This week has been such a struggle, with really having to get a move on with Responsive after the 504 hand in, PPP presentations yesterday and the draft submission deadline for COP today. I am disappointed in myself that I was unable to properly finish the draft of my essay, although I tried my best to get down as much as I could in order to gain some constructive feedback as to where I can make improvements.
'What measures can we implicate as a nation to efficiently utilise the NHS’ resources and ensure its future is secure?'
Providing free health care at the point of delivery has granted the United Kingdom triumph and pride since 1948. Yet, today the National health service is being stretched to spending an extortionate £2 billion per week, and with crippling external factors such as an ageing population and cuts to government spending, the future for the NHS seems to be extremely uncertain. If we look at current statistics and where most of the NHS budget is currently being spent, a red light is flashing on conditions that reflect poor lifestyle choices such as type two diabetes, obesity and addiction rehabilitation. As conditions such as these are commonly judged as ‘avoidable’ and ‘self-inflicted’, a large percentage of health care professionals, and patients suffering with un-preventable conditions become frustrated with the principle that the money could have been better spent elsewhere.
In a society that is constantly being exploited by influences from the media, consumerism and rapidly developing technology, we are indirectly being negatively encouraged to indulge in damaging life-style choices that could have serious consequences on our health and wellbeing, such as consuming too much sugar and processed foods, drinking, smoking and not doing enough exercise, to name a few. This is causing major concerns for the younger generation, currently with one in three children being certified as obese before they start school, the NHS will not be able to cope with the level of demand for weight and lifestyle related conditions in the future.
Already, the nation is taking action to tackle the problem of developing preventable conditions, for example; Jamie Oliver’s latest campaign to put a 20% tax on sugary drinks, and the government’s ‘change for life’ programme, educating people of all ages on ways they can make positive lifestyle changes resulting in better health and wellbeing. If more emphasis and funding was put into educating the nation about the consequences that poor lifestyle choices can inflict, this well may encourage people of all ages to prioritise the importance of their health before making bad decisions, which will ultimately result in the NHS having to spend less money on patients with conditions that could be avoided.
Following the Global ‘Credit Crunch’ in 2007/8, spending cuts have been made to all areas of government funding, removing a large number of essential benefits and services from the nation. The NHS has faced its ‘biggest financial squeeze in history with the budget effectively being frozen since 2010, increasing by just enough to cover inflation’(Kings Fund, 2015) which has resulted in a massive increase in pressure to provide good quality care for all whom require it, as well as tighter decision-making processes when deciding whether patients conditions and circumstances are eligible for NHS funding. The Conservative government promised to annually increase the NHS’s budget in last years general election, giving the public hope that the service will continue to serve its purpose and meet individual needs. However due to other external factors, and the decisions made in the previous Coalition government, between 2010 and 2021 spending will have increased by £356 billion in cash terms, yet approximately £246 billion of the budget will be absorbed by inflation. This will result in a real increase of £116 billion, which only accounts to a 0.9% increase on an annual basis. In a recent BBC Panorama documentary, figures were shown that if the NHS is operating in the same way that it is today in five years time, it will be overspending by approximately £30 billion, which it simply cannot afford to do.
As precious time is running out, effective decisions need to be put in place to prevent the NHS from collapsing; but this is becoming exceedingly difficult with the pressures of providing care for an ageing population that are getting older and sicker. Growing old is not something that can be prevented as opposed to conditions such as type two diabetes, which already consumes a massive 10% of the NHS budget annually. It seems that long term illnesses are becoming somewhat of a huge strain to the NHS, taking into consideration the two conditions listed above as well as cancer, heart and respiratory problems, dementia and depression combined together cover almost 70% of the nations budget. Organisations across the UK have already began strategically planning to tackle this complex issue. In Liverpool, one of the most un-healthy cities in England, representatives from the entire spectrum of the health establishment are currently at the front line of the battle to save the NHS with a programme called ‘Healthy Liverpool’. It’s strategy has five areas devised to follow the input of health care professionals, simultaneously involving the community. These are: Living well, Digital Care and Innovation, Community Services, Urgent and Emergency Care and Hospital Services. Together, these five areas have been put in place to sustain and fulfil the capacity of the services provided and offer the most suitable form of care for each patient, for example having more community services available to work with patients regularly and close to their homes will prevent prolonged and un-necessary hospital stays, which will ultimately save a lot of money as well as keeping the patients comfortable and content. In summary, ‘Healthy Liverpool’ are using a strategic method of moving around the money already available to the areas which need it the most, to prevent it being spent for purposed that could be prevented.
