A report from the Health Foundation assessing Government policies on ill health concludes that a change of approach from an individual to a population level is required


The Health Foundation has called upon the Government to switch the focus of its public health strategy from individual behaviour to population-level interventions.

Addressing the leading risk factors for ill health,1 a report published by the think tank, reviews government policies for tackling risk factors—such as smoking, poor diet, physical inactivity, and harmful alcohol use—and assesses their impact. It criticises the Government for ‘relying heavily’ on changes in individual behaviour, and recommends measures such as taxation, regulation, and public spending: ‘Population-level interventions that are less reliant on individual agency should form the backbone of strategies to address smoking, alcohol use, poor diet, and physical inactivity.’

The authors say the adoption of price-based policies, taxes, and regulation, such as a minimum pricing unit for alcohol, a sugar and salt reformulation tax, and raising the age of sale for tobacco from 18 to 25 years, would lead to ‘immediate gains’.

The review found that trends for many of the leading risk factors are ‘going in the wrong direction’, inequalities are widening, and key national targets will be missed. In addition, the report says, ‘decision making across departments has been disjointed’, with an approach that has been ‘uneven across risk factors’, and is particularly weak on alcohol.

It points out: ‘Public, media, and political discourse about health and risk factors for ill health have been dominated by notions of personal responsibility, individual choice, and the primacy of free markets, alongside an aversion towards policies deemed to be “nannying”.’

Instead, the authors say: ‘The focus should be on modifying the environments in which people live to reduce exposure to these risks and make healthy behaviours the easy option. These interventions should be accompanied by targeted support for individuals that is tailored to the needs of disadvantaged communities.’

The report describes the approach implemented over the past 5–10 years as ‘insufficient’ and ‘inadequate’. It urges the Government to recognise the role of corporations in shaping environments and influencing individual behaviour, and to do more to encourage the private sector to support the adoption of healthy behaviour.

The authors conclude: ‘The costs of government inaction on the leading risk factors driving ill health are clear—for public services, the economy, and for individuals and their communities. As the country recovers from the COVID-19 pandemic and seeks to build greater resilience against future shocks, now is the time to act.’


1. Everest G, Marshall L, Fraser C, Briggs A. Addressing the leading risk factors for ill health: A review of Government policies tackling smoking poor diet, physical inactivity and harmful alcohol use in England. The Health Foundation; 2022. doi.org/10.37828/HF-2022-P10.


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