Category Archives: Health Policy

Hot Topic: Advertising of Junk Food

Context for this post

As part of our Part A preparation, each week we write a briefing on a current ‘hot topic’ which has public health implications.  A useful document to guide choice of ‘hot topics’ has been the Faculty of Public Health  manifesto “12 Steps to Better Public Health”. Below is my briefing plus wider discussion on the advertising of junk food on TV.

FPH Manifesto Summary 

  • A recent Which? report criticised the 2006 Ofcom measures to ban junk food advertising between programmes where 20% of the audience were <16
  • The current measures are ineffectual and fail to cover programmes such as soaps which are still watched by large numbers of young people.
  • A complete ban before the 9pm watershed is needed to effectively reduce consumption of salt, saturated fats and sugars by children and adolescents, reducing the risk of cardiovascular disease later in life.

The problem

  • According to the Department of Health, £838million was spent on food and drink advertising in the UK in 2007.
  • Junk food marketing contradicts messages about healthy eating, undermining children’s ability to choose better food and parents’ efforts to feed them healthily.
  • To combat the rise of childhood obesity it is vitally important that children are persuaded to eat more healthily.
  • Food Standards Agency suggest junk food marketing directly influences children’s food preferences, and indirectly influences what family and friends consider to be a ‘normal’ diet. 

Current regulations

  • Prevent the advertising of “less healthy” products during children’s TV programming. 
    • 70 percent of the television that children watch is outside the hours of ‘children’s TV’ that these rules cover,
    • Research from Which? in 2007 reported that that 18 of the 20 most popular programs watched by children under 16 were not be covered.
  • Products must pass the FSA nutrient profile model prior to Ofcom giving permission to advertise.
    • Points are given for fat, salt and sugar.  If the score is too high, the product is not allowed to be advertised.

A solution being lobbied for is a 9pm watershed for junk food adverts, which has been suggested to have the following benefits:

  1. Protect children: This will eliminate over 80% of instances of kids watching junk food TV advertising.  The current rules only protect children from half this much advertising.
  2. Support parents: It will provide clarity on when junk food adverts will be shown, allowing parents to exercise responsibility over whether their kids see such adverts.  
  3. Improve children’s health: Estimates show that the health benefits from a 9pm watershed for junk food TV adverts will save the nation up to almost a billion pounds a year – at a cost to industry of  £130 million a year, and no cost to the government.

A series of surveys have demonstrated that the majority of parents are in favour of a protecting their children from junk food advertising:

  • BHF survey found that 68% of parents were in favour of pre-9pm junk food advertising restrictions, with only 7% against.
  • Which? found in 2006 that 79% of parents believe unhealthy foods should not be advertised during the times children are most likely to be watching television.

There are currently no legal restrictions on non-broadcast junk food marketing aimed at children. 

  • This category includes marketing through sponsorship, packaging, text messaging and the internet. 
  • This is a growing form of advertising aimed at children and its omission from statutory regulation is a loophole often exploited by food companies.

Therefore… there appears to be a lot of support for a 9pm watershed to be put into place, however what true effect this will have will be difficult to measure because there are so many sources of influence upon the perceptions and desires of children.  Although I feel supportive of this campaign, it’s underlying premise suggests that exposure to adverts is the most important factor… what other influences could be important?  Have these been considered?  E.g. previous exposure to different foods (e.g. junk vs. healthy), parenting styles, friends/peers at school, ease of accessing healthy food…etc.  In essense, my point is that this campaign will only be worthwhile if it is complimented by other relevant actions which encourage behaviour change as realistically we do not know which influences are the greatest (and influences are likely to be different for different individuals).  This policy is a step in the right direction, however when one considers that the sponsors for the 2012 Olympics include Coca-Cola, Cadburys and McDonalds (and no companies representing healthy consumption) one cannot help but be skeptical.



9/11 – Reflections from a Public Health Perspective

It’s September.  This is the month when the critical appraisal papers *generally* are chosen for the January Part A FPH Exam, *typically* from the BMJ… (so I’m making a mental-note to review papers which were published at the end of the month).  But this isn’t just any old September…

This September marks 10 years since the ‘9/11’ attacks.  On Tuesday September 11th 2001, four coordinated suicide attacks by al-Qaeda were carried out on the United States.  Reflections on this 10 year anniversary have started to creep onto all the news channels, and I assume these reflections will be sustained until the anniversary day (a week today). But how can a public health perspective contribute to such reflections…?

