It’s that time of year. Millions of British people resolve to change. Quit smoking. Eat better. Exercise more. Drink less. Breaking a New Year’s resolution is as much a British tradition as making one though. So what can we learn from this ritual about the potential for improving health in Britain in 2015? It tells us that, while Britain remains one of the sickest countries in Europe with stark health inequalities, many people are trying to change their habits and know what they need to do to improve their health. It also demonstrates how millions of individuals resolving to change doesn’t equate to improved health nationally unless wider political and social change occurs too. It’s time that our politicians made their own New Year’s resolution to give public health policy greater priority in 2015, starting with their election manifestos, and I’ve provided some ideas to help them turn over a new leaf.
Lots of individuals resolving to make a fresh start each year isn’t a bad thing, which is why the NHS and NICE encourage it and offer advice. Some people do stick to their resolutions. Those people who stop smoking each January benefit from both immediate and long-term health improvements. Public Health England’s new Stop the Rot campaign is timed to capitalise on many smokers’ motivation to quit now.
However, it’s not all good news. Not least because of the money we often waste. It’s estimated we now spend on average £21,000 over our lifetime on New Year’s gym memberships, sportswear, weight loss programmes, health foods, smoking cessation aids, and self-help books. The demand for smartphone health apps is booming too with 500 million people worldwide now using them. This highlights our desire to change but also how inequalities are reinforced while we all go it alone.
This mass New Year’s ritual helps distract us from the powerful economic, social and environmental influences that shape our behaviour. We’re becoming a society that can’t see health beyond the individual, resulting in the continuous invention of new ways of monitoring our own and each other’s health behaviours. For instance, a failure to lose weight is simply seen as an individual failure. But if you work long hours for little money and have children to feed it’s hardly easy to change your diet and lifestyle overnight. Not everyone lives in an area where they feel safe to exercise either.
While Britain is clearly a nation of self-motivated, self-helping individuals willing to part with mountains of cash each January, we continue to die younger than people in other Western countries. This is partly because of this rampant individualism. We need to make more collective resolutions, as well as individual ones, to make our schools, workplaces and communities healthier. The best way of affecting this change and significantly improving the health of the population remains the political process at a national level. If the Tories win the general election, 2015 could be an apocalyptic year for the NHS – but even if they don’t, and further privatisation is avoided, health inequalities won’t be addressed by the NHS alone nor will the NHS be sustainable unless the nation’s health profile improves.
We urgently need to break with the current political focus on nudging individuals and voluntary “responsibility deals” with the food and drinks industry that have dominated this government’s public health strategy since 2010. Public health has sometimes worked effectively away from the political (and media) spotlight – making our lives safer in the twentieth century while we were sleeping, as Harvard’s David Hemenway puts it – but the major health challenges of the 21st century, such as obesity, won’t be solved without more radical political actions.
It’s not difficult to think of policies that could be both electorally popular and improve Britain’s health. An obvious example would be making free breakfasts and lunches universally available in schools for all 5-16 year-olds. This would help improve diet and be popular with families. Legislating to make more sport available on free-to-air TV is another potentially easy-win. We shouldn’t have to rely on the Olympics every four years to inspire children to be more active. Major new national investments in community-based gyms and other sports facilities would surely be popular if a political party was willing to articulate the health, social and economic benefits. Minimum alcohol pricing and plain cigarette packaging have already been successfully introduced by other governments. And more effective anti-poverty policies would be worth a million self-help books. Britain’s now spending £47 billion a year on obesity alone, more than on police, prisons and fire services combined. If the costs of ignoring this don’t focus politicians’ minds then the millions of voters who want to quit smoking, eat better, exercise more and drink less should do. If not, it shows just how disconnected they are.