Providing better social and community care alone is not enough to save the NHS, though it does show great potential to make a positive impact. Another example of how organisations are trying to tackle this crisis is the public health programme called ‘Change4Life’ launched by the department of health in 2009. The programme is the UK’s first social marketing campaign to try and tackle the causes of obesity, which is becoming a rising global epidemic. Change4Life is targeted at a large audience ranging from children to middle aged adults, also emphasising how to get involved with families. It helps people that are currently involved with making lifestyle choices that are damaging their health, to make gradual and manageable changes to their diet and level of physical activity, as well as focusing on other areas such as suitable levels of alcohol consumption in adults. Reflecting upon the slogan ‘eat well, move more, live longer’, Change4Life encourages six healthy behaviours, which include: eating 5 portions of fruit and vegetables a day, reducing the level of salt intake, cutting back on fat, swapping sugary snacks for healthier options, cutting down on alcohol consumptions and taking part in regular exercise. Statistics show that the affect of Change4Life on public attitudes was extremely positive. In its first year over 400,000 families joined the campaign and over 1 million families claimed to have made changes to their children’s behaviour as a result. In 2016, Change4Life has launched a new healthy eating campaign called ‘sugar smart’ with the aim of informing the public on how they can reduce their intake of sugar and become aware of ‘hidden’ sugars in certain foods. They have launched a new ‘sugar smart’ app which scans barcodes on food packaging and displays the sugar content in grams and cubes, which will help prevent the public, especially children slipping into poor eating habits that could result in a number of health issues in the future. If the sugar smart campaign is effective, the NHS would save a significant amount of money with reduced numbers of children being admitted to hospital with tooth decay; the current leading cause of admissions in children. In 2013, approximately 46,500 children and young adults under the age of 19 were admitted to hospital with tooth decay, resulting in the need for extractions costing the NHS a £30 million, which subsequently is a cause that could be prevented.
If campaigns such as Change4Life, and other community based projects that follow the same principles as Healthy Liverpool were the focus of the public’s lives, then positive changes would be rapidly occurring. However, if we take into account all of the other influential external factors that exist in todays society, then unfortunately these solutions will not solely be the answer to cure our unhealthy population, and ultimately save the NHS.
The food industries that operate in more economically developed countries have a great deal of power and generate a great deal of money, which together can have a heavy influence on consumers choices, leading to influencing lifestyle habits, all in the name of profit. One of their most powerful tools is advertising; the methods undertaken in order to persuade a customer to purchase a particular product.
Two authors in particular that have considered the negative implications of advertising Stegemen (1991) and Berger (1972) have both commented on the fact that both money and power of persuasion is the most pervasive way to generate customer sales. For instance Stegemen has stated in one of his issues of The American Review that “critics portray advertising as a socially pointless attempt to capture market share through psychological manipulation” which demonstrates the ability to acknowledge the language, imagery and placing that companies can use to persuade consumers that they need to buy their products. Berger has a similar judgement by expressing that “publicity is the culture of consumer society”, implying that the basic human need to provide for the self is driven by influences of higher powers, which also emphasises the point made by Stegemen that society is extremely vulnerable to manipulative methods of advertising.
