Concepts and Principles of Modern Public Health for Obesity Intervention

This report discusses the concepts and principles of modern public health that underpin the initiatives of obesity taken by the UK government. It explores the key elements of the public health intervention, its evaluation, and the evidence supporting the intervention. The report also discusses the new obesity strategy launched by the government of UK and ways to evaluate a public health intervention.

Public Health

Table of contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
The concepts and principles of modern public health that underpin the initiative of obesity.....3
The key elements of this public health intervention and evaluation...........................................6
Evidence that supports the intervention and if the intervention could be replicated in the
neighbouring country...................................................................................................................8
Ways to evaluate a public health intervention.............................................................................9
CONCLUSION..............................................................................................................................11
REFRENCES.................................................................................................................................11

INTRODUCTION
The report is about the public health. It discusses about the concepts and principles of the
modern public health that underpin the initiatives of the obesity taken by the UK government.
The public health can be defined as the science and art for preventing the disease and the
prolongation of life. The public sector equity duties and the integrated tools and techniques for
reducing the health inequalities and embedding qualities are discussed in the report. The new
obesity strategy launched by the government of UK is discussed. The report discuss about the
key elements of the public health intervention as well as its evaluation. The evidences that are
supporting the intervention of the UK government are discussed and the discussion is done for
the replication of the intervention in the neighbouring country. The ways of evaluating the public
health intervention is discussed in the report and the way by which the given intervention can be
evaluated is discussed.
MAIN BODY
The concepts and principles of modern public health that underpin the initiative of obesity
The science and art of preventing the disease is referred to as the public health, along
with the prolongation of life. The quality of life is improved through informed and organised
efforts of the organisations, communities and societies. The determinants of the health in the
population are analysed and the basis for the public health are the threats that are faced by them.
The concept of health takes the psychological, physical and social well-being. The public health
can be explained as the interdisciplinary field. For example biostatistics, management of health
services, epidemiology and social sciences are relevant to each other. The sub important field in
the public health are community health, mental health, public policy, environmental health,
behaviour health, and health politic, health economics, and gender issues, sexual and
reproductive health (Svalastog and et.al, 2017). The health care system overall, public health,
primary, tertiary and secondary care.
The implementation of the public health is done through surveillance of cases, promotion of the
health behaviours as well as with the health indicators. The common public health initiative
includes promotion for the delivery of vaccines, smoking cessation, increasing healthcare
accessibility, hand-washing, suicide prevention, breast feeding and for controlling the sexually
transmitted diseases the distribution of condoms.

The principles of public health on which the practise is based upon are equity, inclusiveness,
fairness, effectiveness, evidence-based practise and empowerment. It is evident that societies
having equity to access quality education along with the wealth, food, healthcare and housing
possess the better health in the social gradient. The people at every level can get benefited with
the equity as the trust level among the innovation, communities as well as social mobility is
linked size of the socioeconomic gap in the country (Spike, 2018). This makes it clear that the
better chances of the life result in better health as well as the low living conditions are the key
factor for leading the poor health and reduction in the health inequalities has economic benefit
along with the ideological aim.
The inclusiveness in the public health refers to the right of the people for living standard
lives that are adequate in well-being and health of the person, his family and have the medical
care. Fairness in the public health means all the individuals in the healthcare are treated with the
equal dignity and care, no one at the health care should face any discrimination for the treatment.
Effectiveness of the care given at the health care is necessary and this involves better care from
the health care bodies and provides the treatment that is effective for the patient. The evidence-
based practices are encouraged in the health care as they are more dependable for the best
outcome in the healthcare and have many benefits for following the evidence-based practise.
The public sector equity duties
Under the section 149 of the Equity Act, the public bodies are required to consider all the
individuals while carrying out their daily work of in delivering the services, shaping policy and
regarding the employees under them. The public bodies need to eliminate the discrimination,
encourage good relations within the people and promote the equality in the opportunities when
carrying out the activities. The equality Duty helps in good decision making, help in making the
public bodies understanding the effect of their activities to the people thus, this makes the
services as well as the policies accessible and appropriate for all along with meeting the needs of
different people. When the public bodies are able to understand the impact of their activities in
ways like how the inclusive public services are capable of supporting as well as opening the
different opportunities for the people then they can be more efficient and effective at their duty
(Caperchione, Demirag and Grossi, 2017). The Equality duty helps the public bodies in
delivering the objectives of government for the public services. The Equality Act describes that
having the advancement in the equality involves:

