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‘Awareness campaigns are not a replacement for investment’

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It was my birthday recently and as is customary, I planned how old I was going to be quite meticulously.

Last year I opted for 47, which if we assume  50 is the new 40, and 40 is the new 30, then 47 is the new 37, which is five years younger than Elvis was when he fell to his death from that toilet. It went well I think. I got a lot done – spurred on by the approaching ‘big five 0’, but if I am honest I was getting a tiny bit tired by March. So this year I am going to be 51. Not so young that I have to wear skinny trousers. Not so old that I have to make a noise when I stand up. 

This is my way of making sense of birthdays. Otherwise, when the celebrations stop, birthdays are simply Age Awareness Days aren’t they and that isn’t necessarily a good thing. And, anyway, I am not sure I understand how helpful awareness days are generally?

We know that the world of healthcare is littered with awareness days, designed to promote understanding, familiarity and perhaps sympathy with all sorts of things from Hand Hygiene Day (5 May) to World Sleep Day (15 March – why isn’t it World Sleep Night?).

Essentially awareness days are health adverts. Take No Smoking Day for example (13 March). Figures suggest that 50% of the population and 61% of smokers were aware of No Smoking Day. Proving that smokers are always more aware of what is going on because they talk about stuff when they smoke. More importantly, a third of that 61% made a step toward quitting. Figures on effective change are, as ever, difficult to gather but the logic is simple; raising awareness makes behavioural change available.

Indeed, awareness days have become a staple of public health campaigns. On Your Feet Britain (26 April) encouraged us to stop sitting down. Stress Awareness has a whole week (4-8 November) and we are invited to cut back on the bullying for a few days in December. But, while raising awareness might be a good first step to engendering attitudinal change, I don’t think I am alone in wondering if they might sometimes cover the cracks of a disintegrating health and social policy.

Mental Health Awareness is a good example. This encourages an awareness of the crippling nature of psychic despair. It urges people to “talk about their difficulties”, which is nice. As was the prime minister shining a green light on her house to mark Mental Health Awareness week. But awareness without services is like a plate without food – teasing and pointless. More fundamentally, we know that poverty and disempowerment drive mental ill-health; they grow it, sustain it and help it spread like a virus, and that poverty kills people. And austerity has increased poverty.

This cognitive dissonance is as obvious as it is shameful. ‘Let’s be aware of difficulty but let’s not change the circumstances that create it’. This turns awareness days into facade rather than change agents – as demonstrated by the massive rise in reported mental ill-health.

I am not suggesting awareness days are all bad. Who among us does not need to be reminded to check ourselves for lumps, to think about drinking less or to have the occasional BBQ (27 May) but awareness is neither an end in itself nor a replacement for investment. Services need proper funding yes, but the best way to reduce pressure on those services is to address poverty. Everyone knows that, everyone knows that joining up our thinking would positively affect peoples lives. Are awareness weeks part of that? Or are they a distraction from it?

Mark Radcliffe is author of Stranger than Kindness. 

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