Companies that sell fast food and sugary drinks, for example McDonalds and Coca-Cola are some of the worst culprits of practicing manipulative advertising. A method commonly used by these companies is brand association; a large percentage of their television commercials ironically feature people partaking in activities that release endorphins and make people happy, for example socialising with friends and exercising. The people featured in these commercials are shown consuming the products that the companies sell- sugary drinks and fast food, which creates an association with the customer that says ‘if you buy this product, you will be as happy as the people our in our commercial’, which from a critical perspective is a completely misleading and unrealistic concept. Creating a utopian desire of happiness through advertising is extremely damaging to vulnerable members of our society, particularly children. Fast food companies are particularly good at persuading children, and urging them to continually pester their parents to make repeat purchases of their products. For example including a free toy in the infamous McDonalds ‘Happy Meal’ contributes to the excitement of their dining experience, and it is common for the child to aim to collect all of the toys in a particular collection, therefore making regular visits to McDonalds, and regularly consuming food that contains alarming percentages of saturated fats and sugars; another factor that does not help the growing rate of childhood obesity. (QUOTE 5 HERE)Simultaneously stimulating the imaginations of children through the use of fictional mascots also is a major cause of interest, again creating an element of excitement leading to the desire to buy these unhealthy products. Characters such as ‘Ronald McDonald’, ‘Tony the Tiger’ and the ‘Nestle Bunny’ all subconsciously create brand associations with children; with the help of entertaining narrative elements within animated commercials, children are more likely to take an interest in eating these companies products which contain high levels of sugars and fats, than they are in eating alternative healthy products.(QUOTE 3 HERE)
The level of exposure to unhealthy foods is also somewhat alarming, with up to seven showings of sugary/fast food commercials being shown in between prime time weekend family shows, such as The X Factor and Britain’s Got Talent, which is more likely to increase the chances of families to order fast food takeaways due to the persuasion used in said adverts. Another technique used by supermarkets to encourage impulse purchasing is product placement, which can be targeted at children by placing sugary products such as drinks and chocolate bars directly at their eye level, and at the check-out queueing areas, triggering an urge to buy such products. However, supermarkets are not solely to blame for the rise in weight gain and childhood obesity; the universal ‘traffic light’ system implemented in 2013 was designed to make customers think twice about the healthy and unhealthy ingredients they are consuming. The traffic light consists of a colour coded pie chart informing the customer of the level of total sugars, calories, fats, saturated fats and salt that is contained in individual products, ranging from green to red representing healthy and unhealthy. Detailed food labelling has had a positive impact on the decisions that customers are making in relation to purchasing healthy food products, and has began to make the nation aware of the importance of maintaining a healthy diet. If paying attention to food labelling was taken seriously by the whole population, then the levels of diet related illnesses would significantly decrease, releasing the NHS of the pressures to cope with treating the high level of patients with these preventable conditions.
Looking from a wider perspective, we cannot point our fingers at the food industry alone when searching for a blame for the nations poor lifestyle choices resulting in poor quality of health. Between 1980 and 2014, obesity has more than doubled on a global basis which has been caused by a combination of different factors. However, obesity is not the only condition that has arisen from negative external factors, there are many other problems in society that have an equal contribution to the detriment of our health and wellbeing.
The development of technology has decreased the need for many jobs that require a high level of labour, as well as improving transport links, urban planning and increase of sedentary working environments, resulting in less of a mandatory demand to be fit and active in terms of employment. As the world around is developing so rapidly, the environments that we are situated in have become increasingly fast paced and competitive, with additional pressure to succeed and achieve a sense of satisfaction. With a vast catalogue of complex global issues desperately trying to be resolved by those in power, it is difficult for any one of us to endure extended periods of peace of mind without being directly, or indirectly affected in one way or another. Stress is the bodies natural reaction to situations that cause feelings of unease and uncertainty; taking into consideration all of the factors listed above, our nation has become exceedingly vulnerable in the means of tolerating these external pressures.
A common characteristic of tackling stress is to make poor lifestyle choices which could be seen as a distraction, escape, or ‘coping mechanism’ to help gain a sense of relief from these pressures and insecurities. The vast majority of these coping mechanisms can be extremely harmful to both our physical and mental health, which could include smoking, taking drugs, alcoholism, eating too much/ too little etc. Mental health issues such as anxiety, depression, OCD and phobias affect people of all ages, but more commonly those who are experiencing a considerable amount of stress, for example young people struggling at school and university and people in their twenties struggling to find their feet adapting to the pressures responsibilities of adult life. Deterioration of mental health can have severe consequences that can be heavily influenced by external factors, for example during the recession between 2008 and 2013, the rate of suicide increased by 8% among women, and 9% among men with the correlation of unemployment, debt and repossession. Mental health is commonly misunderstood amongst society, as it is not as black and white as other long term conditions that have more of a physical impact such as cancer, diabetes and heart disease. (QUOTES 6 and 7 HERE) Yet, in hindsight it is easy to look back and wonder if such psychological triggers and stressful circumstances could have been avoided to prevent the increase in mental health issues, in a similar way that we view how the nation has been suffocated with the exposure of unhealthy foods with the powerful exploitation that the art of persuasion possesses.
