Digesting diet and health: the challenges of eating well

Diet-related health problems are rarely out of the news. That’s because so many illnesses and diseases are the result of poor diet. There’s no shortage of suggestions for improving our diet, and for educating all of us on the benefits of eating well.

Policymakers are also concerned about this issue. Since the start of the COVID-19 pandemic, the NHS has been under greater pressure than ever, and government has been keen to address diet-related health problems.  

Examples of this include the most recent legislation to add calorie labelling to  restaurants and takeaways, which has been controversial. The new rules for England make it a legal requirement for large businesses with more than 250 employees, including cafes, restaurants and takeaways, to display calorie information of non-prepacked food and soft drinks.  The Scottish Government is consulting on similar proposals.

Sugar and salt taxes

Another example of regulations directed towards diet-related health problems would be taxes on sugar and salt in foods. There have been suggestions to either tax all foods based on their salt content, or specific foods which are classed as “high” in salt.

A sugar tax – the Soft Drinks Industry Levy – was introduced in April 2018 by the UK Government. It was later reported that consumers had bought 10% less sugar through soft drinks, which will also have lowered risks of obesity, type 2 diabetes and high blood pressure.

A report from the Institute of Fiscal Studies in 2021, looked at the impacts a tax on added sugar and salt could have on purchases of food both at home and out of the home in the UK. The report found that a salt tax could potentially see a decrease in risks of coronary heart disease and strokes.

In addition, the study suggested a salt tax could reduce the number of NHS treatments for obesity-related conditions, resulting in  lower NHS costs. The report also indicated an increase in overall economic output due to a healthier workforce.

However, there may also be less welcome consequences. A ‘snack tax’ has been estimated to potentially add as much as £3.4billion a year to families’ shopping bills. Introducing such a tax during the current cost of living crisis would add greatly to the financial stresses being experienced by households across the country.

Counting the calories

Displaying the number of calories in meals on menus has long been proposed as a way to tackle obesity and health issues, as so many people are unaware of just what is in the food they order. Public opinion is extremely divided on this subject, with some being in favour of this extra measure to help them when eating out if they wish to make healthier choices.

However, adding calorie information to menus may have undesirable effects. 1.25 million people in the United Kingdom have an eating disorder, and the COVID-19 pandemic is likely to have increased this number as more people struggle with mental illness and increased stress.

Beat, a UK-based eating disorder charity, has highlighted  that calorie labelling exacerbates eating disorders of all kinds. In addition, pushing a “diet culture” could send the wrong messages about eating rather than embracing a more positive approach towards food.

A further  study by the British Medical Journal reported only a small decrease in calories purchased when trialling calorie labelling in three chain restaurants in the United States. The researchers also found that after one year, that reduction diminished.

Meeting in the middle?

Another suggestion that has been discussed is tackling health-related inequalities, and understanding why certain groups are more vulnerable to these issues than others. For example, the House of Commons library has reported that in England people living in the most deprived areas were 9% more likely to be overweight or obese than those in the least deprived areas. The briefing also reported that  children in the most deprived areas of England were twice as likely to be obese.. More education focusing on not only what is healthy food, but how to be healthy with fewer resources could help reduce such inequalities.

Final thoughts

From tooth decay and high blood pressure to cancer, eating disorders and mental ill health, there are significant health and wellbeing impacts resulting from unhealthy eating habits. These issues also have serious consequences for healthcare services.

As we’ve seen, legislation has already been introduced to tackle diet-related health problems. But it’s likely that government will have to consider further measures to ensure that the food that we eat is both good for individuals and for wider society.

Further reading: more on food and nutrition from The Knowledge Exchange blog

‘The great training robbery’ – one year on, is the apprenticeship levy having the desired effect?

It’s now been a full year in operation, but will the apprenticeship levy “incentivise more employers to provide quality apprenticeships” and “transform the lives of young people who secure them”, as the government hopes?

A new report from Reform, which has reviewed the available evidence, suggests that “significant reforms are needed”.

Purpose of the levy

Unveiled in 2015 as part of the government’s commitment to deliver three million apprenticeship starts by 2020, the apprenticeship levy aims to encourage employers to invest in apprenticeship programmes and raise additional funds to improve the quality and quantity of apprenticeships.

