Behaviour Change – the new Public Health agenda

In his first speech on Public Health, Health Secretary Andrew Lansley yesterday set out his vision for a new Public Health Service.

Some of the key points he announced included:

  • A new ring-fenced public health budget
  • A new ‘Health Premium’ to target public health resources towards the areas with the poorest health
  • Clear outcomes and measures to judge progress alongside NHS and social care outcomes
  • An enhanced role for Public Health Directors so they have the resources and authority to improve the health of their communities
  • Clearly setting out what was needed to be done, but not telling local professionals how to do it, in order to encourage local innovation

Lansley was critical of past public health awareness campaigns saying:

‘It seems to me that awareness campaigns have too often sent the wrong messages – when they’re screaming at you to drink less, many people are just having their behaviour reinforced – the message doesn’t come out as ‘drink less’ but as ‘everyone drinks, so don’t worry about it’. It tells people that the norm in society is misuse of alcohol.’

Nevertheless he was supportive of the Change4Life campaign but wanted to see it as a much more locally led and much more a local social movement, perhaps contributing to the Big Society:

‘….we need a new approach. We have to make Change4life less a government campaign, more a social movement. Less paid for by government, more backed by business. Less about costly advertising, more about supporting family and individual responses.’

However a significant aspect of the speech that was less reported than the above points was the commitment to a range of behaviour change strategies. This included:

  • Focusing on self-esteem for target groups. Lansley said,  ‘Just as leadership drives organisational success, so self-esteem drives personal fulfilment. That is why, contrary to the media reporting, I applauded Jamie Oliver’s initiative on school dinners and when he went to Rotherham – because Jamie ‘got it’…..The fact is, you can’t legislate for self-esteem from Westminster. We can’t pass the Elimination of Obesity Act 2010. Turning Jamie’s campaign into a list of how often you can offer chips – whilst not rationing roast potatoes cooked in oil – doesn’t do the job.’ Identifying target groups for self-esteem development is something TCC has been working on for a number of years with our unique Values Based Segmentation which can assist with not just the identification, but also help explain why people behave as they do.
  • Identifying and reinforcing positive social norms. Lansley says, ‘Studies has shown that social norms are much more important than policymakers have traditionally assumed.  People are deeply influenced by the behaviour of those around them – and public policy should reflect that.‘ The recognition of this is very important. TCC very much welcomes this having pioneered interventions in this area whether it included peer to peer engagement on sexual health in Barnsley, through to the insight work it provided that assisted Barking and Dagenham Council with its Eyesore Gardens campaign that led to the creation of a new social norm.
  • Commissioning from the best new insights from social psychology and behavioural economics. Lansley made reference to the work of Nicholas Christakis who wrote the book ‘Connected’ about the impact of social networks on behaviour.

These sound like exciting times in public health, despite the financial pressures. Indeed it is in the interests of all public bodies to assist the NHS in reducing some of the future demand pressures on health with evidenced based, value for money, behaviour change campaigns.

Professor Jeff French, a non-executive Director of The Campaign Company, will be posting further guest blog posts here in coming weeks exploring some of the behaviour change issues that public bodies will need to address in order to deliver this new agenda effectively.

Charlie Mansell is Research and Development Officer for the Campaign Company

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