A Public Health England strategy published last year, Place-based approaches for reducing health inequalities calls for prevention initiatives to avoid placing the burden solely on individuals, and to focus instead on the conditions driving poor health. This approach advocates for coordinated action from all parts of the system, including joint working between civic, community and health sectors in a local area.
Addressing the nation's weight has come front and centre of the government's response to a potential so-called 'second wave' of COVID-19 cases. Evidence suggests that those who are overweight are more likely to be admitted to hospital, more likely to be admitted to ICU and then sadly died from COVID-19. The strategy created to address this issue notes that obesity prevalence is higher in more deprived groups, and that children in more deprived areas are more likely to be overweight or obese. The government's strategy sets out how marketing for high fat, sugar, salt (HFSS) foods will be greatly reduced, and calorie information will be added to foods available in restaurants. While this is a welcome move toward helping people better understand the food choices they make, it places the issue of obesity firmly with individual choice, and neglects the core issues which can contribute to obesity, including poverty, or lack of access to affordable fresh food.
The importance of taking a holistic view of people's health becomes clear when you consider the challenges faced by the 10.2 million people living in 'food deserts', areas poorly served by large supermarkets in accessing affordable, fresh food. Those without access to a car or those with mobility issues are most impacted. As set out in our response to the prevention green paper, trusts have an important role in the preventative agenda, but there needs to be a coordinated approach that balances national policy with local level action in a way that advocates for healthy eating, but at a local level provides options including widening retail options and improved public transport to local shops and larger supermarkets.
While this is a welcome move toward helping people better understand the food choices they make, it places the issue of obesity firmly with individual choice, and neglects the core issues which can contribute to obesity, including poverty, or lack of access to affordable fresh food.
The Food Foundation's COVID-19 tracker details how citizens in deprived areas were already struggling to access nutritious food, whether that's through meals provided by schools or community kitchens and cafes. So even when initiatives such as Eat Out to Help Out seek to support the economy by reducing job losses in the hospitality industry, it doesn't work to encourage healthy food consumption if there aren't many healthy food options in an area, or if people can't afford to do so. Wigan's Sunshine House community centre established a pantry service that provided food and toiletry items at a low cost, this is designed to be less stigmatising than a traditional foodbank and maintains the dignity of those using the service. In this instance, adequate local planning can help build healthy places that facilitate healthier lifestyles and create reliable food access.
More broadly, making progress on the wider determinants of health, including fairer wages, better access to schooling and educational systems, developing healthy built environments, and developing national initiatives that can be delivered at local level are key to an overall healthier population. Disparities between postcodes, ethnicity and gender can no longer be tolerated. The continued development of a strong organisation that focuses on health inequalities, and public health, is paramount to improving health and wellbeing outcomes.