At Health Action Campaign we believe that:
Providing health information isn’t enough
Providing information to encourage healthy lifestyles is fine, including through modern technology like health apps.
Unfortunately, health information tends to be understood and acted on most by people who are already health conscious – instead of changing the behavior of those most at risk.
So, we need to find other ways to improve public health.
Upstream initiatives are more effective
Persuading millions of individuals to change the habits of a lifetime is a major challenge – particularly when there are so many forces encouraging unhealthy lifestyles. We prefer upstream initiatives. These make healthy action either
- The legal requirement (like wearing seatbelts or not smoking in work places), or
- The stealth option (for example if food companies reduce the level of salt in products gradually over a number of years then, over time, people consume less salt without realising it) or
- The easy option (for example if transport policies make it easier to walk, cycle or take public transport).
Whichever route is taken the effect is the same - more people pursuing healthy lifestyles.
Win Win approaches to improve health are also useful
For example, our research suggests that:
- Encouraging health at work is a win win for both employees and employers. For employers it usually means fewer staff off sick, lower staff turnover and higher productivity.
- Food companies now have several ways to produce food with less sugar, salt and saturated fat, without using artificial alternatives or adversely affecting taste. There is also the potential to add healthy ingredients, such as fibre, fruit and vegetables. And consumer research companies regularly report rising demand for healthier food. So, it is probably in the commercial interests of food companies to mass produce healthier food.
- Tobacco and alcohol companies now have healthier alternative products they can provide, in particular e-cigarettes and low alcohol drinks. While not risk free they are safer than cigarettes and conventional alcoholic drinks and there is growing consumer demand for them.
Talking about the social determinants of health is too simplistic.
Yes, our background can predispose us to die younger or live longer, to experience years of chronic illness or enjoy many years of good health. So, tackling social inequality is important if we want to reduce health inequalities.
At the same time, it’s important not to be fatalistic and see our health and longevity as predetermined by our background. Our research suggests that a range of factors (like education, being part of a social network, volunteering, a healthy lifestyle and success in an aspect of our life) seem able to compensate and help us live longer, healthier lives.
For example, the five General Secretaries of the Trades Union Congress (TUC) between 1924 and 1984 were all from working class backgrounds. Yet they lived to an average age of 80 - well above average for men at that time. Achieving recognition in their chosen field seems to have helped protect their health.
So, we need to act to tackle social inequality – while also encouraging action that can help individuals improve their chances of living a long and healthy life, wherever they were born.
We should beware of medicalizing normal human emotions
We need to do everything possible to reduce the risk of serious mental illness (like schizophrenia, bipolar disorder and anorexia) and where that is not possible to ensure early diagnosis and treatment.
However, we should also beware of medicalizing normal human feelings and emotions - like interpreting worry, anxiety or feeling down or stressed as symptoms of mental ill health. Our research suggests that the increase in reported mental distress among university students, for instance, is partly due to some students being led to interpret, report and seek support for feelings and emotions that would have been accepted as a normal part of life only a generation or so ago.
This has coincided with of a number of changes in society (often stemming from a well-intentioned desire to protect and safeguard young people) which have probably unwittingly reduced young people’s resilience and coping skills, with potentially adverse effects for their mental health and wellbeing.
We need to appeal to hearts and minds
Evidence is an essential starting point for public health – but how we make the case needs to rely on more than facts and statistics. Health promotion is competing with massive advertising and lobbying for products that increase health risks (like alcohol, tobacco and junk food) – including competing with advertising that makes use of humour, emotion and visual impact to engage hearts and minds.
One good example of a hearts and minds approach, which we recommend more public health campaigns follow, was the high profile, multi-dimensional campaign to reduce sugar consumption in the UK, in particular sugary drinks. This campaign included likeable celebrity chefs as well as health experts, and a strong social media element alongside extensive coverage on TV and in more traditional media, including an online petition to Parliament which crashed the government website – a powerful combination.