Since Steve Barclay took over as health secretary last October, he has continued the government’s recent trend of relaxing public health policy.
The tobacco control plan remains unpublished, restrictions on junk food advertising have been delayed and plans for a national approach to tackling health inequalities have been abandoned, focusing instead on a major conditions and diseases strategy.
New Ipsos polling shows that while 95 per cent of the UK public believe part of the responsibility for keeping people healthy lies with the individual, 75 per cent also believe the government has a role.
However, only a minority – just 13% – believe the government has implemented the right policies to improve public health, and there is strong support for a range of government interventions that do more to prevent disease.
So what else can the government do?
Smoking, poor diet and harmful alcohol use are major preventable causes of ill health and key factors in the almost 20-year gap in life expectancy between people living in the most deprived areas in the UK.
Addressing these risk factors will not only improve an individual’s well-being and quality of life, but will drive economic growth and address inequalities and help reverse the alarming rise in ill health among the economically inactive.
Much of what determines our health lies outside the health and care system – things like safe housing and employment, clean air and green space. These building blocks of health are unequally distributed across society – for example, the poorest areas of the country have five times as many fast food outlets but only one fifth of the green space as the wealthiest areas.
Instead, however, government policy over the past decade has focused on promoting individual responsibility for health through education, applications and behavioral support.
While these policies play a role, they will not be enough to help lift the heavy lifting of sustained behavior change across the population. There is also a need to address the underlying building blocks of health and enable people to stay healthy.
The tide lights the smoke
Prevention policies that work at the population level rather than targeting individuals to address issues such as smoking and poor nutrition may be among the most effective and equitable.
For example, the UK’s sugar tax has led to dramatic reductions in the amount of sugar in soft drinks, with some early data suggesting a reduction in obesity, particularly among children living in more deprived areas. And all this by selling healthier products without people having to change their buying habits or impacting overall industry sales.
Over the past decade, these population-wide approaches have become an increasingly neglected part of national policy – but polls show the public want to see the government take more preventative action.
On obesity, just 16 per cent of people think the government is tackling the issue effectively. Around 66 per cent of people support and 14 per cent oppose proposals to ban junk food advertising on TV before 9pm and online.
The same support (66 per cent) is also seen for introducing the National Food Strategy’s recommendation to extend the sugar tax to foods high in sugar and salt, while subsidizing healthy food for low-income families.
Alcohol is responsible for more than 300,000 hospital admissions a year, and deaths have skyrocketed since the pandemic. 72 per cent of the public believe the government has a responsibility to reduce alcohol-related harm, yet there has been no national plan to do so since 2012.
Finally, it’s about smoking where people are particularly keen for more government action to help people stay healthy. And that is where population-level policies, such as smoking bans in public places and advertising restrictions, are so influential in reducing harm.
The poll finds that an overwhelming 78 percent of people support a tax on manufacturers to fund tobacco control measures such as local “stop smoking” services.
When it comes to the age of consent for buying tobacco, 69 percent of people support raising the limit from 18 to 21. Additionally, 52 percent support (and 24 percent oppose) raising the age at which you can buy tobacco by one year, every year, until no one can buy cigarettes.
In June 2022 the government published an independent review to determine how England can be smoke-free by 2030, which includes some of these measures.
However, despite the review’s findings and wider public support, the government has yet to respond to or update its recently expired tobacco control plan.
A healthy population is essential for a productive society. If the government wants to grow the economy, raise standards and reduce the gap between rich and poor, it must be willing to implement the evidence-based – and popular – policies that prevent disease in the first place.
- Adam Briggs is a senior policy fellow at The Health Foundation. Sally O’Brien is specialist public health secretary at The Health Foundation
Protect yourself and your family by learning more Global health insurance