Like my googlereader and my drafts folder, my podcast app has a frighteningly large backlog. This evening while on random play it stumbled on an episode of Little Atoms from 2008, with Ben Goldacre, in which he talks about the media’s obsession with simple, glamorous and individualistic quick fixes to complex social problems:
The idea that food, and particularly very specific individual types of food or specific molecules in food, are the most important lifestyle risk factors for ill-health is itself a very political and I think bogus project. The reason that people in Hampstead live ten years longer than people in Kilburn isn’t because they’re careful to eat a handful of brazilnuts every day to make sure sure they’re not deficient in selenium, it’s because of a whole complex nexus of complex interlocking social and political issues involving, you know, work exposure, social support, stability and all of that stuff.
To profess to people that these commodifiable lifestyle interventions — because it’s always those, it’s never, you know, walking schoolbuses or cycle paths, it’s always, you know, cherry juice, something that a press agency can put a release out about — to pretend that diet is the biggest lifestyle risk factor for ill-health is to my mind a very right-wing individualist manifesto. It’s the deserving sick in the way that people used to talk about the deserving poor. You’ll be chatting to somebody and they’ll say, “well, I have to walk past this council estate every day on the way to the tube and you can say what you like but I think it’s got to be diet because you see some of these people and they’re feeding their kids crisps for breakfast and they’re only three and it’s got to be diet hasn’t it?” Well, yeah, diet might be part of it, but I think you’ll find it’s a bit more complicated than that.
All the evidence shows that public health interventions that have an effect on the health of a whole population are things that you do or change at the level of the whole population. You know, change what’s available in the supermarket. People eat what’s available to them easily and people behave in ways that are easy for them to behave. So, say, if you make London a really hostile environment to cycle in then people won’t cycle in it. If you design stupid cycle paths, some of which — I could show you photographs — are shorter than the length of a bicycle; if you put bicycle paths right next to a set of parked cars, so that if you cycled in it then every time somebody opened a door you would just die, but if you cycle outside it then all the cars get really indignant and beep their horns because they think that you should be in the little green cycle path then, if you do all of that then people will cycle less and people will be less healthy in your capital. Whereas if you make excercise something that can be integrated naturally into people’s everyday lives then people will become healthier.
But fascinatingly all over the country there will be people who are working as public health professionals who will be sending out press releases saying, oh, we’re trying to get a walking schoolbus scheme together locally so that people don’t have to drive their children into obesity by driving them to school, and they’ll maybe use a little pun like that and feel really pleased with themselves, but they’ll be ignored and local papers won’t cover it and national papers won’t cover it, because newspapers want the goji berries, they want the glamorous easy quick fix.
It seemed an appropriate thing to share ahead of tonight’s Street Talk at the Yorkshire Grey, where Harry Rutter will be talking about the relationship between urban design and public health.
Sadly we have a society — or a media, at least — that does not merely ignore these projects in favour of glamorous miracle cures: we actively cry “state intervention” at anything that might make the world a better or nicer place.