Handily, The Lancet have today published a series of articles which examine the health consequences of the 9/11 events.

The editorial “9/11 – Ten Years On” observed that the US governmental responce focused on defense, security and emergency preparedness.  Not only did this encourage fear and anxiety amongst the general population, it stigmatised many muslim communities and individuals.  Furthermore, health was pushed onto the backseat of political agendas, and the author suggests that:

“.. 9/11 was a huge opportunity cost for the health of the American people.”

As well as US domestic health effects, the 9/11 events have had international consequences.  One postitive outcome has been an increased post 9/11 commitment to global health encompassed by the US national security strategies.  The US recognised that investing in global health (amongst other aspects of development) had positive outcomes in terms of stability and security for their country. 

The 9/11 events, responses and consequences have provided a lot of reflections and learning for public health; from the micro (such as individual health protection, occupational health, suicide attacks), to the macro (health policies, emergency preparedness and reponse).

Articles of interest include:

“The events of 9/11 not only represent an example of a local act with global consequences, but also an instance where poverty and perceived injustice can contribute to catastrophic global instability and insecurity. It is now abundantly clear that human-made crises will, if not resolved decisively through politics and diplomacy, create the conditions for human-made disasters.”

Response to ‘Tackling Health Inequalities’ guest post by Kate Thomson

I was interested to read Kate Thomson‘s guest post entitled: Tackling Health Inequalities: restructured into a luxury? which discussed the impact of the ‘scrapping‘ of the Public Health National Support Teams, and the impact thereon for sustaining ‘healthy policies’

Personally this topic is of great interest as between 2007-2009 I was part of the Health Inequalities National Support Team (HINST); I participated in pre-visit negotiations with areas, on-site visits through to follow-up work.  It was fast-paced work with a dedicated team of experts from across England who truly understood population health and how to systematically address health inequalities.

Here are my thoughts and response to the article:

The NSTs were not ‘quietly abolished’ as reported in the media. Each NST was set-up with a particular target in mind (e.g. 2010 PSA to reduce inequalities in health outcomes by 10 per cent as measured by infant mortality and life expectancy at birth); their objective was to work closely with DH policy teams and poor performing areas in order to identify areas for improvement and offer support, as outlined in the article. Each NST however, being tied to a particular target, had a life expectancy in itself. This was known to all NST staff who were (in the majority) brought in on short-term contracts due to end on 31st March 2011. Coinciding with the change of government, all NSTers were aware that contracts would not be extended.

The NST working-model engaged change management principles to gain ‘buy-in’ and cooperation from areas – and yes, some were certainly easier to engage than others! From my observations and experience, the key was ensuring areas understood the differentiation between ‘support’ (such as that provided by the NST) from ‘performance management’ – and this was key to a successful pre-visit negotiation.

Support entailed both identifying strengths, good practice and areas for improvement; demystifying targets and building self-belief that delivering on set targets was achievable; tailoring bespoke recommendations to each unique area. The consultancy offered by each NST was free of charge yet a ‘memorandum of understanding’ was signed by each local organisation in the area prior to an agreement being set up. What enabled the NSTs success was motivation and committment from all sides and agencies to engage in the process, listen and discuss the outcomes, and take forward recommendations with follow-up support.

Personally, I felt the work of the NSTs was beneficial to local areas in boosting the agenda of and commitment to public health topics, expertise and sharing of best practice across areas. Furthermore, the work of the NSTs was beneficial to the Department of Health – through providing local case-studies of good practice, grass-roots updates on target delivery and assurance of progress. A great strength of the NSTs was their ability to work across and benefit different layers of the healthcare system.

Unfortunately, as the NSTs were a time-limited task force lacking sustainable mechanisms within the wider system (as with many good projects who fail to achieve mainstream funding), despite it’s achievements the end is nigh.

I enjoyed reading the above piece – it is an interesting perspective which raises important questions. How can we ensure the momentum and gains achieved by the NSTs are not lost in these NHS reforms? Should the model of ‘support’ be integrated into the new system – and if so how and where? At present, the new system is being created and developed which opens the opportunity to mould the ‘brand new world’ of the NHS.