More public health interventions required to tackle grim reaper of 'lifestyle' diseases

Theories of practice and public health: understanding (un)healthy practices is published in the journal, Critical Public Health, and written by Dr Stanley Blue, lecturer at the School of Social Sciences, Prof Elizabeth Shove, of Lancaster University, Prof Mike Kelly, Director of the Centre of Public Health at NICE, and Chris Carmona, public health analyst at NICE.

The authors say new ideas are needed to tackle non-communicable -- or 'lifestyle' diseases -- such as heart disease, cancer, asthma and diabetes. They explain how some social practices reinforce each other, such as getting a takeaway and watching TV on a Friday night, whereas others, such as drinking a bottle of wine at home or going to the gym, compete for time in our busy days.

They cite the smoking ban as an example of a measure that effectively decoupled the relationship between going out for a meal or a drink and having a cigarette. A similar approach, with social practice at the heart of public health policy, could be taken to eating and exercise, rather than traditional methods which rely on persuading people to make the 'right' decision by going to the gym or eating their five a day -- and which treat such decisions as matters of personal choice.

Dr Stanley Blue said: "Smoking, exercise and eating are fundamentally social practices, therefore we need to re-shape what is deemed socially acceptable and normal in order to change them.

"Current public health policy is dominated by the presumption that individuals are capable of making 'better' choices for themselves on the basis of information given to them by the government or other agencies. This does not account for the fact that practices like those of smoking and eating have histories of their own.

"Trying to get individuals to stop smoking or eat healthily overlooks the fact that these are fundamentally social practices. Public health policy will have to find the courage to break away from its traditional mould if it is to stand a chance of confronting the grim reaper of lifestyle diseases."