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Let's get tough with our public health policy!

Lynn Young
Primary Healthcare Adviser for the RCN

Public health is set to take on a much higher profile in the NHS, and mainly because  the nation is in the grip of an obesity epidemic. Politicians and the Chief Medical Officer, Sir Liam Donaldson, are publicly proclaiming that healthier lifestyles must become the norm if we are to reduce the current levels of obesity, encourage people to live well and not become obese in the first place.
The food industry should also cooperate by taking responsible action so it can play its part in the battle to combat this major but preventable health problem. Schools, local government, employers and, of course, the NHS need to form a strong alliance and take multipronged and thoroughly joined-up action to do what it can to help people help themselves eat better and be more active.
What a sedentary lot we have become! And what about children who no longer walk to school, take regular exercise at school (or indeed anywhere else) and spend endless hours at the computer or in front of the television? This rather provocative statement is, of course, a sweeping generalisation, but modern life has brought its own particular problems. Whereas, not so long ago, far too many children suffered from rickets on account of too little food and poor nutrition, we now have a large number of children with diabetes, simply because they are too fat.
We are about to have a full-scale and long-term campaign to bring the health message into our schools, workplaces and sitting rooms via television. The biggest challenge, though, is to get the message to those who do not wish to hear it and who have no intention of changing their lifestyle anyway. Changing habits is a difficult business, and eating is probably the most fundamental of behaviours, so it takes enormous motivation to shift towards a healthier direction. More poor people are obese than relatively wealthy people. In this way, obesity relates to smoking in terms of who is affected.
People who are socially deprived have to struggle hard to get through the day, let alone address the eating habits of themselves and their family. But children are the key to success. In a number of poorer areas where the children have been introduced to a portion of fresh fruit each day, great enthusiasm has been shown. How tragic that some of these children had never eaten an orange, apple or banana before! But the good news does not end there, as some of the new fruit fans went home and nagged their parents to eat more fruit and make sure that the home is always well stocked!
The government, meanwhile, is considering restricting the advertising of so-called junk food during the times that children are likely to be watching TV. Issues such as unethical sponsorship, school dinners and the reintroduction of medical school officers are also being explored.
However modern we become, we still tend to go back and reintroduce measures that flourished in the past. School nurses might well argue that they are certainly up to the task of helping children pursue the health path and  that the use of doctors in this role would be a waste of public funds. And we do not need to start visiting the gym if we prefer to live without them. The message is, it is not necessary to spend hours on a boring exercise bike, but we could leave the car at home (or sell it!) and learn to enjoy cycling and walking.
The cycle fanatics are also seizing the opportunity to spread their health message. Plans across the UK are about to be drawn up to create a vast number of cycle lanes, so that wimps like me will be happier to get on their bike to get to their chosen destination.
Is this health fascism, or is it high time the government took courageous and sometimes unpopular action to prevent a mass outbreak of diabetes, cardiovascular disease and general lethargy caused simply by a rampant prevalence of overweight?