Last Friday I worked from home. As a consequence I was able
to get out early to do my shopping. Usually I shop at my local Tesco’s (there
are other food retailers) and on this occasion it was no different. In the
store there was a sign saying how successful this year’s food collection (in
partnership with the Trussel Trust and FareShare) had been. Twice a year
customers are encouraged to donate an extra item of food when they go shopping,
which is then distributed to foodbanks. Tesco pledge to add an extra 30% to the
donations and this year the food collection helped provide 4.7 million meals to
people this winter.
As to why, in the UK, in 2014, we need to have foodbanks is the
subject for a future blog. I was struck however, in reading of the food
collections and a story seen on the same day about the rationing of french fries
in Tokyo’s McDonald fast food outlets. Despite airlifting over 1000 tonnes of
potatoes there is a shortage of potatoes and McDonald's are having to serve only small portions of chips to their customers.
There is a considerable evidence base that links fast food intake to obesity. But whilst the lack of availability of fast foods might be a good news
story in the UK, where the rates of obesity are around 61% of the population,
the same isn't true for Japan where only 3.5% of the population are classed as
being obese.
Japan has a unique approach to dealing with obesity. And selling
completely black-burgers, this year's 'food craze' isn't it. Unlike Dubai, who
pays people to lose weight, or New Zealand where overweight immigrants cannot
gain an entry visa, Japanese citizens must adhere to a government-mandated waistline measurement or face the consequences. Waistline measurements have been set for men and
women aged 40 – 74. For men, 33.5 inches, women, 35.4 inches. These limits are
part of a wider approach to reduce the health costs resulting from problems
such as diabetes and vascular disease, particularly in Japan's growing ageing
population.
People whose waistlines are bigger than the prescribed limits
are required to attend counselling and support sessions. Companies and public sector
organisations face fines if the targets set are breached – these targets include
not only current employees, but their families, and even retired employees. Employees
have annual check-ups. The fines imposed can run into millions of pounds a year
for large companies. Somehow I can't see Public Health England adopting this approach
to improving the health and wellbeing of the general population.
But I was impressed with the approach set out in the Care Act
2014, which possibly represents the greatest reform to how we conceptualise
integrated health and social care since the Beverage Report. According to the Social Care Institute for Excellence the Care Act represents a real opportunity to adopt
an assets-based approach to planning, commissioning and developing social care.
Asset-based or strengths based approaches recognise and value the
relationships, skills, shared facilities and networks we use as individuals and
in our communities.
Such approaches help ensure that people who might require
services are not just problems that need fixing by the State. It’s a person-centred
approach that recognises that individuals should be given a voice which can
enable them to have a greater say in the way local health and care services might better help support them. Possibly, it could also be an approach that
is more effective at improving the health and wellbeing of individuals and the communities
they live in than reducing the number of chips served or imposing fines for bigger
waistlines.
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