Health promotion is the process which includes motivating people to develop better self-management and empowering individuals to make them develop healthy lifestyle choices. In order to accomplish this, the strategies of health promotion mainly focused on counselling, health education and support mechanisms. In the UK, it is currently seen that the food environment is not properly maintained that has lead to the rise of various diseases such as obesity, heart diseases, liver disorder and others. In this assignment, the way food environment is impacting the health of the UK population and the extent of successful health promotion initiatives has been developed in this aspect is to be discussed along with providing recommendations to make wider changes.
The presence of a healthy food environment leads individuals to have good nutrition, in turn, reducing the influence of risk for chronic diseases such as obesity, heart diseases and others (Cobb et al. 2015). This is because healthy food environment leads individuals to easily have access to proper nutritious food that effectively provides the required nutrients in the body and avoid consumption of junk foods that adversely affect their health by building up harmful substances in the body. In the UK, it is seen that the food environment supports huge amount of fast food outlets that are harmful to the health of the individuals compared to healthy food outlets. This is evident as a 34% increase in fast food outlets has been seen in the UK from 2010 to 2018 indicating the food environment supports high fatty fast foods and others compared to healthy eating (www.bbc.com, 2018). This has influenced the individual in the UK to lower their expenditure on healthy foods at home by 3.2%and increase their expenditure to have unhealthy fatty foods at resultant or outside by 9.5% as seen since 2013 (www.gov.uk, 2018). This indicates that the food environment is inappropriately managed for individuals in the UK where the population is seen have more access to unhealthy foods compared to healthy foods.
The food environment of the UK supporting high amount of unhealthy fast foods has lead to an increased number of chronic diseases among individuals out of which obesity is one of the key chronic diseases. It is evident as a study informed that the presence of fast food outlet within 10 miles of schools contributes to cause 5.2% obesity among children (iea.org.uk, 2018). Moreover, Public Health England informed that 63% of the adults and 1/3rd of the children between 2-15 years of ages are at risk of developing obesity due to presence of unhealthy food environment in the UK as one of the key factor (www.gov.uk, 2017). As mentioned by Dubowitz et al. (2015), fast foods have increased amount of unsaturated fats in them which are unable to be easily broken down and used by the body. Thus, the individuals having fast foods leads to increased build-up of fats in the body that adds to their weight leading to give rise to obesity.
The unhealthy food environment along with obesity is seen to give rise to various health complications such as cardiovascular diseases making the UK individuals face intense health issues. It is evident as 2/3rd of the total people who are affected by obesity in the UK are facing cardiovascular diseases or type-2 diabetes (discover.dc.nihr.ac.uk, 2017). This is because obesity as well as unhealthy foods are raising the cholesterol level of the individuals as well as are leading to build up fats within the arteries creating high blood pressure (Celis-Morales et al. 2017). Moreover, it is seen that 90% of the individuals in the UK affected by type-2 diabetes are overweight or obese which has resulted due to intake of unhealthy food intake and other factors (assets.publishing.service.gov.uk, 2014). The diabetes and obesity are interrelated because with increase in body fat and weight the tissues in the body become resistant to use up insulin in the body. This leads to increased level of blood sugar and unused insulin in the body causing type-2 diabetes (Czech, 2017).
The Public Health England (PHE) in the UK to improve the food environment around the population has taken up the intervention of restricting the growth of fast food outlets and takeaways in different areas and limiting access to fast food outlets for children near schools and colleges (Lobstein and Jackson‐Leach, 2016). It is executed with the intention to lead individuals to develop the habit of having healthy foods at homes and limiting children to have school meals which are healthier in nature rather than buying food from fast food outlets. This is because PHE data shows that the density of outlets providing fast food ranges from 26 to 232 per 100,000 population in the UK (www.gov.uk, 2018). The easy built up this nature of the environment where unhealthy fast foods are easily available has made children, as well as adults, opt for them as they are easier to avail, tastier and are low priced compared to healthier foods. Moreover, it is seen that children when exposed to easy availability of increased fast food options they avoid making healthier choices (Renehan et al. 2019). This is evident as it is reported in a survey that 85% of respondents reported to avail fast food and takeaway that are within 400 m of their living space (www.london.gov.uk, 2018). Thus, the intervention was taken so that control of food environment for the children as well as adults in and around areas in England can be developed to ensure they make healthier choices.
The PHE intervention was taken up in Luton Borough where the council restricted opening of fast food pullets within 400m of school and colleges as suggested by Royal College of Pediatrics and Child Health and the PHE (www.london.gov.uk, 2018). This was done with the intention to reduce childhood obesity by improving the food environment in the area where restricted access to unhealthy foods is made. Moreover, under the health intervention to restrict fast food outlets and takeaways, it was also seen by the PHE that no over-concentration of this nature of food outlets are present in any district, local of town centre area (www.london.gov.uk, 2018). This is to ensure that a mix food environment exists in the area where healthier foods are equally available for adult individuals along with fast foods of their preference. It is done with the intention that the presence of mixed food environment would lead individuals to avoid being concentrated on having fast food and chose healthier foods for their daily purpose (Welker et al. 2016).