 Eliminating the disadvantages that are suffered by the people because of their protective
characteristics.
 For the people with the protective characteristics steps are taken for meeting the needs
where the needs can be different from other people.
 The protective characteristics people are encouraged for taking part in the public life or in
the activities where the participation is very low.
The Act help in reducing the socioeconomic inequalities as well as help in the reduction of
the discrimination against the people with protective characteristics, age, gender reassignment,
namely, marriage, civil partnership, maternity and pregnancy, sex and sexual orientation,
disability and religion, through the duty on the public bodies.
Integrated tools as well as techniques for reducing the inequalities of health and embedding
equalities
The relevant parts that need to be placed in place for the equitable outcomes are the
equitable delivery and commissioning process, for putting the process into practice a competent
and diverse workforce, equitable public as well as effective engagement of user; and taking
actions for eliminating the inequalities due to the external factors. The factors of the all brought
together in the EDS (Equality Delivery System) for improving the quality performance at NHS
along with embedding the equality in the business planning process for delivering the outcomes
that matter for most people. The goal of EDS is to produce better health outcomes, improve the
access and experience of the patients, beyond compliance and inclusive leadership at all the
levels.
All the current and planned NHS commissioning organisations have the EDS. The
organisations using the EDS are able to meet the Equality Act requirements and five domains of
operating the NHS framework can be helped in focusing.
The barriers to the equity are deeply embedded and are multi-layered in the structures,
processes as well as organisational culture (Gupta and et.al, 2019). Activities are developed with
the common set of policy framework for the in order to improve the sustainable outcome that are
developmental and does not impact the short or the medium terms significantly. Thus, it is
required to measure the processes, milestone outputs and area of improvement outcomes.
The measuring of the compliance with the legislation of equalities is not easy and
straightforward. The organisation needs to look for the things making sure that they are

processes and not the outcomes. The organisation does not always have the sufficient
disaggregated data for knowing if the inequalities are able for measuring the progress or for
making the appropriate risk assessment. The improvement in the hard data collection in the
equalities is a long term task and there is always the likelihood that a portion of data cannot be
robust.
New obesity strategy launched
The government of UK has announced new strategies for aiming to reduce the prevalence
of obesity, the following measures are included:
 The NHS England weight services are aiming for supporting more people in losing
weight with the expansion.
 The legislation made the cafes, bars and restaurants as well as the takeaways to label their
menus for drinks and food with the calories the food item hold (Glasper, 2020). It is made
compulsory for the businesses having more than 250 employees and also follows the
consultation in 2018.
 The legislation restrict the promotion of food items high in sugar, fat or salt, and also
restrict the buy one get one free offer on the food. The displaying of the food items on the
prominent location within the stores are banned like the entrance or the checkout point of
the stores.
 The new laws include the banning of the displaying of the advertisements on the
television and online before 9 pm of the foods that are high in fats, sugar and salt as this
is the time when the children are likely to see them. Along with this, the government also
hold a short consultation for deciding whether the online food advertisement high in salt,
fat and sugar should be banned for all the time of the day.
 The Public Health England (PHE) started a new health campaign for the promotion:
Better health – let’s do this! Along with this the website will be providing information as
well as the free tools for supporting people for losing weight and the NHS have a weight
loss app of 12-week.
 The law launch two consultations one for the labelling of the nutrition on the front-of-
pack and the other on the labelling of calorie on alcohol.
The new launched strategies of the government are linked with the concept of health that is
psychological, physical and social well-being. The main focus of the government is to look for

the childhood obesity (Talbot and Branley-Bell, 2020). The coronavirus pandemic has increased
the focus of the government on the obesity. The aim of the government with these initiatives is to
make the adults lose weight. The risk of having adverse impact on the obese or overweight due
to the coronavirus is high in comparison to the healthy weight people.
The key elements of this public health intervention and evaluation
It was found from the studies that the obesity can increase the risk of developing the
coronavirus. In July 2020, the UK government take initiative for by setting new policies for
tacking the obesity along with the Better Health Campaign for encouraging the improve their
health by losing weight. It is a positive approach and the best intention from the government for
improving the health of people. The reduction in the level of the obesity and overweight is
particularly important for helping the NHS to cope up with the on-going coronavirus situation
and along with this for handling the other health concerns that arise due to the obesity like higher
risk of the type II diabetes, some type of cancer and cardiovascular disease.
The rise of the obesity through the decades can be observed and identified that it is due to
the changes in the environment along with the way of lifestyle where the dense energy food are
available very easily and this is making everyone very inactive (Burton and et.al, 2019). Hence
the tackling of obesity need many changes for making people active, eat healthy and that is not
easily fixed much time and energy is required for handling this.
The two key elements are:
The measures introduced by the government are tackling the aspects of the obesogenic
environment. First key element was found from the evidences that the advertising and the
marketing of the food have an influence on the preferences of children in food, so restricting the
advertising and promotion of the food high in fat, sugar or salt will significantly help in reducing
the intake of such food by the people. Second key element is people can be able to make
healthier choices by having the calorie information on the menus for food at the restaurants,
cafes and takeaways, the evidences shows that it will encourage the people opting for the meals
that are less in calories.
The people who are in the need of support for losing weight are provided with the help
from the NHS England as well as PHE initiatives (Tyrrell and et.al, 2017). But looking at the
scale of problems it is required for making many changes in different areas for the success of the
objectives. The action need to be done to handle the socioeconomic inequalities that are linked

