Boris Johnson, obesity, and personal choice

If Boris Johnson wants a healthier population, his government needs to reduce poverty and inequality, something which is completely within its power to do, but which it shows no credible intention of doing. In this context, the Prime Minister’s new obesity strategy looks at best superficial, at worst cynical. Being wealthy enough to describe £250,000 as ‘chicken feed’,  it is hardly surprising that Johnson has no understanding of what life is like for people on a low income, but he shows no signs of curiosity or any desire to understand – surely a requirement for anyone claiming or aspiring to be a One Nation Conservative?

The link between poverty, disadvantage, and ill health is well documented, for those who care to find out, and seen most clearly in the stark difference in life expectancy between rich and poor. But perhaps more relevant to the subject at hand is the difference in Healthy Life Expectancy. In March this year the ONS reported that, “Males living in the most deprived areas of England can expect to live 18.9 years less in 'Good' health compared with those in the least deprived; with the gap at 19.4 years for females.” 

This is the manifestation of a deep-rooted, multi-faceted systemic problem of social injustice – not a problem which will be solved with an advertising campaign or any an approach which is based on the assumption that it is a matter of personal responsibility, a lifestyle choice. For people living in deprived areas on low incomes, choice is a luxury they frequently do not have.

In 2016, Public Health England published The Eatwell Guide,  official government guidance on a diet that meets all our nutritional needs. Obviously, for a household to be able to eat this way, they must be able to afford the foods recommended, and have the resources and facilities to cook them.

In 2018, the Food Foundation researched the affordability of this recommended diet, and concluded that for households in the bottom 10 per cent of the income scale, almost three-quarters of their disposable income would need to be spent on food in order to eat in the recommended way. In contrast, those at the top of the income scale would need to spend only six per cent of their income to eat healthily.

And of course, to buy that good nutritious food, one has to get to a shop that sells it. Some deprived areas have been called ‘food deserts’, because fresh food isn’t available without access to a car or bus – and those bus fares reduce the amount of money available to spend on food when you get there. And if you’re choosing between paying the rent and putting money on the gas or electricity meter, it’s logical to choose food that doesn’t take much cooking.

For all of us, what we eat is not so much a free choice as a product of family background, culture and experience, frequently constrained by income levels. There are sections of a supermarket which some people will simply bypass, because the food there is too expensive for them. Most of us now know that cheap, satisfying carbohydrates are not recommended, but if you want to avoid hunger on a very low income, they may seem your only option.

And of course, in addition to the people who can’t afford to eat healthily, there are so many people who can barely afford to eat at all, and are reliant on food aid because their income is so drastically low. In 2019, the Trussell Trust found that the average weekly income of a foodbank user, after paying rent, was £50. What people in this position need to improve their mental and physical health is money, not a lecture about diet and exercise.

Obesity, because it is visible, is easy to target, and easy to frame as matter of lifestyle choice and personal responsibility. But other factors which contribute to those shocking health inequalities, like poor housing or working conditions, and the sheer unremitting stress of living in poverty, cannot easily be framed as a matter of choice or personal responsibility, and so are highly unlikely to be the subject of a campaign by Boris Johnson. Through its policies, his government is actually making matters worse in many of these areas, from the erosion of social security, to the failure to provide decent housing. Indeed just in the last few days his government introduced new laws to further relax planning rules, just as independent researchers found that the government’s previous relaxation had led to poorer quality homes. There was talk of a new era of slum housing.

Health information and advice is rarely wasted – but it is no substitute for the social and economic justice needed to make a healthy life a possibility for everybody.

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© Bernadette Meaden has written about political, religious and social issues for some years, and is strongly influenced by Christian Socialism, liberation theology and the Catholic Worker movement. She is an Ekklesia associate and regular contributor. You can follow her on Twitter: @BernaMeaden