, therefore, that the country is stuck within a Catch-22—a sedentary culture precludes it from growing an economy, and a failed economy further stops the nation from taking tangible actions towards lasting change.
Recently, there have been proposals on the island to recommence mining of a previously unreachable secondary phosphate layer. Initial efforts seem promising and may provide the funding necessary to implement lasting change. This would allow Nauru to reinvigorate its sclerotic economy and, by proxy, begin to address its obesity problem.
However, as things stand, the prospects of a reinvigorated Nauruan economy are distant at best. For now, the combined weight of Nauru’s colonial history, cultural habits, and economic malaise continue to undermine the health of its citizens and their long-term economic prospects.