For better health, focus on the environment, not on the individual

We are approaching a critical juncture when it comes to the nation’s health. Our population is ageing and we are living far longer than previous generations, but many of us live our later years in poor health. Evidence is mounting that the NHS is struggling to cope with existing demand, let alone the pressures our health system will face from an older population with ever more complex needs.

Obesity is one of the biggest challenges facing our future health and society. Around three quarters of people aged 45-74 are overweight. Since 1993 the proportion of UK adults who are overweight has increased from 53% to 64%. This means more people will experience knock-on effects like heart disease, strokes, and diabetes.

Obesity is a difficult public health challenge, but it is fixable. On average, we consume about 195 excess calories — roughly equivalent to a packet of crisps — every day. If half those currently overweight reduced their intake by 250 calories, 10 million would move down a weight category. We don’t need a revolution, we need policies and incentives to help us make small, sustainable changes.

The current government has a confusing record on obesity. During the pandemic we saw a series of welcome commitments to improve the nation’s health. Since then, political pressure has chipped away at many of the promised measures and we’re seeing a retreat back to a misguided focus on individual responsibility. Of course our own actions count, but the evidence from recent decades shows that going all-in on education and willpower does not work..

The imminent health disparities white paper is an opportunity to leave behind the failed policies of the past, but only if it charts a course to change our failing food system.

Stop blaming individuals

In the last 30 years, successive governments have published 14 targets and 689 policy recommendations related to obesity. Most focussed on individual responsibility, willpower, exercise and education. These policies have evidently failed. The problem is not people’s desire to lose weight – 38% of UK adults say they are trying – but rather how difficult it is to do so.

The white paper should shift blame away from individuals and focus at last on the wider food system – what surrounds us, shapes us and has a significant impact on the decisions we make about what we eat. This means a focus on reshaping the food environments we are surrounded by, with a particular emphasis on reformulating unhealthy food and drinks.

"The white paper should shift blame away from individuals and focus at last on the wider food system – what surrounds us, shapes us and has a significant impact on the decisions we make about what we eat."

We know this approach works. By the time the sugar tax was introduced in 2018, most drinks sold by Coca-Cola had been reformulated below 5g sugar per 100ml. Sales and profits held up but sugar consumption in soft drinks fell by 30%.

Mandatory targets work

We must disrupt the junk food cycle if we are going to improve health. To do this, we need supermarkets, restaurants and manufacturers to take steps to create healthier options, make access easier for all and stop pushing unhealthy choices through promotions.

We want to see policies that encourage retailers and restaurants to rebalance their sales from junk food towards healthier options. If we want to tackle obesity we need to reduce the number of calories people eat, so any targets need to incentivise reducing the total number of calories sold.

To be most effective this should target high energy junk food. To avoid repeating the failures of the Conservative Government’s 2011 Public Health Responsibility Deal, these targets must not be voluntary or self-regulated. Targets should be legally enforceable and ambitious enough to deliver the impact needed to improve health. The food and drinks industry must be our collaborators and not our opponents. Many within the industry are supportive of these measures and, as was the case with the sugar tax, the sector will innovate to make products healthier and more appealing.

Give power to local areas

The government’s commitments on levelling up promised to give everyone the opportunity to flourish. At its core was the commitment to see people everywhere living longer and more fulfilling lives. Yet men living in the most deprived areas of England die on average 9.7 years earlier than those living in more affluent areas, while for women the difference is 8 years. We know that obesity is one of the factors that contributes most to the burden of disease in the UK – many chronic health conditions are a symptom of obesity. The white paper should have a principle at its core to empower and incentivise local areas to create healthier neighbourhoods that are committed to turning the tide on obesity. Communities need devolved powers and greater control to create environments that enable everyone to access healthy and affordable foods, regardless of where they live. We applaud the recent announcement of Bristol, Southwark, Haringey, Greenwich and Merton to implement their own local advertising bans.

These measures are just a start, but taken together they could set us on a new course and reverse a decades-long trend. We cannot miss another opportunity to turn the tide on our long term health.

Author

Lauren Bowes Byatt

Lauren Bowes Byatt

Lauren Bowes Byatt

Deputy Director, A Healthy Life mission

Lauren is the Deputy Director of A Healthy Life mission

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