The severity of this crisis means we need an overarching “obesity test”, now. Photo: Getty
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Why all new legislation should face an obesity test

Obesity is not a future theoretical threat, it is a present catastrophe.

David Cameron convened another COBRA meeting last week. Normally associated with terrorist threats and natural disasters, this time it was for a crisis in health. We’ve known about it for years, we’ve seen the catastrophic effects on individuals, we have had a plethora of advice on prevention and we have some frightening numbers of the cost to the economy. Were they discussing the greatest threat to the nation’s health and possibly economic security, ie obesity? No. Obesity, which has been blubbering for attention from politicians for a couple of decades, was elbowed aside by the far more fashionable ebola.

Obesity is not a future theoretical threat, it is a present catastrophe. In the past 20 years, the proportion of adults that are obese has risen from 13.2 per cent to 24.4 per cent among men and from 16.4 per cent to 25.1 per cent among women. Including being overweight, the numbers are far worse: 57.6 per cent to 66.6 per cent among men and from 48.6 per cent to 57.2 per cent among women. Most people have heard of the repercussions of being obese: diabetes, heart disease, joint problems, though less known tends to be the rising association with cancer. In 2007 the cost to the UK economy of overweight and obesity was estimated at £15.8bn per year, including £4.2bn in costs to the NHS. 2007 was also the year that the Labour government brought out its seminal Foresight Report on “Tackling Obesities” which set out to answer the question “How can we deliver a sustainable response to obesity over the next 40 years?” The project assembled evidence and expertise from diverse academic disciplines as well as interested organisations within and beyond government.

Eight years on, one fifth of the way through the report’s timeline, and it’s safe to say the situation has not improved. We’re still getting fatter and we still have fat-sugar-responsibility-blame demonising headlines on a loop. The Foresight Report rightly asked for a system-wide approach and a portfolio of policies to be put in place. Politicians can point to things that have since been done, but they are self-evidently inadequate. The approach has remained to piecemeal, to voluntary, to weak, to uncoordinated and to blaming.

In “Careless eating costs lives” we have responded to the obesity crisis by putting together a portfolio of policies, acknowledging both that only a cross-cutting, robust approach will suffice and that there are more avenues to explore. Where previous activity has been limited, we are calling for extended application; where schemes have been half-baked, we are setting out a considered whole-sector approach; where good things have begun, we ask for them to be embedded in law as the new foundations of progress.  For instance, the coalition government’s much debated voluntary “Responsibility Deal” has actually seen 713 different organisations and manufacturers sign up to one or more “pledge” to improve labelling, content, nutrition or workplace health. They have shown it can be done, so why not now phase in this deal as mandatory for all manufacturers, just as the Disability Discrimination Act was phased in over a period of years, allowing a reasonable amount of time for companies to adjust? Likewise, the ban on advertising unhealthy foods on TV aimed at children, needs to be now extended across daytime TV, not just during the early-afternoon. Having calories detailed on some menus now needs to become the norm, from KFC to Starbucks to Pizza Hut.

Above all, the severity of this crisis – the drain on individuals, economies and the NHS – means we need an overarching “obesity test”. All government departments need to consider the impact of proposed policy on eating behaviours and public health, to ensure it does not compound the crisis. This is essential because the causes are so complex and multifaceted. Health, education, business, treasury, transport, trade, farming and local government all have their part to play, but if the “obesity” question is not being asked, the unintended consequences of policy could be a more obesogenic environment than we have already.

If a new policy or initiative makes it easier to supply fast food, harder to walk to the shops, more difficult for schools to serve balanced meals, cheaper to buy junk grub then it should be rejected. Those are obvious. But due consideration should also be given to prevention: mental illness and counselling services, early years support and cooking classes are all vital to ensuring problem symptoms are tackled before they turn into the signs of excessive weight gain. One friend remarked to me that everyone in the over-eaters anonymous groups that she had ever attended had reported a history of abuse.

No, obesity isn’t as captivating as ebola. And as ever, those with the least resources, the lowest resilience, and often the easiest to ignore are the hardest hit. But with a tidal wave of calories surrounding us, we can’t go on ignoring obesity – because it will sink all of us if we do.

Julia Manning is Chief Executive of 2020health

Photo: Getty Images
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What's to be done about racial inequality?

David Cameron's words on equal opportunities are to be welcomed - now for some action, says Sunder Katwala.

David Cameron made the strongest, clearest and most high profile statement about ethnic inequalities and the need to tackle discrimination ever yet offered by a British Prime Minister in his leader’s speech to the Conservative Party conference in Manchester.
“Picture this. You’ve graduated with a good degree. You send out your CV far and wide. But you get rejection after rejection. What’s wrong? It’s not the qualifications or the previous experience. It’s just two words at the top: first name, surname. Do you know that in our country today: even if they have exactly the same qualifications, people with white-sounding names are nearly twice as likely to get call backs for jobs than people with ethnic-sounding names? … That, in 21st century Britain, is disgraceful. We can talk all we want about opportunity, but it’s meaningless unless people are really judged equally”, said Cameron.
While the proof of the pudding will be in the eating, this was a powerfully argued Prime Ministerial intervention – and a particularly well-timed one, for three reasons.