The levy mandates that employers in England with annual wage bills of over £3 million pay a tax of 0.5%, which can then be spent on apprenticeship training. Employers pay their levy contributions via the PAYE system into a digital account held by HM Revenue and Customs (HMRC). Smaller employers can also access the funds generated through the levy, but they must pay a ‘co-investment’ of 10% towards the cost of the training.

According to the 2015 Spending review and Autumn statement, the levy was expected to raise £3 billion per annum by 2019/20. However, the evidence reviewed by Reform suggests the levy is instead leading to unintended consequences.

Lower quality apprenticeships and bureaucratic burden?

The number of apprenticeship starts following the introduction of the levy has continued to fall. Reform highlights that the number of people starting an apprenticeship in the six months after it was introduced was over 40% lower than the same period the previous year. The most recent figures are little improved – in December 2017 there were 16,700 apprenticeship starts compared to 21,600 in December 2016.

Reform also found that younger and less experienced people have been particularly badly affected with the focus now being towards Higher and Degree level apprenticeships. And many apprenticeships are now for low-skilled, low-wage jobs or for re-labelled management programmes and do not meet the original definition of an apprenticeship, thus diminishing the quality.

The OCED recently highlighted the importance of maintaining skilled roles in apprenticeships, noting that:

“In the long run, even just a small proportion of low-quality apprenticeships can damage the overall reputation and “brand” of apprenticeships.”

Skills, Knowledge, Abilities

The use of the levy to re-badge existing training courses as a way to shift the costs onto government is a particular concern. A CIPD survey of more than 1000 organisations in January 2018 found that:

  • 46% of levy-paying employers think the it will encourage their organisation to rebadge current training in order to claim back their allowance
  • 40% of levy-paying employers said it will make little or no difference to the amount of training they offer
  • 35% of employers will be more likely to offer apprenticeships to existing employees instead of new recruits

Commenting on the findings, skills adviser at the CIPD, Lizzie Crowley, said “this is not adding any additional value and is creating a lot of additional bureaucracy and cost.

Reform argues that the impact on the public finances of allowing employers to re-label courses in this way should not be underestimated. It is estimated that inappropriately labelled ‘apprenticeships’ represent 37% of the people training towards any apprenticeship standard – a figure that could become even higher if employers are allowed to continue to rebadge training as they see fit.

If current trends continue, the government could be spending almost £600 million per annum by 2019-20 on training courses that have been incorrectly labelled ‘apprenticeships’.

stacked pounds shutterstock_66808108

Concerns have also consistently been raised over the complexity of the levy for employers. It has been claimed that the slump in apprenticeship starts could be blamed on “a combination of confusion surrounding the Apprenticeship Levy and the ‘increased administrative burden’ it placed on employers”. The Reform report highlights that the substantial increase in bureaucracy, among other issues, has led business groups to brand the levy ‘disastrous’, ‘confusing’ and ‘broken’.

Despite this, however, there is still support for the levy. A recent survey by the Chartered Management Institute (CMI) of over 1,500 managers found that two-thirds (63%) agree that it is needed to increase employer investment in skills. It has been suggested that employers have ‘fundamentally failed’ to prepare for the levy as the scale of the challenge was not recognised. And a lack of clarity from the government has also been attributed some blame.

Way forward

The evidence would suggest there is potential for the levy but not in its current form.

The Reform report recommends six significant changes if the objectives for funding apprenticeships are to be realised:

  • there should be a renewed focus on quality over quantity
  • a new internationally-benchmarked definition of an ‘apprenticeship’ should be introduced
  • the 10% employer co-investment requirement should be removed
  • a simpler ‘apprenticeship voucher’ model should replace the existing HMRC digital payment system
  • all apprenticeship standards and end-point assessments should be assigned a fixed cost
  • Ofqual should be made the only option for quality assuring the end-point assessments to maintain standards

If the necessary changes are made, the Reform report concludes that “apprentices, taxpayers and employers across the country stand to benefit for many years to come.”


