Social determinants of health
People can only make personal choices about diet, physical activity and other health behaviours within a specific context. An „obesogenic‟ environment makes healthier choices hard to make.
Social determinants of health
Social, cultural and economic pressures can make the exercise of individual choices difficult, and these pressures can affect some people more than others.
The drivers of obesity – and their interdependencies – are complex
Source: “Tackling Obesities: Future Choices – Project Report” (2nd edition)
Western
Europe
Eastern
Europe
McDonald's stores
01000
20003000
40005000
6000
1970 1980 1990 2000
W Europe
E Europe
Concentration and clustering of hot food takeaways – opportunities for healthy planning policies
‘Place’ – fast food,
everywhere
“Chronic over-production”of sugar, butter Court of Auditors
Cheapest calories from oils, sugars, starches
1p for 100 kcal
45p for 100 kcal
’Price’ - Common Agriculture Policy
Prices relative to all-food price index UK: 1980-2000
0.4
0.6
0.8
1
1.2
1.4
1.6
1980 1985 1990 1995 2000
Soft drinks
Fresh fruit
National Statistical Office and DEFRA, 1980-2000
Fruit prices increase 33% while soft drinks fall 22%
The power of marketing
“At its most imaginative and wonderful best, [advertising] does more than influence consumers’ choice between brand x and brand y. It has the capacity to influence as well as reflect attitudes, behaviour and cultural norms on a much wider scale.”
Baroness Jean Coussins, ASA Council member ISBA Annual Conference, Thursday 28 Feb 2008
Entertainment or information?
“The Daily Mail, as you know, is engaged in a philosophical project of mythic proportions: for many years now it has diligently been sifting through all the inanimate objects in the world, soberly dividing them into the ones which either cause - or cure - cancer.”Ben Goldacre, The Guardian, December 2007
Food labelling
“Food labelling should be improved as a matter of urgency… A „traffic light‟ system should be investigated.”Health Education Council Canterbury Report 1984
Statutory nutritional standards for school foodApply to all public sector provision – hospitals, prisons, armed servicesPowerful purchasers shape markets
‘Public sector food provision’