Meeting of the Parliament 15 November 2018
I would like to thank the many organisations that have provided briefings for this afternoon’s debate. I, too, am glad to discuss the systemic change that we need, so that people can live more active, healthier lives. I am also glad to see a range of amendments that present different but complementary ideas, to help us achieve that.
It is fair to say that a real challenge confronts us. The proportion of people in Scotland who meet guidelines for physical activity has not much changed since 2012. Just about two thirds of us manage moderate levels of physical activity for two and a half hours a week. Although the overall proportion of adults who are overweight or obese appears not to have increased since 2008, there has not been the positive reduction that we all want.
Over the past decade, we have certainly learned that public health messages that are focused on individual behaviours tend to fail—and to fail people on lower incomes in particular, as David Stewart stressed. They can also cause unintended harm by stigmatising some behaviours and some bodies.
When discussing the social determinants of health, Professor Michael Marmot often reminds us of the alternative health messages that we could be giving people. Instead of telling people to follow a balanced diet and to keep active, we might advise them not to be poor, and if they cannot avoid that, then to try
“not to be too poor for long”,
and not to
“live in a deprived area”,
or
“work in a stressful, low-paid manual job.”
That kind of parody indicates just how much of our health is determined by factors that we, as individuals, can do little to control. Yet, in 2018, we are a long way from seeing public health campaigns on our trains and buses announcing that poverty is a risk factor for poor health.