If you enjoyed reading this, you may be interested in our other posts on diversity in apprenticeships and higher apprenticeships.

Follow us on Twitter to see what developments in policy and practice are interesting our research team. 

Should the UK introduce a tax on sugar?

An assortment of liquorice allsorts sweets.

by Stacey Dingwall

Recent months have seen two enquiries to our Ask a Researcher service for evidence on sugar consumption in the UK. Namely: should this be taxed?

Sugar has become somewhat of a villain in the UK, with magazine articles, research and governments all telling us that we should be greatly reducing, or even eradicating completely, our consumption of added sugars in particular. The week beginning 30th of November even saw the first National Sugar Awareness Week, part of a campaign to encourage the government to establish a sugar reduction programme in the UK. However, is a ‘sugar tax’ really necessary?

Sugar consumption: a public health issue?

According to the Royal Society for Public Health (RSPH), absolutely. Last month, they published a review of how to tackle obesity in the UK, which included the introduction of a sugar tax. The report notes that, according to the latest forecasts, half of all adults in the UK are expected to be classed as obese by 2050. Key to reversing this trend, it is argued, is to tackle issues around diet and nutrition among children, who are now spending double the amount of time per day in front of screens than children in 1995 (something that has been shown to increase cravings for food and drink, but not for nutritionally sound items). Alongside other developed nations, the UK is also seeing an ever increasing rate of consumption of high-sugar carbonated drinks.

While the RSPH recommends placing restrictions, or ending, the use of advertising and sponsorship by junk food and drinks companies around family and sporting events, it also argues that this is not enough to tackle the country’s obesity problem. The RSPH supports the introduction of a tax on sugary drinks of 20%, or 20p per litre. Their report highlights evidence which suggests that this could prevent or delay around 200,000 cases of obesity per year, and points to the experience of Mexico, who introduced a tax of 10% at the start of 2014. During that year, sales of sugary drinks declined by 6% overall, and by 9% among those living in the most deprived areas of the country (the demographic group most likely to be obese).

What does the government think?

After a delay, the UK government published Public Health England’s (PHE) review of the evidence for action with regards to sugar reduction in October. The report:

  • agrees that too much sugar is consumed in the UK
  • favours a reduction in advertising to children
  • recommends the introduction of a tax on full sugar soft drinks of 10-20%

This, combined with a range of other measures, it is argued, could save the NHS £500 million per year. The PHE recommendation was also supported by the House of Commons Health Committee, in their recently published Childhood obesity – brave and bold action report. Having heard evidence from parties including Sustain and Jamie Oliver, a key figure in the campaign for the introduction of a sugar tax, the Committee recommended that such a levy should be introduced at 20%, in order to achieve maximum impact.

The Prime Minister, however, is still not convinced, stating that he believes there are “more effective” ways of tackling obesity. The government is due to publish a strategy on childhood obesity in the New Year.

What does the evidence say?

A number of countries have implemented a form of taxation on sugar or saturated fats. These include:

  • a tax on saturated fats in Denmark
  • Finland’s tax on sweets, ice cream and soft drinks
  • Hungary’s public health product tax
  • France’s tax on sugar- and artificially-sweetened beverages

According to a review of using price policies such as these to promote healthier diets by the World Health Organization, food pricing policies are feasible, and can influence consumption and purchasing patterns as intended, with a significant impact on important dietary and health-related behaviour. Crucially, however, the same review notes a lack of formal evaluation in this area.

A report published earlier this year by the activist group Taxpayers’ Union of New Zealand, Fizzed out: why a sugar tax won’t curb obesity,  questioned the validity of nutrition related taxes. Reviewing the experience of Mexico, they suggested that the reduction in consumption of sugary drinks following the introduction of an excise tax of one peso per litre in January 2014 had been overplayed.

It’s also the case that the Danish tax on saturated fats was repealed by the government after only one year. This was due to a number of economic impacts that quickly became apparent after the tax was implemented, and resulted in plans for similar taxes to be abandoned. In fact, fat consumption in Denmark has been on a downward trend for some time now, therefore no tax incentive was required. And according to the Danish minister of finance, “to tax food for public health reasons [is] misguided at best and may be counter‐productive at worst”.

