How to tackle public health

Sugar is the new fat, the prevalence of obesity rises with the nation’s appetite and the government is under ever greater pressure to Do Something About It. But what can, and should, it do?

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First of all, to those who argue that eating healthily is solely the responsibility of the individual:

When symptoms consistently present in certain areas and cohorts of the population, on a systemic level; the response must also be systemic.

We cannot simply blame bad parenting, or individuals with more junk food than sense.

Access to healthy and unhealthy food is important. Education is important. Skills with which to shop and cook and eat well are important. And the correlation between poor health and deprivation, crime, and inequality is significant.

These things matter, and they demonstrate that issues around food and fat are complex. Suggesting those who are dangerously overweight just ‘eat less’ is an unhelpful oversimplification.

So what should governments do? What is the best way to tackle public health?

Increasing the amount of information available about certain foods has been state sanctioned for a few years now; think of the ‘traffic light system’ on certain products. While some research may support this move, one of my problems with the approach is that it comes at the education problem from entirely the wrong angle.

Most people know that ready meals, sweets, takeaways, alcohol etc. is bad for you. They already know. A label highlighting this fact might add some guilt to the decision, but will it actually lead to behaviour change?

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Delicious.

Limiting accessibility to unhealthy foods (sugar tax, removing certain foods from vending machines etc.) is generally seen as unpopular, and tarred with the nanny state brush. The idea that you have a free choice to eat well when supermarkets deliberately position and promote unhealthy food so that you will buy too much of it, again and again, is (in my opinion) arguable.

But those moves aside, there are several things which could help.

Tesco has stopped selling sweets by their checkouts; points of the shopping experience where people are stuck in a queue, bored and vulnerable to last-minute, impulse buys.

There’s loads of ‘nudge’ tricks like this which aim to make the healthy decision the easiest to make; position healthy food at eye level on supermarket shelves, try cardboard cut-outs of doctors to influence shoppers’ habits in the grocery isle, the list goes on.

The Change4Life campaign is a great example of government intervention. Could this be extended and expanded, making healthy eating seem not only possible, but fun?

And for education which really makes a difference, what about improving food and cookery classes at school?

Providing free seminars on nutrition in the areas which need it most – focusing not just on the bland ‘pies are bad for you’ line, but on how to make delicious meals that are also good for you.

Supporting street markets and better public transport to ensure everyone has access to healthy ingredients.

Promoting a culture that takes this as given, as normal, instead of something which is too much effort, too expensive, or ‘not what we do’.

It’s an incredibly tricky problem; one which overlaps with many other areas of public life and real change will take time. Behaviour change of any kind is hard. 

And yet I’m hopeful! There’s so much opportunity for small changes that will make a tangible difference to the way we think about food, the way we shop, cook and eat. We don’t need a diet mentality; we need a revolution.

What do you think? Should better public health be solely down to individual willpower?