The Pender Health Promotion Model is to be used for analysing health intervention of PHE to reduce access to fast food outlets to improve the food environment in the UK. According to Pender Health Promotion Model, the situational influences present in the external environment is able to increase or decrease the participation of individuals in health promotion behaviour (Khodaveisi et al. 2017). In this aspect, the step taken by the PHE in the intervention to restrict easy access to fast food and takeaway outlets was effective in nature for promoting better food environment for individuals. This is because in the intervention the situational influence in the external environment is negative in nature for the people as their access to fast foods was restricted that made them face hardship and barriers in availing unhealthy fast foods. The Pender model informs that individuals are solely responsible for regulating their own behaviour (Choo and Kang, 2015). However, from this aspect, the PHE intervention to restrict access to fast food outlets may not be effective in promoting healthy food environment in the UK. This is because the model informs that individuals regulate their personal behaviour and thus UK individuals may personally orient to adapt their behaviour is extending their access to fast food by walking long distances rather than having healthy foods.
The Pender Health Promotion model informs that health professionals are a part of the interpersonal environment who have influence on individuals to develop changes in behaviour in turn promotion of good health (Khodaveisi et al. 2016). In the health intervention done by the PHE, it is seen that no nurses, doctors or any other nature of health professionals are included who can inform the individuals about the reason behind the steps taken and influence them to create changes in their lifestyle to get adapted to restricted access fast food and achieve healthy food environment (www.london.gov.uk, 2018). Thus, this indicates that the intervention could not be effectively successful in promoting better food environment among the UK individuals. The model informs that the reconfiguration of person-environment interaction is to be self-initiated in making changes in the behaviour of individuals through health promotion (Goodarzi-Khoigani et al. 2018). In the intervention taken by PHE, they reported that the changes in person-environment interaction made was forceful in nature and not self-initiated from the perspectives of UK individuals as it is seen that they still highly prefer fast food diets compared to healthy foods. Thus, the intervention in the promotion of healthier food environment may not be successful as the individuals would still be seeking unhealthy food as personally, they do not feel threatened of having such foods.
In this respect, changes in wider determinants related to the intervention are required to be made for the UK individuals to successfully improve the food environment and promote the health of people. Thus, it is suggested that health education are to be provided to the UK individuals about their present unhealthy food environment and the way it is affecting their health to make them develop self-initiated reconfiguration of the person-environment interactive pattern. This is because health education aware the individuals about the way their personal activities are running their health without their concern (Park et al. 2015). Therefore, with effective health education, UK individuals would be self-initiated to change their behaviour by avoiding access to fast food when they are restricted ensuring successful positive food environment development. Moreover, it is suggested that health professionals are to be included who would be responsible for promote positive food environment among the individuals. This is because such initiative would lead people to understand the intensity of the situation regarding negative food environment making them get personally influenced to create changes in behaviour to support the intervention by PHE to promote good food environment.
The above discussion informs that the food environment of the UK is negatively managed as wide number of unhealthy fast food outlets and takeaways are easily available as well as frequently used by individuals for eating. The Public Health England was seen to implement the intervention to restrict access to fast food centres for adults and children by locating them 400m beyond schools and colleges and keeping a check on their build up in any area. The Pender Health Promotion model was used for analysing the intervention and wider determinants like health education and involvement of health professionals are suggested to be included in the intervention for its successful establishment in promoting positive food environment in the UK.
During the initiation of the assignment, I researched information regarding which aspect that is physical exercise or food environment requires more focus at the present to be promoted in the UK. In relation to this, I researched many journals, articles and government websites where it was informed that though few of the UK individuals are aware of their physical activity but very few are concerned about the food they are eating. This made me select analysis of the food environment in the UK and the intervention taken in improving it. During research about the food environment, I experienced issues with identifying valid data to present as evidence. Thus, I researched online regarding the way to collect valid data and understood that searching government websites would offer me opportunity to get valid and reliable data to present the assignment. I also faced issues with proper presentation of the facts as I was seen to be unable to write them properly within the given word count. Thus, I researched about the way to write short and valid sentences which helped me resolve the issue. However, building of my research skills in this assignment at the initial stage helped me to easily identify the health intervention taken by the UK government in promoting positive food environment along with health promotion model to be used to analyse it. In future, I have going to work on improving my research, writing and presentation skills so that hindrance experienced in this assignment are not faced again.
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