Firstly, the Prime Minister was able to root his case in an all-but-universally accepted appeal for equal opportunities. It will always prove more difficult in practice to put political energy and resources behind efforts to remedy discrimination against a minority of the population unless a convincing fairness case is made that values cherished across our whole society are at stake. Cameron’s argument, that any party which tells itself that it is the party of the ‘fair chance’ and ‘the equal shot’ must have a response when there is such clear evidence of discrimination, should prove persuasive to a Conservative Party that has not seen race inequalities as its natural territory. Cameron argued that the same principles should animate responses to discrimination when it comes to race, gender and social class. Put like that, wanting job interviews to be fair – by eradicating conscious and unconscious patterns of bias wherever possible – would strike most Britons as offering as clear a case of the values of fair play as wanting the best baker to win the Great British Bake-Off on television.
Secondly, Cameron’s intervention comes at a potential "tipping point" moment for fair opportunities across ethnic groups. Traditionally, ethnic discrimination has been discussed primarily through the lens of its impact on the most marginalised. Certainly, persistent gaps in the criminal justice system, mental health provision and unemployment rates remain stark for some minority groups. What has been less noticed is the emergence of a much more complex pattern of opportunity and disadvantage – not least as a consequence of significant ethnic minority progress.

Most strikingly of all, in educational outcomes, historic attainment gaps between ethnic minorities and their white British peers have disappeared over the last decade. In the aggregate, ethnic minorities get better GCSE results on average. Ethnic minority Britons are more likely, not less likely, to be university graduates than their fellow citizens. 

As a result of that progress, Cameron’s intervention comes at a moment of significant potential – but significant risk too. Britain’s ethnic minorities are the youngest and fastest-growing sections of British society. If that educational progress translates into economic success, it will make a significant contribution to the "Great British Take-Off" that the Prime Minister envisions. But if that does not happen, with educational convergence combined with current ‘ethnic penalties’ in employment and income persisting, then that potential could well curdle into frustration that the British promise of equal opportunities is not being kept.  Cameron also mirrored his own language in committing himself to both a ‘fight against extremism’ and a ‘fight against discrimination’: while those are distinct challenges and causes, actively pursuing both tracks simultaneously has the potential, at least, depolarise some debates about responses to extremism  - and so to help deepen the broad social coalitions we need for a more cohesive society too.

Thirdly, Cameron’s challenge could mark an important deepening in the political competition between the major parties on race issues. Many have been struck by the increase in political attention on the centre-right to race issues over the last five to ten years. The focus has been on the politics of representation. By increasing the number of non-white Conservative MPs from two to seventeen since 2005, Cameron has sent a powerful signal that Labour’s traditional claim to be ‘the party of ethnic minorities’ would now be contested. Cameron was again able to celebrate in Manchester several ways in which his Cabinet and Parliamentary benches demonstrate many successful journeys of migrant and minority integration in British society. That might perhaps help to ease the fears, about integration being impossible in an era of higher immigration, which the Home Secretary had articulated the previous day.

So symbolism can matter. But facial diversity is not enough. The politics of ethnic minority opportunity needs to be about more than visits to gurdwaras, diversity nights at the party conference fringes and unveiling statues of Mahatma Gandhi in Parliament Square. Jeremy Corbyn’s first speech as Labour leader did include one brief celebratory reference to Britain’s ethnic diversity – “as I travelled the country during the leadership campaign it was wonderful to see the diversity of all the people in our country” – and to Labour bringing in more black, Asian and ethnic minority members - but it did not include any substantial content on discrimination. Tim Farron acknowledged during his leadership campaign that the Liberal Democrats have struggled to get to the starting-line on race and diversity at all. The opposition parties too will no doubt now be challenged to match not just the Prime Minister’s rhetorical commitment to challenging inequalities but also to propose how it could be done in practice.

Non-white Britons expect substance, not just symbolism from all of the parties on race inequalites.  Survation’s large survey of ethnic minority voters for British Future showed the Conservatives winning more ethnic minority support than ever before – but just 29 per cent of non-white respondents were confident that the Conservatives are committed to treating people of every ethnic background equally, while 54 per cent said this of Labour. Respondents were twice as likely to say that the Conservatives needto do more to reach out – and the Prime Minister would seem to be committed to showing that he has got that message.  Moreover, there is evidence that ethnic inclusion could be important in broadening a party’s appeal to other younger, urban and more liberal white voters too – which is why it made sense for this issue to form part of a broader attempt by David Cameron to colonise the broad centre of British politics in his Manchester speech.

But the case for caution is that there has been limited policy attention to ethnic inequalities under the last two governments. Restaurateur Iqbal Wahhab decided to give up his role chairing an ethnic minority taskforce for successive governments, unconvinced there was a political commitment to do much more than convene a talking shop. Lib Dem equalities minister Lynne Featherstone did push the CV discrimination issue – but many Conservatives were sceptical. Cameron’s new commitment may face similar challenges from those whose instinct is to worry that more attention to discrimination or bias in the jobs market will mean more red tape for business.

Labour had a separate race inequalities manifesto in 2015, outside of its main election manifesto, while the Conservative manifesto did not contain significant commitments to racial inequality. The mid-campaign launch in Croydon of a series of race equality pledges showed an increasing awareness of the growing importance of ethnic minority votes - though the fact that they all involved aiming for increases of 20 per cent by 2020 gave them a slightly back-of-the-envelope feel. 

Prime Ministerial commitments have an important agenda-setting function. A generation ago the Stephen Lawrence case opened the eyes of middle England to racist violence and police failures, particularly through the Daily Mail’s persistent challenging of those injustices. A Conservative Prime Minister’s words could similarly make a big difference in the mainstreaming of the issue of inequalities of opportunity. What action should follow words? Between now and next year’s party conference season, that must will now be the test for this Conservative government – and for their political opponents too. 

Sunder Katwala is director of British Future and former general secretary of the Fabian Society.