Today I was asked by a government policy analyst: "I'm trying to think of an example of a situation when ethnicity or culture matters in regulatory policy. Can you help me out?"
Here's my best attempt. I challenge others to try to come up with a better example.
The regulation: In Canada, Vitamin D must be added to milk.
"Addition of Vitamin A, Vitamin C and Vitamin D to fluid milk is a legal requirement under Health Canada's Food and Drugs Act (see Appendix 1, Table 1). Vitamin D is added to all forms of milk while Vitamin A is added only to skim and partly (partially) skimmed milks. Evaporated and powdered milks which are sold at retail in Canada have similar requirements for vitamin addition. In addition, Vitamin C is required to be added to evaporated milks. Section B.08.027 of the Food and Drug Regulations (FDR) exempts certain dairy products which are used in or sold for the manufacture of other food from the vitamin addition requirements which are specified in the above prescribed food standards" Source: www.inspection.gc.ca
Why does ethnicity and culture matter?
Ethnicity and culture matter, first, because they influence the amount of Vitamin D supplementation a person will need to maintain good health. The people who are most at risk of Vitamin D deficiency are those who are do not absorb sufficient vitamin D through exposure to sunlight. People relatively more skin pigment have a heightened risk for Vitamin D deficiency, because they require up to six times the amount of sun exposure to absorb the same level of Vitamin D as a person with relatively less skin pigment (reference). Since a person's level of skin pigmentation is largely genetically determined, ethnicity influences the risk of Vitamin D deficiency. Culture is a factor, also, because it will affect the extent to which people are willing to expose their skin in public - and thus the amount of vitamin D they will absorb from sunlight.
Ethnicity and culture matter for a second reason, also. The addition of vitamin D to milk was mandated in 1965. At that point in time, the overwhelming majority of the Canadian population could trace their heritage back to a milk-drinking culture - British, German, French, and so on. Most children drank milk most days. So fortifying milk was a good way of making sure that all children were able to obtain sufficient vitamin D from their diet.
Now a significant portion of Canadians can trace their ethnic origins back to parts of the world where there is no cultural tradition of regular milk drinking, or where lactose intolerance is common - South East Asia, for example (see here for the relationship between ethnicity and lactose intolerance). Lactose intolerance means that fortifying milk is a less effective way of making sure that every Canadian gets sufficient vitamin D.
There may also be an association between Inuit or other First Nations status and Vitamin D deficiency, as living in extreme Northern latitudes - as some members of Canada's First Nations do - is also a risk factor for Vitamin D deficiency. Culture matters here, too - the risk of vitamin D deficiency would be expected to be higher among Inuit people who do not have access to a traditional diet which includes vitamin-D rich meat and fish.
Does the regulatory environment need to be changed?
There is some evidence (e.g. here) that Vitamin D deficiency is a problem in Canada - breast-fed babies of women who have vitamin D deficiencies are particularly at risk. The kinds of policies that could be considered are:
- relying less on fortification and more on education, outreach, and routine testing for vitamin D deficiency as ways of ensuring Vitamin D adequacy
- possibly increasing the level of vitamin D fortification required in food
- possibly adding vitamin D to a wider range of foods
Fortification has risks associated with it, however, so someone who actually knows something about the subject would need to be consulted before taking that seriously as a policy option.
That's it - my example of a situation where culture or ethnicity matters in the design of regulatory policy. Can you come up with a better one?