Whether the UK Prime Minister will be swayed on this matter remains to be seen. It’s likely that a ‘sugar tax’ will continue to be deemed too politically sensitive to introduce, especially as one in five people continue to live below the poverty line.


Related reading
Child obesity: public health or child protection issue?

Our popular Ask-a-Researcher enquiry service is one aspect of the Idox Information Service, which we provide to members in organisations across the UK to keep them informed on the latest research and evidence on public and social policy issues. To find out more on how to become a member, get in touch.

Follow us on Twitter to see what developments in policy and practice are interesting our research team.

Who pays for parks? Are ‘green benefit districts’ the answer?

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Southwark Park, London. Photograph: Mike Faherty. Licensed for reuse under a Creative Commons License

The benefits of urban parks are well told. Quite apart from their environmental impact, green spaces really do make a difference to our quality of life: from health to housing, community cohesion to crime prevention, city parks generate spin-offs extending far beyond their green acres.

They also cost money. Even before the economic crisis of 2008, the Commission for Architecture and the Built Environment was highlighting the challenges of maintaining urban parkland:

“We risk a never-ending cycle of large areas of poor quality urban green space that are restored with public money, then decline, then need more public investment to restore them to a good standard.”

In the age of austerity, those challenges have intensified: between 2010/11 and 2012/13 local authority spending on open spaces in England was cut by an average of 10.5%. Now, more than ever, local authorities have to think more imaginatively about sources of revenue and capital funding for urban green spaces.

Last summer, the Policy Exchange think tank came up with some ideas for attracting more money to maintain urban parks. These included:

  • extending the Gift Aid scheme to community civic improvement groups;
  • requiring new green spaces to include a long term funding plan;
  • allowing communities and local authorities to apply for funding to employ park keepers in those spaces identified as crime hotspots.

The report also encouraged the idea of green benefit districts. Also known as park improvement districts, these are urban parks, gardens, and green spaces whose upkeep is funded in part by a tax on nearby residents.

It’s an approach that echoes the concept of business improvement districts, defined areas where participating businesses pay a levy for security, landscaping and other improvements to their trading environment.

Some communities in San Francisco are already exploring the idea, teaming up with housing developers to establish a green benefit district that aims to protect and enhance 25 small parks, community gardens and ad hoc recreation spaces.

In the UK, green benefit districts might prove to be a harder sell. Many people feel that they are already contributing quite enough for the maintenance of parks through the council tax, and the Policy Exchange report stressed that the idea would not be appropriate in deprived areas.

But the authors suggested that home owners living near parks might be persuaded to pay more for amenities that raise the value of their properties.  An analysis of price increases of homes in south London before and after a £2.7m regeneration of Southwark Park revealed a significant increase in prices of properties located within 100m of the park. The report could not conclude that this increase was due to renovation of the park, but suggested that the link between green space quality and property prices was worth further investigation.

The green benefit districts idea has received a cool response from coalition ministers, who suggest that cutting waste and inefficiency in local government is preferable to additional taxation. But, with the prospect of councils’ budgets being squeezed further in the coming years, the idea of green benefit districts might well take root.


 

Further reading

The Idox Information Service has a wealth of research reports, articles and case studies on urban green space. Items of interest include:

The contribution of green and open space in public health and wellbeing

Future parks (Birmingham City Council seeking NHS funding for upkeep of parks)

Time to re-think parks (innovative income generation for public parks)

Park land: how open data can improve our urban green spaces

Rethinking parks: exploring new business models for parks in the 21st century

N.B. Abstracts and access to subscription journal articles are only available to members.

The Autumn Statement 2014

Pound coin

By Alex Thomas

Chancellor George Osborne’s 2014 Autumn Statement was delivered at 12.30 GMT today in the House of Commons. The Autumn Statement is an opportunity for the Chancellor to update MPs on the Government’s plans for the economy based on the latest forecasts from the Independent Officer for Budget Responsibility (OBR).

As many predicted the chancellor committed to further tightening public finances within the statement. He went on to say that if the Conservatives remain in government after the May General Election there will be substantial savings in public spending. Continue reading