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Nursing professor issues warning on government public health plans

  • 8 Comments

The government’s plan to “nudge” the public into becoming healthier could fail because of the contradictory messages put out by advertisers and the media, a leading nurse academic has warned.  

The government’s “Big Society” idea includes attempting to improve public health by providing incentives, or “nudges”, to quit smoking or lose weight, rather than through bans and regulation.

But Professor Anne-Marie Rafferty, from the Florence Nightingale School of Nursing and Midwifery at King’s College London, warned last week that many behavioural incentives were “embedded in environments which are riddled with contradictions”.

Speaking at a King’s Fund debate on public health in London, she said: “Women’s magazines, for example, on the one hand have lovely pictures of gorgeous meals you can cook for your favourite dinner party guests, and juxtaposed with that is something about ‘we all must lose weight and have the perfect Elle MacPherson figure’.

“What can we do to reconcile these highly conflicting and contradictory cues that they [the public] get from the environment. It’s not just about lining all the incentives up.”     

  • 8 Comments

Readers' comments (8)

  • I think perhaps it is more peoples mindset and whole way of thinking more than anything.

    Many people don't care about health, they do what is easy, or what feels good, or whatever their desires/habits tell them to, and none of that is neccassarily compatible with health and well being.

    It is this mindset that we need to tackle I think.

    Saying that , I do agree that there are many contradictory and often quite frankly moronic messages about health that get out there into the public domain.

    I don't think incentives in and of themselves are a bad thing (depending on what they are of course), they CAN work; but only if they are coupled with 'punishments' too. A carrot AND stick approach, so to speak.

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  • The commercial world will always run rings around any Government attempts to "nudge" the public towards healthy living. Stronger regulation is the only credible way forward.

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  • Anonymous | 26-Jan-2011 2:18 pm, I do agree, but I think SOME carrots are needed as well. How about (just off the top of my head) compulsory 2 yearly health checks, then anyone who smokes/drinks excessively/is obese/takes drugs etc, gets a sliding scale increase in their NI contributions, effectively they will use more money from the NHS, so they should pay more. Conversely anyone who is healthy, doesn't smoke/drink, and works out, etc pays less. This is a damn good incentive I think.

    Just one quick example (and yes I know it isn't perfect) of how the carrots and the sticks could work together?

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  • Ah yes and how about an increase in NI contributions from those with or who are likely to get sport related injuries and the scores who return from skiing holidays with injuries that drain NHS resources notto mention the time off work

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  • Anonymous | 27-Jan-2011 12:36 pm don't be ridiculous. First of all, people (and I am one) who undertake activities like that abroad already pay PRIVATE insurance, besides they will cost the NHS less in the long run by participating in HEALTHY activities. Think about it. Second of all, you cannot compare an ACCIDENT with a long term negative lifestyle choice such as smoking or taking drugs. Think about things before you come out with them?

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  • Mike, "people (and I am one) who undertake activities like that abroad already pay PRIVATE insurance"

    That will only pay for your treatment abroad if you sustain an injury, the NHS will still have to pay for your treatment when you return home.

    The only way to improve the fitness of our society is to start the education at school. Get children interested in sport and healthy living and they will continue throughout their lives. It is too late for most adults, "you can't teach an old dog new tricks". I bet Mike wasn't an obese couch potato that suddenly had a eureka moment and turned into the super being he professes to be be overnight.
    People that are unfit and then turn up at the weekend to do some sport are the people who fill up our A&E departments and our emergency theatres.
    Since the NHS started people have been told not to worry about their health as the NHS will take care of them, free of charge, then suddenly in the past maybe 20 years we have been told to take responsibility for your own health because the NHS has finite resourses and we will refuse to treat you if you are overweight, or smoke, or drink, or don't exercise.
    It is all down to money. If we had money to throw at the NHS and had loads more nurses that were paid more, we wouldn't give a toss about the state of Joe publics health.

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  • Anonymous | 28-Jan-2011 9:40 am, that is assuming there IS long term treatment once home (there isn't always), and money spent on treating accidents due to HEALTHY pastimes is more than reimbursed by those people not using the NHS for long term conditions due to poor lifestyle choices. If you are healthy, you don't get sick as much. Simple as that.

    And I'm not professing to be a superbeing, I just look after myself and I'm just not one of the idiots who ruin their health and their bodies through choice or laziness or whatever excuse they choose.

    'we wouldn't give a toss about the state of Joe publics health?' Wouldn't we? I would, because I take my health promotion role seriously. I think that says more about you than anything else.

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  • Any change in lifestyle is going to take a generation or more to change. Those of us old enough to remember, smoking was so much promoted by the media, in films and even by the medical profession. I used to work with someone who was told to take up smoking to help with a medical condition. Unfortunately, I don't remember the condition, no comments about age-related memory please. When all these 'idiots', (not my quote), die early there could be less burden on the NHS, less people to care for and less jobs perhaps. The government won't ban tobacco, they need the revenue. They are two faced, promote 'healthy' lifestyles so this blames the public, not them. Clever tactics, and we swallow it. When we all start living longer the retirement age may increase even more and more cuts in pensions. This is a big, big picture and we should not be too quick to judge. We can't predict our future or our need for NHS treatment, be it long term conditions or through dangerous activity, or sheer bad luck. Even if you get private treatment, most consultants also work for the NHS, so private treatment is taking care away treatment from the NHS. Anyone remember Barry Sheen (RIP) who was held together with metal? However we live our lives, there will always be some sort of trade off. As professionals we are not here to be judgemental or was my training in vain? Oh, and what about McDonalds, Pizza Hut, Kentucky Fried Chicken, should they all be closed?

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