The rapid rise in Britain’s incidence of childhood obesity is an “absolute scandal,” Sir Malcolm Grant, Chair of NHS England, said at Wednesday’s launch of the Campaign for Social Science’s new report, The Health of People. “We have 10 percent of children going into school by age 5 who are obese. By age 11 it is 20 percent. How can we as a nation feel complacent about that?” Grant asked. “We have to stop normalizing obesity and we have to stop poisoning our children, and we have to start coming to grips with what is a very serious social problem.”
He pointed to the high sugar content of many fizzy drinks as one of the primary contributors to childhood obesity. “There is a long way to go beyond fizzy drinks; this is just a starting point.” Combating the disease requires a combination of prevention through schools, diet, and “intelligent guidance” to parents, he said.
Grant was delivering the keynote address to an audience of MPs, health policymakers, and researchers at the event. He was joined by an expert panel, including Professor Susan Michie, director of the Centre for Behaviour Change at UCL, Sharon Witherspoon, head of policy at the Campaign for Social Science, and Halima Khan, executive director at The Health Lab.
The Health of People report comes as pressures on the NHS to deal with an aging population, growing rates of obesity and a rise in long term chronic conditions continue to mount. The report demonstrates how the social and behavioral sciences can help find cost effective strategies to improve public health and service delivery through behavior change, prevention and greater use of data science.
The Campaign argues that biomedical science can’t tackle the challenges facing health alone. Social science understanding of the social and economic factors of ill health, the costs and benefits of clinical interventions, and how to change people’s habits are essential to healthcare today.
The Health of People report was compiled by an expert working group of leading social scientists and health practitioners from across the UK, sets out additional recommendations to improve public health, including:
- The creation of ‘implementation laboratories’, linking research, clinical care and policy to understand what works and improve uptake of effective interventions
- Adopting a new ‘social consent model’ linking health and social data to improve the quality of NHS services and patient experiences
- Training programs to connect high-level data skills to health research
- A joined up health and social care system enhancing how patients engage with biomedical and technological interventions
- Establishing a ‘strategic coordinating body’ of research funders, public health organizations and relevant learned societies to support multidisciplinary health research and its translation into policy and practice
- Further embedding social science research into national healthcare policy
The Health of People is the successor report to the Campaign’s 2015 pre-election The Business of People, outlining how social science can help guide government in key policy areas, including the economy, demographic change and migration to and from the UK.
Michie, who chaired the working group that produced the report, said obesity is a prime example of how people’s health is affected by their social and material environments.
“There’s no way around it, if we want to make progress in obesity people need to change their behaviors,” she said. “We need to take on the influencers on people’s eating and sedentary behaviors, and be able to understand how their social and material environments contribute to health.”
During the event, Michie outlined the impetus behind the report. She said much of the contribution that the social and behavioral sciences can make to health is largely untapped, and stressed that the project aims were to “show the impact of social science evidence and methods for population and health services.” This is designed to inform and influence key decision makers in the health and research sectors, while charting a path to a step change in the use of social and behavioral science for population health and wellbeing.
She said the social sciences provide models, ways of thinking about problems, and methods for a more comprehensive and coherent approach that takes account of the interactions between physical and social contexts, and people’s motivations and capabilities.
In this way, the report set out to challenge many of the “common sense” assumptions about people’s behaviors and their relationship to poor health. Existing strategies often rely on provision of information or guidelines designed to increase awareness. Alone, however, such initiatives are unsuccessful.
“People could have all the knowledge and skills required”, she said, “but behavior isn’t going to change unless we also have the physical and social environment that enable that behavior to take place.”
She identified three areas where the recommendations of the report would be particularly helpful: the general population; patient management of acute and long-term conditions and disabilities; and the delivery of high quality healthcare by providers, planners, and commissioners.
Witherspoon spoke of the essential role of data in leading to health improvements.
“A real stumbling block at the moment in our ability to realize the potential for the social sciences to contribute to a healthier UK is access to data,” she said.
The report proposes a new “social consent model” to tackle these issues, using social science research linking health and social data to understand the causes of ill health across large populations, the effectiveness of existing interventions, and where services can be improved.
The “social consent model” promotes transparent and lay use of “de-identified” data for public benefit and incorporates stringent data security standards and privacy protections. These safeguards mean that social science research using health data can help improve patient safety, cut down on UK-wide variations in healthcare delivery, find more effective behavioral interventions, and reduce costs.
Khan called attention to an “evidence trap” that has contributed to the lag in progress in dealing with certain health conditions. She said there is a “cycle in which underinvestment in research leads to a lack of evidence, which leads to a lack of implementation, which means there’s less opportunity for doing research in the first place.”
“We’ve been in this cycle for a long time. Had we been able to spend more money on the prevention agenda 10-20 years ago, we wouldn’t be in the position we’re in today.”
The panelists also highlighted the unique moment of the report’s launch, coming on the heels of other efforts to look at the sustainability of the NHS and how to make improvements to population health for the long term. Paramount among these is the Academy of Medical Science’s Health of the public in 2040, the recommendations of which are complemented in the Campaign’s The Health of People.
Michie added that the enthusiasm around the launch of The Health of People demonstrated a growing “critical mass across professional, scientific, and political agendas” to maintain momentum and lead to substantive changes in health policy and practice.
“This is a starting point for critical mass, a starting point for the kind of debate that we absolutely need to have if this is going to be not just where we are in 10 years, but if we’re really going to make long-term progress.”