Better Health For All

• by Dr Tom Scanlon
• Director of Public Health
• Brighton & Hove City Council

They say anticipation is the better part of pleasure and I have to confess that as a kid I quite enjoyed Lent. Like a good Catholic boy, I would defer some gratification for 40 days and 40 nights; for a few years it was sweets. This worked well because I was paid in sweets for delivering a neighbour’s milk after school, gifted sweets from mum’s old school friend who came to tea every Friday, and continued to make small pocket money purchases throughout my ‘fast’.

So as Easter Sunday approached my hidden stash accumulated and my excitement escalated. Not in the spirit of things perhaps, and indeed maybe there is a God as my annual sweet fast/fest came to a tragic end when my big brother – a bit of a Hyde and Hyde character back then, stumbled across my hoard and with his mates devoured the lot – on Good Friday too. Like a bad Catholic boy, I never quite forgave him.

Of course, if Joe had been at the launch of our Sugarsmartcity initiative in early October, he would have said he did me a favour (he tried that same line all those years ago).  Althoughhough when I think back; a whole Lenten’s worth of sherbet dib dabs and cola cubes in 1969 compares very lightly with the quantities of sweets and sugary drinks we experience today, often proffered in cut price supersize at a checkout – when all you came in for was a newspaper.

We now know that sugar consumption is indelibly linked with dental caries, obesity, and in drink form to Type 2 diabetes. National guidelines have been dramatically revised down by 50%, so that just one can of coke (9 teaspoons of sugar) contains more than the recommended total daily free sugar intake for an adult (7 teaspoons).  In Brighton & Hove each year, around 25% of children leave primary school obese or overweight, and just under 300 have teeth removed in hospital, while an estimated 9.2% of our adults is diabetic; so it felt like the right time to launch a city-wide Sugarsmartcity campaign.

Just as anecdote is a powerful evidence-based tool, so serendipity is an excellent means of planning.  A public health colleague knew a chef who knew Jamie Oliver’s Campaign Director, and as ‘make connections’ is a local public health mantra, she did.  Jamie Oliver had just released Sugar Rush and as campaign directors love to campaign – Jo Ralling was more than happy to join us and has proven herself quite a driving force.  We had recently appointed a new consultant for health improvement, a fast food/restaurant public health lead, and we have a very successful public health schools programme with 95% engagement. Our Healthy Weight Partnership Board has been running for five years, so the practical and governance infrastructure was already in place, coupled with a fresh ‘appetite’ to tackle sugar.

I knew there might be some concern from local elected members about being linked to a tax (just as it appears there is nationally) so I agreed that we would run it as a public health professional campaign linked to FPH objectives, but in partnership with Jamie Oliver team. That said; our Health and Wellbeing lead publicly endorsed the work at the Health and Wellbeing Board.

After the media launch, we kicked off with a children’s public debate – at Jamie’s Italian Restaurant, chaired by the youth mayor with a panel from industry, the voluntary sector, health and education. Another debate for young people will follow shortly. We have produced and already adopted new snack and lunch policies in several schools and Jamie Oliver’s team have helped to source them free cooking and growing equipment. I co-signed a letter with Jamie Oliver, sent to over 500 local restaurants by e-mail proposing a voluntary children’s charity levy of 10p on sugar-sweetened drinks.  Independent restaurants are signing up – we’ll take stock at the end of the month.

The blitzkrieg of media – they love talk of taxes, and bans – has helped us to target the local hospital, leisure centres and school meals service. The university hospital trust is now formally reviewing their vending machine policy. The school meals provider has already revised its pudding (sugar) policy and we are optimistic that we will hear more from local supermarkets on sugar free checkouts, and leisure centres on vending.

The national debate, accusations of big business pulling government strings and manipulation of Public Health England evidence has all helped. Serendipity is one thing; but having excellent public health and communications colleagues, and a professional campaign team like Jamie Oliver’s, doesn’t half help.

I thought at the start that even if we just get our population more sugarsmart – so that people understand better what they are eating, and how it affects them and their children, that would be something.  However, we have already achieved a lot more and I know there is more to come.  It’s working well – ‘sweet’ as young people say…