How has health messaging changed over the last 30 years?

Posters on a London Underground escalator wall

Matt LambertAs we celebrate our 30th birthday at World Cancer Research Fund (WCRF), Matt Lambert (our Health Information Officer) looks back over some of the nation’s key health messaging campaigns, and how they have evolved and changed over the years.

At its heart, health messaging aims to communicate and disseminate health information to inform and influence the decisions and actions of the public to improve health – something that is at the core of what we do in the Health Information team at WCRF.

Drink ’til you drop

Drink til you drop to a sensible drinking level

In the 1990s there was an increased focus on the negative effects of alcohol on our health, with a number of campaigns aimed to educate the public about units and ‘sensible’ quantities of alcohol. In 1995, the ‘Sensible Drinking’ report called for the establishment of daily benchmarks to help individuals decide how much to drink on single occasions and to avoid excessive drinking. This report also mentioned the link between alcohol and cancer, but as the evidence was still emerging, the conclusion was far more cautious than it would be today: “we conclude that whilst there is no decisive evidence that breast cancer is causally related to drinking alcohol, the potential significance, for public health, of a weak causal association between alcohol and breast cancer is such that we recommend, in particular, that this matter be kept under review.” By 2017, the evidence is conclusive that alcohol increases breast cancer risk.

Six teaspoons of sugar

Most fizzy drinks contain six teaspoons of sugar

We also began to see campaigns highlighting how much sugar was in fizzy drinks. ‘Most fizzy drinks’ – launched in 1992 – carried much of the same messaging used today to warn of the health risks of eating and drinking too much sugar. At this time, most of the evidence was about the negative effect that sugar had on our oral health, but there was to be a greater focus on the wider health effects of too much sugar over the coming years.

Sid the slug

I've always known it. Too much salt is bad for your heart - Sid the SlugOne of the earliest high-impact campaigns was the work the Food Standards Agency (FSA) did on raising awareness of excess salt. In 2002, they committed to a nationwide salt reduction initiative to reduce the UK salt intake to 6g/day. This initiative included famous campaigns such as ‘Sid the slug’, ‘Check the label’ and ‘Is your food full of it?’ Salt reduction was one of the key targets for the government at this time, with a focus on getting the food industry to reduce salt levels. The campaigns did seems to increase awareness of the dangers of excess salt, as public awareness of the 6g a day limit went from three per cent to 34 per cent. With the food industry reducing levels of salt in their products, many food products are now 20–40 per cent lower in salt than they were 10 years ago. From a public health perspective, the real success was that adult daily intakes of salt were reduced by 15 per cent.

Just eat more

5 A DAY Just Eat More (fruit & veg)

Probably one of the biggest, and certainly most well-known, health awareness campaigns was the launch of the government’s ‘5 A DAY’ campaign in 2003. The aim was to encourage people to increase their consumption of fruit and vegetables to at least five portions a day, and to raise awareness of the health benefits. There was an initial increase in people eating their 5 A DAY, from 24 per cent in 2001 to 30 per cent in 2006. However, since then the proportions have varied between 26 per cent and 29 per cent.

Healthy weight, healthy lives

Healthy weight, healthy lives: a cross-government strategy for England

With the increasing prevalence of overweight and obesity figures over the previous two decades, the government launched its first campaign in 2008 to try to reduce the rising rates; ‘Healthy weight, healthy lives: a cross government strategy for England’. Despite this, overweight and obesity rates seem to have stalled since 2000, and they have certainly not yet decreased.

Change 4 life

Change 4 Life - Eat well, move more, live longerTo try and stem the rising rates of obesity, the government launched its Change4Life campaign in 2009, the country’s first national social marketing campaign to tackle the causes of obesity. It has evolved over the years, and to this day it is a popular programme to help families be healthier by eating well and moving more. There was also a lot of focus on sugar and how people can eat less of it.

Sugar swaps

Time for sugar swapsGiven the increased focus on sugar as being detrimental to our health over the previous years, 2015 saw the launch of ‘Sugar reduction: from evidence into action.’ The government then announced a sugar tax on added sugar beverages. The aim was to help tackle childhood obesity by encouraging manufacturers to lower the amount of sugar in soft drinks or reduce portion sizes. Since this, the sugar in soft drinks sold in the UK has dropped by almost 30 per cent.

The present and future

Better Health - Let's do this2016–2020 saw a greater focus on childhood obesity; especially given that rates of childhood obesity had been gradually increasing. And most recently the government launched its ‘Better Health’ campaign to help tackle adult and childhood obesity rates. The aim of the campaign is to get people more active and eating healthier, largely in response to evidence that people living with overweight and obesity are more likely to experience severe symptoms from COVID-19.

The spotlight on overweight and obesity is something that we will no doubt see for many years to come – and with the government’s latest campaign, hopefully, we will start to see a reduction in adult and childhood obesity rates in the future.

Image credits

Drink ’til you drop: Royal Colleges of Psychiatrists, Physicians and General Practitioners
Most fizzy drinks: Science Museum, Health Education Authority
Sid the slug: Food Standards Agency
Healthy weight, healthy lives: Department of Health and the Department for Children, Schools and Families
Change4Life: Public Health England
Better Health: NHS