Effective poverty and obesity campaigns need more than just stats

It’s time for anti-poverty and anti-obesity campaigners to tell a new story, says Abigail Scott Paul.

Jamie Oliver’s recent comment that people in poverty ‘think in a different gear’ is another in a regular diet of stories putting the spotlight on the links between obesity and the choices made by people in poverty. These stories suggest we are amid a swelling epidemic of over-eating and under-exercising, largely caused by the behaviours of people in poverty, especially those who are parents.

So what is the real story behind the headlines?

Traditionally anti-poverty and anti-obesity campaigners have relied upon research and statistics to counter the personal responsibility narrative that dominates the discussion and persuade policy-makers and the public to take action. In the second part of this blog, my colleague Chris Goulden has examined the evidence to tell that story.

But there is a more important story, one that doesn’t focus on statistics and rates. Currently, the public narrative on both poverty and obesity ignores the impact of people’s environment and circumstances on their decisions.

The combination of low pay, insecure work, high living costs and insufficient social security is locking families on low incomes in a daily struggle to make ends meet. Living in poverty affects the way that people behave. It creates a stressful environment where less immediate priorities, such as losing weight, feel unobtainable when it’s more important to focus on surviving day to day. The unstable environment of poverty is one where contemplating healthier aspirations against a predictable backdrop is something of a privilege for the better-off.

That’s why people who are in poverty ‘think in a different gear’, to use Jamie Oliver’s phrase. But it’s not anything inherent or cultural – instead it’s created primarily by the conditions of poverty itself.

Last week, in Britain’s Fat Fight, Julie confronted Hugh Fearnley-Whittingstall as he campaigned to the people of Newcastle to lose weight. She berated him for talking to the ‘middle-class’ people and challenged him to speak to residents in the poorer parts of the city; the ones who could only afford fish fingers to eat. Hugh agreed to a tour of Walker and Byker and was visibly astonished at what he saw: poor housing, run-down estates and discount shops. It acted as a wake-up call: Hugh saw for himself the restrictions poverty places on people in terms of accessing healthy food.

Our weight is largely determined by our environmental circumstances and how we respond to a backdrop of cheap food, persistent advertising, living in areas of fast food retailers, and where high-sugar, processed food is plentiful.

And this is where it becomes notoriously difficult for anti-obesity and anti-poverty campaigners to make a convincing argument for policy change, when public thinking on both poverty and obesity are dominated by the frame of ‘personal responsibility’, which says we can solve both poverty and obesity if people make better choices in life.

What story are the stats telling about the link between poverty and obesity? (courtesy of Chris Goulden)

There is a link between poverty and obesity levels – but poverty isn’t the only factor causing obesity. Obesity rates are highest in areas of Northern England like Doncaster, Darlington, Barnsley and North Tyneside. But some low-poverty areas also have high obesity, such as Swindon. And there are lower obesity rates in areas of high deprivation, such as London boroughs of Camden and Southwark. When you look at each sex separately, the link with poverty persists for women but not for men.

If poverty were solely driving obesity, then these differences wouldn’t exist. So, there is not a clear-cut connection.

For children aged 10-11, there is a different pattern by area than for adults. For example, Southwark is among the top ten for highest levels of being overweight or obese. This could be due to the slightly weird way in which childhood obesity is measured. Notwithstanding these criticisms, over time we can still measure whether things are getting better or worse and how different areas compare. From this, it’s clear the link with deprivation is strong and there’s been a growth in the gap between those living in poorer versus richer areas in the last decade.

There’s a slightly different picture again for younger children. There are significant downward trends for being overweight among boys of reception age and no worsening for girls. Although there is again a widening of the ‘obesity gap’ between poorer and richer areas – in other words, it’s declining slower in the most deprived areas.

Obesity is rising slowly

Looking back over the last ten years or so, the total proportion of adults who are obese or overweight (as judged by a Body Mass Index of over 30 and 25 respectively) has hardly changed at all. But it’s true that it’s higher now than in the early 1990s and the rates have persisted at an excessive level – nearly a third of adults are obese and just over a third are overweight. Obesity itself is rising slowly. Given the links between weight and other health conditions, these levels are clearly concerning. But the idea that things are getting rapidly worse right now is not well supported.

Given all these different and sometimes contradictory figures, simply saying that obesity is getting worse and is driven by poverty is clearly not a sufficient explanation. That’s why we need to tell a different story.

Loosening the constraints of poverty would be the best thing we could do to help people to focus on building a better, and healthier, future. This is the story anti-poverty and anti-obesity campaigners like Jamie Oliver and Hugh Fearnley-Whitingstall need to be telling.

Britain’s Fat Fight continues this Wednesday at 9pm on BBC One.