Scotland’s public health leaders have come together to call for more action to improve access to sustainable healthy food options and opportunities to be physically active.

Public Health Scotland (PHS) and the Scottish Directors of Public Health have published a consensus statement, outlining the ‘urgent need’ to support health and wellbeing of Scotland’s population through decisive action around diet and weight.

The organisations say more must be done to equip individuals, public services and community groups to promote the benefits of healthy eating and an active lifestyle.

Dona Milne, Director of Public Health at NHS Lothian, says:

“The places where we live, work, learn, care and play must prioritise health.

“We must accelerate efforts to ensure all communities have access to sustainable, affordable and healthy food and drink options and opportunities to be physically active.”

This comes just months after health organisations hosted a conference calling for systemic change to address Scotland’s declining health through “embedding a culture of prevention”.

Around two in three adults in Scotland are living with overweight (including obesity), while one third (33%) of children start primary school at risk of overweight (including obesity).

Now, PHS and the Scottish Directors of Public Health outline the social and economic impact of food and activity options – with Scotland’s most deprived communities experiencing the highest rates of obesity in both adults and children.

The organisations outline the need for affordable healthy food options across Scotland, as people in the most deprived areas would need to spend 50% of their disposable income to eat a healthy diet compared to just 11% for those with the highest income.

Avoiding weight stigma

They also recognise stigma associated with obesity both in society and in the healthcare system as barriers to accessing support.

The statement says people must have access to effective weight management services that are cost-effective and tailored to their needs in a non-stigmatising way.

It says that a comprehensive and inclusive approach must encompass digital and group-based support and the use of prescription medications as part of a range of treatment options offered to people living with obesity.

The average wait time for tailored weight management services in Lothian is more than 250 days, with disproportionate waits for those in the 40% most deprived communities.

The organisations highlight the intersection of diet and physical activity, stating that a healthy balanced diet can enable being physically active which supports both physical and mental health.

However, the statement outlines that Scotland’s current food environment does not support equitable access to healthy food options and thereby increases health inequalities across the country.

Researchers and policymakers shared that regulation of our food system is key to reducing obesity in an event hosted by PHS on proposals to limit unhealthy food’s promotion.

The cost of health

Now, PHS Organisational Lead for Food and Physical Activity and Registered Public Health Nutritionist, Claire Hislop, says that by improving affordable healthy food options, individuals, public services and the economy will benefit:

“Having an environment where healthy food is available and affordable, and where physical activity is part of everyday life, will help improve the health of everyone in Scotland. 

“This statement sets out the challenges we face around eating well and maintaining a healthy weight, making recommendations for key areas for action.

“Addressing these actions comprehensively will not only improve individual health outcomes but also support the sustainability of public services and the economy.”

The organisations say that the cost is seen in the number of ‘healthy years’ – wherein people live with a high quality of life – lost to excess weight and poor diet, with one in ten healthy years lost to excess weight and one in ten lost to poor diet.

They add that it is also reflected in the annual cost of obesity in Scotland was estimated to be £5.bn in 2022.

This statement follows recent research revealing the public health threats of physical inactivity among adults highlighted an increased risk of heart disease, type 2 diabetes and some cancers.

The organisations say the Scottish government has ‘laid the foundations for action’ through policy proposals which present an opportunity for a whole-government approach that prioritises social, commercial, economic and environmental drivers of health inequalities.

Now, PHS and the Scottish Directors for Public Health say this policy intent must be translated into ‘practical actions’ that are underpinned by clear leadership at both a national and local level in places where people live, work, learn, care and play.

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