Public health - moving beyond the rhetoric
Last modified on 21/12/2018

I’d like to start by wishing you all a restful festive break and a happy New Year. I have no doubt it has been a busy year for many of you, and 2019 promises more of the same. I thought I’d use this blog post to discuss my chairman’s theme again, given that it will be a key focus for the BDA in 2019.

Last month, the respected charity the King’s Fund, published a report entitled A vision for population health: Towards a healthier future. The King’s Fund is an independent charity working to improve health and care in England. The report outlined a number of key areas for action to improve public health, including diet, lifestyle and environment and wider determinants of health such as poverty, housing and education.

The report is written, according to its authors, against the background of stagnating progress in public health. They highlight a number of ways in which the health of the population has stopped improving in the last decade:

  • Slowing growth in life expectancy - more so in the UK than most other countries.
  • Little or no improvement in how long people live with illness and disease since 1990.
  • Rising infant mortality in 2015 and 2016.
  • We now have amongst the worst adult obesity rates in the developed world.
  • Growing health inequality between the richest and poorest.

It also comes less than a month after the UK Department of Health and Social Care launched their own vision ‘Prevention is better than cure’. Matt Hancock MP, the Secretary of State for Health and Social Care, stated that “our focus must shift from treating single acute illnesses to promoting the health of the whole individual. That requires more resources for prevention.”

It’s pretty clear that government’s around the UK and experts in the health and care sector have recognised that things have to change, and that prevention and public health are the way forward. But as we outlined in our response to Matt Hancock, we need to move beyond the rhetoric of a prevention focused NHS to the practical delivery of services in the NHS and beyond. The government needs set clear targets to make sure that those working in health recognise this has a priority as well. Plus, the government has to stop undermining its own efforts by cutting public health funding for local authorities. These are all points highlighted by the King’s Fund as well.

I believe dietitians, in every part of the NHS and beyond, are one of the key professions for actually putting these laudable ambitions into practical action. At every stage of the King’s fund report, it is easy to see how we, as nutrition experts, can play a leading role. They highlight that diet quality is now the single biggest risk for death, ahead of smoking. They point to the need to integrate prevention at every level, from the acute to the community. They also recognise that people need to be supported to improve their diet and wider health, not just be given more information on how to do so.

Dietitians Week in June of this year highlighted the great many ways that dietitians were already delivering these services. One would hope this shift in tone from the top will mean there will soon be opportunities to expand these services and develop new preventative approaches.

But we need to be ready. I’d urge you to start building the evidence of impact. Prepare yourself to shout loudly about what you do, because you can be sure that other professionals will be pushing their case as well. Let the BDA know what you are doing so we can keep adding to our list of case studies and press governments to front up the cash to expand them across the country.

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