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OPINION

'Health promotion is swimming against a tide of greasy kebabs'

  • 10 Comments

There are – and I consider myself an expert in this area – many different ways of not knowing things.

There is the clear “I simply do not have any idea what you are talking about”, with which I would greet any enquiry regarding nuclear fission, Eastenders or Swedish. There is the “I don’t think I know that” uncertainty, which comes when asked something I might once have known or think I should know (How can I get to any London hospital? What is  the capital of Venezuela?). Or there is the “Ohh, I should know that, don’t tell me…it’s coming…” stuff that I absolutely believe I do know but for some bizarre reason cannot quite access at the moment. Like, what is my middle name? What day is it? Or, is smoking good for me?

For decades the struggle to encourage people to live healthier lives has been blighted by an allegedly unknowing client group. When the first The Health of The Nation strategy launched 22 years ago it was underpinned by a belief that if we informed people that a fat-laced kebab with BBQ sauce is not a healthy meal they will internalise this new information and take a packed lunch down the pub – where they will have two units of alcohol and jog home, stopping only to nibble on some peeled apple and almonds.

But it turned out that getting the key messages about health across were more complex than anticipated. People didn’t seem to know – or perhaps didn’t want to know – that chips, lots and lots of beer, sitting down all the time and smoking were unhealthy. When, after 15 years of leafleting, shouting and showing really discomforting adverts, we began to get the message across, the pro chips and fags lobby shifted their defence away from “I didn’t know being 34 stone was bad for you” to “I am a free man and I have the right to make unhealthy choices” – which rather paralysed the health promotion lobby.

Indeed, not only has the shift from focusing on individuals’ health and wellbeing to fighting for their right to choose how they live their lives undermined the health promoters, it has also fuelled and serviced our relentless march toward neoliberalism too. Binge drinking bad for your health? It may be, but it is very good for the marketplace. And it is the marketplace we service first, health comes later.

Where once we warned the NHS would be unsustainable unless we reduced heart disease, we now have lobbies for the drink and tobacco industries arguing against tax rises that would drive consumers to buy illegally imported products and ultimately deny the exchequer tax income.

And of course, left in the middle of this unending battle for a healthier population are nurses. I wonder, do you ever just think  “Ah, to hell with it”? What about when our individualistic worship of the marketplace and a willingness to only “know” what suits us runs away with the national consciousness? Or when words like “rights” are so bereft of meaning they become an excuse to do anything you want regardless of consequence. Do you ever think “Actually I think I’ll become an estate agent”?

Mostly of course you don’t. Mostly you keep trying to help. Not that that’s being noticed or valued at the moment – budgets, taxes and economics dominate and television programmes seem to celebrate people at their angriest, fattest and unhealthiest. Mostly you keep quiet and carry on. And I do admire the carrying on part. I just wonder, isn’t it a little like swimming against a very strong tide?

Mark Radcliffe is a senior lecturer and author of Gabriel’s Angel.

  • 10 Comments

Readers' comments (10)

  • Mark at times it's like health promotion is almost considered a crime. I tried to suggest to a pregnant women that she might like some support to give up smoking, boy was she cross! I heard all about her rights, how i had no right to judge her, and what business was it of mine if she chose to share a fag with her baby - her exact words.
    I'll wait for the complaint to come in, no doubt with a claim for compensation for distress caused!!

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  • tinkerbell

    aparently on the horizon programme i am currently watching on our unconscious mind' Do we control our life' we are hardwired to be optimistic. This is so we can strive to improve our life and take risks including smoking and eating a kebab.

    It says our brains run mostly on 'auto pilot'.

    Cognitive dissonance springs to mind.

    Even when we know something is bad for us are presented with the facts and figures this programme says we will still remain optimistic and revert back to our own optimitic view and forget the negative data presented to us.

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  • Dr Why ?

    tinkerbell | 13-Mar-2012 11:03 pm

    I also watched that programme.

    But it has always been true, that people selectively quote whatever argument suits what they already wanted to do.

    There is also a sort of 'colour-blindness', which seems to kick in - if the message isn't what people want to hear, it is almost as if they cannot hear it at all. I mean, how much more 'evidence' could Cameron et al have wanted to see, that the reforms to the NHS they are imposing, are flawed ? Almost every clinical 'expert group' has come out against - and what goes for cameron et al, also goes for people who resist their own more healthy behaviour.

    Not that I am a great follower of the 'healthy living' advice - I don't smoke, I'm not obese, and I always wonder how harmful being obessed with 'healthy living' is, anyway, in terms of the self-induced stress being paranoid about it introduces ?

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  • tinkerbell

    Dr Why ? | 15-Mar-2012 2:11 pm

    But you never mentioned whether you drink or not? Not that it's any business of mine of course.

    I think until they find some new thing that is harmful to us, they should realise that we have all got the message and maybe just have a rest doling out too much more information as we all seem to be suffering from information fatigue about whats good and not good for us, and then finding a few years later that they've reversed it all and eggs are now good for us. Bit like the woody allen film.

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  • tinkerbell

    Woody Allen film was called 'Sleeper'.

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  • Dr Why ?

    tinkerbell | 15-Mar-2012 3:36 pm

    Dr Why ? | 15-Mar-2012 2:11 pm

    But you never mentioned whether you drink or not? Not that it's any business of mine of course.

    Yes, I do drink - quite often while I am eating my cheese sandwiches, so that is two sins in one, eh ?

    But, as you pointed out for eggs, not all 'definitely known to be true' health advice is actually correct - and I remember those early studies which looked at drinking, and when the overall long-term survival rates actually peaked among the people who drank a bit (who lived longer than non-drinkers). Drinking isn't, I believe, like smoking - and as I don't get falling-over-drunk, or get into drunken fights, using those things as a reason to not drink, wouldn't be rational !

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  • tinkerbell

    Dr Why ? | 17-Mar-2012 10:46 am

    and as I don't get falling-over-drunk, or get into drunken fights, using those things as a reason to not drink, wouldn't be rational

    and then have to get up and go to work too.
    Much too demanding for most of us mortals methinks after a late shift to an early with only a few hours to fit it all in and get some sleep in between. Maybe when i was younger, but couldn't possiby fit it all in now.

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  • MeThinks

    Dr Why ? | 17-Mar-2012 10:46 am

    tinkerbell | 17-Mar-2012 11:09 am

    Yes Tinkerbell, I've noticed that some things seem harder as I get older, as well !

    I also find that as I get older, the world seems to become even more absurd, and that my lack of understanding of what the heck is going on around me becomes more pronounced - foolishly, I used to think that older folk could understand the world better !

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  • tinkerbell

    MeThinks | 18-Mar-2012 12:24 pm

    I totally agree. It's seemingly a paradox. We need the wisdom of a child.

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  • Tiger Girl

    MeThinks | 18-Mar-2012 12:24 pm

    tinkerbell | 18-Mar-2012 11:00 pm

    Yes - when I was a mere kitten, I used to think the grown-up cats knew what they were doing. Now that I'm a grown-up cat, I'm not so sure !

    Just briefly scanned something in today's Guardian, and having spent loads of money on 2 aircraft carriers, only one being now affordable, if I got the story right the MoD experts ordered some planes from America which it turns out won't be able to land on the one remaining carrier, even when it eventually can afford to have plane son it. I think it mentioned another £2bn, to change to a version of the plane able to land on the carrier !

    And the MoD is surely supposed to be this country's experts on that sort of thing !

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