To conclude, each and every one of us will fall ill at some point in our lives, whether this is a result of self inflicted action, external influence or natural occurrence, and we will rely on the National Health Service to aid our recovery and nurse us back to health. Our nation is extremely gifted to have access to this fantastic service, but in todays society with an ageing population and a large number of long term health conditions spiralling out of control, the NHS is struggling to cope with the demand of patients needing care and the lack of funds to provide it, resulting in a rising level of uncertainty this service to continue in the future. It is almost impossible to devise a solution that will solve all of the problems contributing to the decline of the NHS, but it is not so difficult to highlight areas that require drastic improvement to reduce the risk of serious health conditions caused by poor lifestyle choices. Persuasion in the means of comfort is more powerful than persuasion in the means of positive change, and due to gradual changes in social and working environments since the rise and development of technology, we have become surrounded with easier and less laborious methods of completing every day tasks. Therefore we are less inclined to take ‘the long way around’ requiring more physical means of activity, than we are with the ease of completing things at the touch of a button. The combination of our generation adapting to a sedentary approach to life, food companies using exploiting methods of advertising, lack of knowledge about maintaining a balanced diet, external pressures to succeed and coping mechanisms that follow are all contributing to destroying the NHS, and to some extent, can all be prevented. Current undergoing campaigns using social marketing methods and alterations of areas where care is provided are proved to be helping this crisis, but it is uncertain whether or not alone they are powerful enough to completely put a stop to avoidable conditions such as the worryingly sharp increase of obesity and illnesses related to it. (QUOTE 4 HERE)There is no set answer that will provide a successful solution to this vast complexity of life threatening problems, but if the forces in power such as the government and public health committees implement stricter regulations that overcome the power of persuasion by comfort that so many vulnerable people are succumbed to, in the form of improved health education, and other solutions to make people aware of the damage that their behaviour is causing to their health, the power of positive change may succeed, resulting in the NHS increasing in strength and being able to survive in the foreseeable future.
Bibliography
- 'Critics portray advertising as a socially pointless attempt to capture market share through psychological manipulation' Stegeman,M. (1991)Advertising in competitive markets, the American Economic Review’ Vol.81, No.1 p210-223
- ‘Publicity is the culture of the consumer society. It propagates through images that society’s belief in itself’ Berger, J.(1972)Ways of Seeing’.Harmondsworth: Penguin. p139
- ‘As with any industry, money and influence will be used in a manner that will support the continued viability of the industry. When the interests of industry and public health clash and are opposed, however, the insidious nature of industry practices becomes apparent’ Kushi, Lawrence, H. (2003) Review of Food Politics: How the Food Industry Influences Nutrition and Health. Journal of Public Health Policy, Volume 24, No.1, Palgrave Macmillan Journals p63–66.
- ‘To combat food oppression effectively, activists must lobby the government to create meaningful, sustainable change through education, regulation, taxation and redistribution’. Freeman, A.(2007)Fast Food: Oppression Through Poor Nutrition.California Law Review Vol.95, No.6 p2221–59.
- ‘More generally, fast food restaurants would not choose to advertise if advertising did not increase the demand for their products. Unless fast-food demand perfectly crowds out demand for other foods that are equal in calories, body weight will increase since consumers will never choose to perfectly offset the increased food demand with more exercise’. Chou, S,Rashad,I,and Grossman,M.(2008)Fast‐food Restaurant Advertising on Television and Its Influence on Childhood Obesity. The Journal of Law & Economics 51. [University of Chicago Press, Booth School of Business, University of Chicago, University of Chicago Law School] p599–618.
- ‘Some see mental illness as routed primarily in environmental factors such as family upbringing and social stressors’ Schnittker,J, Freese, J and Powell,B. (2000)Social Forces Vol.78, No.3, p1101-1132
- ‘Mental illness has the dubious distinction of serving as a mirror for the complexities and demands of the surrounding society’ Harold W. Demone, Jr. (1968)The Annals of the American Academy of Political and Social Science, Vol. 378, p22-33
Fig.1: Holcroft,J. (2014), Unknown title, [editorial illustration], available from <http://digitalsynopsis.com/design/32-retro-style-thought-provoking-illustrations-john-holcroft/>
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Fig.3: Sales,E. (2014), Witty Illustrations [illustration], available from <http://www.lostateminor.com/2014/02/06/witty-illustrations-eduardo-sales/>
Fig.4: Seth,M. (2014),Childhood Obesity [infographic], available from <https://www.behance.net/gallery/CHILDHOOD-OBESITY-Infographic/14701727>
Fig.5: DRL.(2010), Diabetes [advertisement], available from <http://creativecriminals.com/drl/diabetes>
