UK Gov commitments don't stand up to scrutiny
A top public health expert at the University of Cambridge has said that efforts to tackle major issues facing the UK - including the nation’s health and climate change - are showing a gulf opening up between the intended target and the reality. Dame Theresa Marteau’s editorial has just been published in the journal Science and Public Policy…
Theresa - I was struck by the number of laudable ambitions that recent governments were issuing to improve our health and tackle climate change, such as halving childhood obesity by 2030, achieving net zero emissions by 2050, which critically depend on being able to change behaviour at scale. And I was also noticing that there were many excellent reports that were coming out summarising the evidence on achieving the sustained behaviour change that these ambitions depend on that didn't seem to be a featuring in the policies. So I wanted to examine the extent to which that impression was realised when I looked at some of those policies.
Chris - So, targets are being laid down, gauntlets are being thrown down, if you will, but there's no evidence for why, how, or what to do in order to achieve those outcomes.
Theresa - What I do in this editorial is that I look at four current government ambitions to improve the health of the population and tackle the climate emergency, all of which were required to an extent being able to change behaviour at scale. And what I found was that all four of them were off track to varying degrees or predicted to be off track. Halving childhood obesity by 2030, that's possibly the one that's most off track. That seems to be set to double, not halve by 2030. In 2018, 20% of 10 year olds were living with obesity. And in 2021 that figure had gone up, not down, to around 25%. Unfortunately, the rates are much higher for children living in deprived neighborhoods where the rates of 34% compared to their peers living in least deprived areas where it's 14%. Eradicating smoking by 2030. We are making some progress there, but eradicating smoking means having smoking rates of 5% or under, and we're only at 14%. And it's estimated that it will take until 2050 to realise that ambition. Two more ambitions, increasing healthy life expectancy by five years, by 2035, and narrowing the gap between the rich and the poor. Unfortunately recently healthy life expectancy fell by half a year. It doesn't sound much, but the trend had previously been increasing a number of years that we can expect to live in good health. So that had fallen by half a year between 2010 and 2018. And the gap in the number of years that we can expect to live in good health between those in the richest and the poorest neighborhoods is 19 years current projections that unless there's a major change, that it will take almost 200 years to gain those extra five years in healthy life expectancy. On net zero, we've actually been making good progress, but in 2021, the Climate Change Committee expressed concern that the targets for 2035 will be missed, possibly by large margin, noting a lack of credible policies to reduce the greenhouse gas emissions, particularly from food systems and travel, including flying.
Chris - You've got to have targets to aim at though, haven't you? There's an old saying, isn't there? What gets measured gets done? So there's nothing wrong with having targets. Is your beef that the targets are off target to the extent that we are just not addressing them? Or is it that they're being set pie in the sky, that they're just so unachievable, unassailable that we may as well not have them?
Theresa - No, I think targets and timelines are really important. We achieve more with them and they're very ambitious. These targets. I think the problem is that the policies that have been implemented are not strong enough to achieve those targets. So as I say, they are ambitious, but if there were stronger policies in there that could achieve them, then the gap would be narrower. The other evidence that seems to be being neglected is the monitoring of these policies and when they're found to be off track, because there's uncertainty with all evidence and all policies. So you don't know until you've implemented about how well they're going to do. The important thing is to monitor and if you find that you are off track to then adjust the policy so that you can get back on track. And it seems that that adjustment is not happening, which is why these key ambitions are off track. Some to quite a large extent.