In an obesogenic society, we need the state to help make our lives more healthy
Was anyone else listening to BBC Radio 4’s Today programme in the early hours of the morning on the 27th of December? Improbably, I was. Celebrity chef Jamie Oliver used his guest-editing slot to highlight the issue of how state intervention could improve children’s health.
His stimulating reflections and interviews set me thinking how old-fashioned the notion of the state intervening to improve diet and lifestyle, has now become. Oliver’s first TV series on the nutritional failings of school meals was aired on Channel 4 in 2005. Its invective against chicken nuggets led to a playground rebellion, possibly from parents more than children. But, over time, it struck a chord and has been extremely successful.
In today’s world, campaigns to steer adults and children towards healthier lifestyles and diets, as they once did, might seem utopian and fanciful. Which is where Jamie Oliver and premiership footballer Marcus Rashford – another celebrity food campaigner – come in.
A lot of good ideas seem utopian until they are promoted by an influential champion. Shouldn’t school meals be free in all UK primary schools as they are in Scotland? Shouldn’t the sugary drinks tax, whose future is now uncertain, be extended to non-sugary unhealthy foods. Shouldn’t we prevent the pre-watershed advertising of junk food on television?
These were Jamie Oliver’s proposals. He argued that such measures will help children do better at school, to the benefit of the economy, and save the NHS money, pointing out that we are spending huge sums on a reactive health service that is mopping up the consequence of binge drinking and unhealthy eating.
Lifestyle politics
National policies which advocating moving health spending upstream to prevent people from becoming ill because of their diets and lack of exercise and, later, specific campaigns to reducing smoking prevalence and obesity were the hallmarks of New Labour from 1997 – it was called ‘lifestyle politics’.
The approach continued, in a reduced form, in the party’s second term, from 2001. During New Labour’s third term, in 2007, following a sustained campaign from the environmental health profession, smoking in public enclosed places was banned – the measure was vigorously opposed across the media at the time and portrayed as draconian, but, in practice, it has proved extremely popular with the public.
A common argument of the political right and some parts of the left is to say that it’s not the state’s business to intervene in diet or lifestyle, that ‘sin taxes’, for example on unhealthy foods and alcohol, are ‘nanny state’ measures and that they have an undue financial impact those on low incomes. However, to the consternation of right-wing commentators, the coalition government, from 2010, continued to pursue, albeit in a watered -down form, some of the policies of New Labour.
It introduced a ‘voluntary public health responsibility deal’, in 2011, through which businesses signed up to promoting healthier diets and physical activity. In 2012, the coalition published an alcohol strategy, including the concept of minimum unit pricing, now successfully introduced in Wales and Scotland – but not England. Public Health England (PHE,) created in 2013, was given a specific mandate to reduce health equality.
PHE's first CEO, Duncan Selbie, talked a lot about the need to cut obesity, smoking prevalence and excessive drinking as a means to improve the nation's health. Unhealthy lifestyles, as he often pointed out, are the largest contributory factors to diabetes and cardiovascular disease – change them and we could save the NHS billions. Public Health England was abolished in 2020 after a mere seven years. It had ruffled feathers by being ‘too political’.
Sugar and salt taxes on hold
As coalition chancellor, George Osborne, who was interviewed on Jamie Oliver’s Today programme, was happy to use fiscal levers to nudge people towards health. It was Osborne who introduced a sugary drinks tax in his March 2016 budget. Later that year, the Brexit referendum precipitously removed the coalition from power. The huge drain on public finance of Covid-19 now appears to rule out large-scale upstream public heath investment. And a political shift to the right has made further restrictions of TV junk food advertising and legislation to make food formulations less sugary and salty far less likely.
In local government, environmental health departments are being forced to fire fight as budgets continue to shrink, so that only a technical remit remains. In a different, less austere, world, EHPs would play a greater role in promoting healthier eating in homes, restaurants and school canteens, as well as in preventing contamination and infectious disease.
Perhaps the tide is turning. Liz Truss’s prescription, in her brief tenure as UK prime minister last year (it lasted for less than two months), that it is misplaced for the state to protect its poorest and most vulnerable members through progressive taxation was roundly rejected. And Jamie is banging on again about school dinners. That, surely, has to be a good thing.
Will Hatchett has been a journalist since 1986 He was editor of a weekly, then monthly magazine, Environmental Health News from 1998 until 2018. The views expressed here are purely his own
This blog was posted on the RHEGlobal website
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