Meeting of the Parliament 03 April 2019
I congratulate the Conservative group on selecting health education as its topic for debate this afternoon. I agree with the bulk of Brian Whittle’s opening speech, which stressed the importance of nutrition, not least in tackling the pandemic of obesity and type 2 diabetes. In my remarks, I want to focus on the preventative health agenda and look at the bigger picture—the role that austerity and health inequality play in Scottish health education.
Last year, as joint convener of the cross-party group on diabetes, I was invited to visit young people at Charleston academy in Inverness to talk about diabetes. The class that I spoke to had an in-home app that could read the bar codes of supermarket products and translate a food’s composition into the amount of sugar that it contained. As an experiment, the young people scanned a large box of Jaffa cakes; it contained 32 lumps of sugar, which is, of course, a major contributor to the development of type 2 diabetes.
As we have heard from Brian Whittle and the minister, being classed as obese or overweight is a significant contributing factor to developing type 2 diabetes. With our obesity crisis, it is—unfortunately—no surprise that the figures on the condition make for bleak reading: over 257,000 people in Scotland are diagnosed with type 2 diabetes and a further 500,000 are at risk of developing it. As we all know, with a diagnosis of type 2 diabetes can come serious complications including a risk of blindness and amputation. As the minister said, the NHS spends almost £1 billion on tackling diabetes, and 80 per cent of that goes on managing avoidable complications.
When faced with the complexity of our obesity and diabetes problems, it is easy to feel overwhelmed. Some of us—I note that Stewart Stevenson is not in the chamber—may longingly hark back to the good old days, when food was less processed and children played outside rather than sitting playing “Football Manager”, but nostalgia is not a solution. The key is an approach that does not just restrict unhealthy foods, which is negative, but that makes a balanced diet a much more practical option. We all know that the growth of out-of-home eating means that any strategy needs to have a consistently strong approach to the labelling and marketing of foods by restaurants and takeaways.
However, the environmental shift needs to encompass more than just our food culture. Although the nature of our public health challenge may look modern, under the surface the root causes are the same old story: poverty, social deprivation and inequality are significant contributors to people being overweight, and it is the least well off who are most at risk. For example, a quarter of children who live in our most deprived areas are at risk of obesity compared with only 17 per cent in the least deprived areas. The problem was captured very well in the Health and Sport Committee’s “Report on Health Inequalities” in 2015, which states:
“A boy born today in Lenzie, East Dunbartonshire, can expect to live until he is 82. Yet for a boy born only eight miles away in Calton, in the east end of Glasgow, life expectancy may be as low as 54 years, a difference of 28 years or almost half as long again as his whole life.”
Therefore, our health inequalities are just inequalities; they cannot be explained away purely as being about the food choices that individuals make. As food prices have risen, it has become harder for families on a tight budget to buy meals that are both filling and nutritious, and evidence shows that consumers want to buy healthier food but think that it is more expensive. Regulation of product promotions needs to be more ambitious than merely reducing the number of unhealthy foods that are on offer.
Placing restrictions on the formulation, sale and advertising of food products is beneficial, but it is also complex and tricky. Reversing our obesity crisis will require a cross-Government commitment that is realistic about the impact that poverty has on individual health. It is fine to talk about active travel, but what if it is not safe to walk or cycle in a local neighbourhood? It is fine to talk about healthy eating, but what if fresh fruit and veg cannot be bought at local shops due to rising food prices?