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In the past six months, there’s been a sea change in politician’s bravery to be bold with public health policy. The Prime Minister has staked his legacy on banning smoking for those born after 2008 (as long as he can get the Bill through parliament) and the Leader of the Opposition is ready to take on all-comers who want to label his policy to supervise kids’ toothbrushing and have a prevention-first revolution as ‘nanny statism’. Why? Well there’s an election on the way and voters want action to curb the harm from tobacco, alcohol, obesity, and gambling. New polling from The King’s Fund reinforces this message.
This shift is in the nick of time. England’s population is getting less healthy. Life expectancy and health outcomes are lower in England than almost all comparable countries in Europe and the assumption that children will live longer than their parents is in doubt. The situation is worse depending on where you were born – women living in Buckinghamshire can expect to live in good health for 13 years longer than women living in Blackpool.
This is not just an issue for individuals living with illness, or for the NHS which cares for these people, it has become a significant economic issue that politicians can no longer ignore. Figures from the Office for National Statistics found that, on average, between October and December 2023 2.8 million people were not working because of long-term sickness. This will be holding back economic growth. In 2021, the loss of earnings from long-term sickness cost the UK economy £43 billion – 2% of gross domestic product (GDP).
However, the action politicians are proposing is still far from what is required to turn around the nation’s poor health. Much more can be done, and our polling shows that the public support several additional policy interventions. Take obesity, for example. It is one of the four largest preventable risk factors for major conditions such as cancers, stroke, diabetes and mental ill health. The NHS spends around £6.5 billion a year on treating the consequences of obesity.
Our polling shows significant public support for restricting advertising of unhealthy food and drink – 65% support and 15% oppose action – while 67% tend to support the government requiring companies to reduce the salt, sugar and fat in their products, with only 14% opposed. More people support (41%) banning retail promotions of unhealthy foods such as ‘buy-one-get-one-free’ offers than oppose (35%). There are policies sitting on the shelf - legislated for by this government – ready to go to restrict junk food advertising and supermarkets aimed at children.
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If politicians commit to further action and receive negative headlines describing the policies as the product of the ‘nanny state’, they should take courage from the past examples where, despite the headlines, the public conclude the policies are common-sense. The term ‘nanny state’ was first used by a parliamentarian to criticise the introduction of the 70mph speed limit in 1965, fast forward to 2021 and polling suggests that 82% of the public now support the idea of reducing the speed limit to 60mph to reduce carbon emissions. Sticking with cars, seatbelt use in the UK is consistently above 90%, despite it taking 15 years and 11 attempts to legislate to make it law for drivers and passengers to wear one. And on the health front, the majority of the public continues to support the 2007 smoking ban in public places and the 2018 soft drinks levy.
There will always be opposition to public health interventions, for example, by those who feel the state should play a minimal role in telling people how to live, whose interests are affected, or who see a political opportunity. It’s a story a century old. When Victorian lawmaker’s tried to improve the cleanliness of water to protect the population from a cholera epidemic in Europe, they were met with opposition from ‘vested interests’ who feared the loss of personal freedoms or represented business interests. Yes, that’s right, there was even opposition to clean water.
I’ll end on a word of caution for political leaders looking to introduce public health policies: the public’s view is nuanced. There is an important difference between the general concept of government’s intervention in people’s lives and support for specific policies. Mistrust of the concept of the ‘nanny state’ is real, but so is the public’s eagerness for policies that will improve the health of the nation.
Full polling results from Ipsos Mori polling 2024 of 1,115 respondents
44% of people disagree that the government is doing enough to address unhealthy diets, 28% agree, 25% neither agree nor disagree and 4% don’t know.
42% of people disagree that the government is doing enough to reduce harmful levels of alcohol intake, 29% agree, 26% neither agree nor disagree and 4% don’t know.
40% of people disagree that the government is doing enough to support people to live a healthier life, 33% agree, 24% neither agree nor disagree and 3% don’t know.
39% of people disagree that the government is doing enough to promote physical activity, 32% of people agree, 25% neither agree nor disagree and 4% don’t know.
67% of people support requiring companies to reduce the salt, sugar and fat in their products, 14% oppose, 17% neither support or oppose and 2% don’t know.
65% of people support restricting advertising of unhealthy food and drink, 15% oppose, 18% neither support nor oppose and 2% don’t know.
45% of people support a minimum price for alcohol across the UK, 27% oppose, 23% neither support or oppose and 4% don’t know.
41% of people support banning retail promotions of unhealthy foods such as ‘buy-one-get-one-free’ deals, 35% oppose, 22% neither support or oppose and 2% don’t know.