On the same day (Friday 6 April) that the sugar tax on soft drinks came into effect in the UK, Britain’s newspapers and news feeds were awash with reports of London’s rising death toll through stabbings and shootings, which have passed 50 so far this year.
So what’s the connection, I hear you ask? None, through any direct scientific correlation that I can point to. But they do, I believe, have something in common.
The first represents the government’s attempt to address a seemingly intractable childhood obesity problem, likely to lead to many associated illnesses in later life and, potentially, premature death. And the second is the tragic and pointless loss of life of far too many – primarily black – young people.
Both problems have resulted in widespread calls for urgent and immediate action – although nobody seems to agree on precisely what this should be for either.
What is certain is that they both result from complex societal failures that will require holistic and equally complicated solutions to resolve. Quick, knee-jerk reactions – including throwing a few million quid at some new initiative or another – may be the expected political responses. But they are unlikely to bring about long-term solutions to either desperate problem.
One thing both – let’s cause them ‘epidemics’ – have in common is an association with poverty and deprivation. Yes, I know that an association is not a cause. However, I believe that addressing this particularly strong association could help to reduce the number of deaths caused by both gang-related stabbings and obesity-related morbidities and mortalities.
Murders of young black men
As a society, we need to deal with the poverty, absence of any stake in society, and lack of good black male role models that exist for many young black men across parts of our nation. It is leading to too many black boys from deprived estates in London and elsewhere joining murderous gangs that derive their income from dealing in drugs. Young kids are joining these gangs, either through fear and coercion, or as a way of finding some form of misguided group loyalty. Giving them a better alternative and hope for more fulfilling lives has to be part of the answer to this awful problem.
London’s murder figures also coincided with the 50th anniversary of the murder of Dr Martin Luther King at the Lorraine Motel in Memphis, Tennessee, on 4 April 1968. I am sure I am not alone in being deeply moved by hearing again on BBC Radio 4’s Eddie Mair programme earlier this week King’s famous ‘mountaintop’ speech on the eve of his assassination.
King was a courageous civil rights campaigner who fought hard, yet peacefully, against the injustices and inequalities that existed then between black and white Americans. From the TV coverage this week, it is clear that, despite some progress, those racial divisions have not gone away. And, neither have the disappeared in the UK either, with examples of covert racial discrimination still far too prevalent.
It is staggering that, according to government statistics (Ethnicity Facts and Figures), young people from ethnic minorities between the ages of 16 and 24 are almost twice as likely to be unemployed (23%) as their white peers (12%) – despite having similar qualifications.
At the same time, according to the latest NHS figures, children from poorer backgrounds are more affected by problems of childhood obesity.
Over the years, I have attended many conferences about the UK’s obesity problems. Time and again I have heard the repeated refrain that obesity is a “disease of the poor”.
In the past, as summed up by the words of the hymn All Things Bright and Beautiful: ‘The rich man in his castle, The poor man at his gate’ – in a somewhat shocking acceptance of such inequality at the time it was penned – the rich were fat and the poor were thin.
That situation has now been reversed, with the poor, generally, being fatter because of worse diets and lifestyles. Some fear, post Brexit, it could worsen as access to healthier food becomes even more difficult for poor people.
So, in both cases not a causal relationship – but clearly a very strong association.
The costs of both, in terms of human misery and burden on the nation’s limited resources are unsustainable. The extra demands on our already overstretched NHS of treating people with knife and gunshot wounds, are dwarfed by the human costs among those affected and their families and friends. However the treatment for type 2 diabetes, which is associated with obesity, accounts for just under nine percent of the annual NHS budget or around £8.8 billion a year.
Sugar levy on soft drinks
Many health campaigners have welcomed today’s introduction of the sugar levy on soft drinks, which they see as a primary cause of obesity in the young who consume more of them than the general population. Campaigners point to the success of similar taxes in Mexico, France and Norway, although others have questioned whether they are leading to sustainable obesity reduction levels.
Meanwhile, industry bodies such as the British Soft Drinks Association and the Food and Drink Federation, though recognising the seriousness of obesity associated with poor diets and lifestyles, argue that demonising a single nutrient – sugar – is an ineffective “gesture” that is unlikely in itself to resolve a wider societal problem.
I tend to agree. Much more needs to be done and, while some things are happening, in isolation they are unlikely to be enough.
In August 2016, the government set out its approach to reduce the prevalence of childhood obesity in its ‘Childhood obesity: a plan for action’. This included a key commitment to launch a broad, structured sugar reduction programme to remove sugar from everyday products. All sectors of the food and drinks industry were challenged to reduce overall sugar content across a range of products that contribute most to children’s sugar intakes by at least 20% by 2020, including a 5% reduction in the first year of the programme.
At the same time some health campaigners accused the government of being nobbled by the food industry and watering done what was a far tougher obesity reduction ‘strategy’ rather than a ‘plan’. And the politicians failed to explain, if not a dilution of the original strategy, why the name change had been made. Campaigners have continued to call for more action and tougher controls on the advertising of ‘junk’ food to children, with tighter restrictions on broadcast and other product advertising and placement.
However, through the offices of Public Health England (PHE), the food and drink sector were set the challenge of seeing what could be achieved through reducing sugar levels in products, reducing portion size, or shifting purchasing towards lower sugar alternatives.
Calorie reduction plan
PHE subsequently followed this up earlier this year with a broader calorie reduction action plan. The calorie reduction programme challenges the food industry to achieve a 20% reduction in calories by 2024 in product categories that contribute significantly to children’s calorie intakes (up to the age of 18 years) and where there is scope for substantial reformulation and /or portion size reduction.
The threat from government in the form of even tougher legislation and restrictions is the Sword of Damocles hanging over the food industry’s head if it doesn’t respond appropriately or if the voluntary measures don’t work.
But, whether its voluntary (or mandatory) reformulation of food and drink to make it healthier or Prime Minister Theresa May’s plan to take £90M from dormant bank accounts to address the problem of youth unemployment associated with race inequality, will it be enough?
I suspect there are more systemic issues to be resolved if we as a nation are to reduce obesity in poor young and older people, or deaths among young black men in our cities. And that comes down to dealing with the poverty (both financial and of ambition) and deprivation that lie behind our increasingly unequal society.