Public health interventions needed to tackle grim reaper of 'lifestyle' diseases

Interventions such as the smoking ban help to break habits instead of relying on individuals to make the right decision for their health

More public health interventions, along the lines of the smoking ban, are needed to tackle Britain's devastating toll of ‘lifestyle’ diseases, including heart disease and cancer, according to academics.

A new paper, by Dr Stanley Blue, lecturer in Social Sciences at The University of Manchester, claims that there needs to be a shift in public health policy, with less focus on efforts to change individual behaviour and more attention on breaking social habits and practices that are blindly leading us into bad health.

Theories of practice and public health: understanding (un)healthy practices is published in the journal, Critical Public Health, and written by Dr Stanley Blue, lecturer at the School of Social Sciences, Prof Elizabeth Shove, of Lancaster University, Prof Mike Kelly, Director of the Centre of Public Health at NICE, and Chris Carmona, public health analyst at NICE.

The authors say new ideas are needed to tackle non-communicable - or 'lifestyle' diseases - such as heart disease, cancer, asthma and diabetes. They explain how some social practices reinforce each other, such as getting a takeaway and watching TV on a Friday night, whereas others, such as drinking a bottle of wine at home or going to the gym, compete for time in our busy days.

They cite the smoking ban as an example of a measure that effectively decoupled the relationship between going out for a meal or a drink and having a cigarette. A similar approach, with social practice at the heart of public health policy, could be taken to eating and exercise, rather than traditional methods which rely on persuading people to make the 'right' decision by going to the gym or eating their five a day – and which treat such decisions as matters of personal choice.

Dr Stanley Blue said: “Smoking, exercise and eating are fundamentally social practices, therefore we need to re-shape what is deemed socially acceptable and normal in order to change them.

“Current public health policy is dominated by the presumption that individuals are capable of making ‘better’ choices for themselves on the basis of information given to them by the government or other agencies. This does not account for the fact that practices like those of smoking and eating have histories of their own.

"Trying to get individuals to stop smoking or eat healthily overlooks the fact that these are fundamentally social practices. Public health policy will have to find the courage to break away from its traditional mould if it is to stand a chance of confronting the grim reaper of lifestyle diseases."

Notes for editors

Dr Stanley Blue is available for interview.

Theories of practice and public health: understanding (un)healthy practices is published in Critical Public Health and written by: Dr Stanley Blue, lecturer at the School of Social Sciences, The University of Manchester; Prof Elizabeth Shove, Director of the DEMAND research centre and Professor of Sociology at Lancaster University; Chris Carmona, Public Health Analyst at NICE and Prof Mike Kelly, Director of Public Health at NICE.

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