with the risk of obesity and the effect is more under the economic effects due to the coronavirus
pandemic.
Losing very small amount of weight for the obese will be very beneficial for them as
losing the about 5%-10% of the body weight will help them in improving their health by the
health makers. The will be able to achieve the appropriate of close to appropriate blood pressure,
blood glucose control and blood cholesterol. The obesity stigma is prevalent and the government
have taken steps for helping the people out of this and motivating them for losing weight. The
PHE report sited that the link between the covid-19 and obesity is that the people with obesity
are delaying the medical help as they have to face the discrimination at the health care setting.
People can gain obesity due to complex reasons and not just due to the lack of the willpower and
motivation. Many changes are required for helping the people lose weight for improving the
health of the nation.
The Better Health Campaign was evaluated by the data collection and sampling. The
tweets from 27th July to 7th August in 2020 were collected by using the Ncapture having at least
one of these terms in the tweets that are: #BetterHealth or Better health Campaign (Iacobucci,
2017). The data was collected in 10 days for getting the immediate results of the campaign and
for ensuring that the sample is not unwieldy. The sampling was done by extending the retweets
from the sample. The tweets where chosen that are written only in English, the tweet from the
health organisations advertising was excluded as they do not represent the reaction of public. The
advertisements of the companies are also excluded from the sample. At last 181 tweets were left
for the qualitative analysis.
Evidence that supports the intervention and if the intervention could be replicated in the
neighbouring country
The evidences that support the interventions of the UK government for reducing the
obesity in the people are given as follows:
In 2019, Smith in the research “Food Marketing Influences Children’s Attitudes,
Preferences and Consumption: A Systematic Critical Review”, said that marketing of the
unhealthy food as well as beverages are widely increasing the risk factor for the increase in the
development of the childhood obesity along with noncommunicable diseases. The marketing of
food involve different ways and techniques for influencing the consumption, attitudes and
preferences of the children. The article reviews the comprehensive contemporary account for the

impact of the marketing and advertisement on the children in the age group of 0-18 years. The
article uses five academic databases electronically by using the key terms for primarily studies
that include the quantitative and qualitative both (Smith and et.al, 2019). The article document
various ways of advertising in which the marketing techniques on television for the products are
able to affect the preferences, attitudes and increase the consumption. Thus the studies help in
contributing as a strong evidence for supporting the interventions of the UK government.
In 2018, Boyland and Halford in their research, “Television advertising and branding.
Effects on eating behaviour and food preferences in children”, provide with the most intimate
promotions of the food commercials. The research states that despite the rules and regulations by
the government the children are exposed to such food advertisement that are not good for their
health and can increase the changes of childhood obesity. The advertisements are using the fun
themes and promotional characters; this has shown an increase in the consumption of foods that
are high on carbohydrates, fats, sugar and salt. Thus this research is a strong evidence for the
government taking the interventions for the health of public (Boyland and Halford, 2018).
In 2017, Roberto and Khandpur in their research “Improving the design of nutrition
labels to promote healthier food choices and reasonable portion sizes”, provides easy and
accurate understanding about the nutrition that is good for the public health goal that is important
for considering the strategy for addressing the obesity and poor diet of the people. Update in the
labelling of the nutrition on the packed foods along with developing a uniform front for the
labelling system. The restaurants providing people with the nutrition labelling in the menus give
opportunities to educate the people of the nutritional content of food. People will get aware when
choosing the food and the portion of sizes, thus, this will make the people to make healthier
choices. The paper discusses about the current concerns of the communication strategies through
the nutrition label, takes about the opportunities that informative nutrition labelling can bring and
the areas of future research that is the nutrition labelling as the tool for the improvement in the
diet (Roberto and Khandpur, 2017). This is a strong evidence for the UK government for
implementing the intervention to the people of UK.
The neighbouring country of UK is France and the initiatives of the UK government can
be implemented for the population of France. The obesity rates in France are lowest and have
been stayed steady for many years. But the rates can get increased as per the OECD projections
and the rate may increase by 10% in ten years. The population of France is found to be slim and

healthy majorly instead of the facts that the eating is a leisure experience there. The major reason
for having less obese people in France is due to the fact that they are served smaller portions of
food at the restaurants while the restaurants at UK are proving unlimited and bottomless rules.
According to the studies it was found that the portion served in France restaurants is far less than
in any other country. The quality of the ingredients is in the main focus than the quantity. Hence
the interventions by the UK government can be replicated in France for keeping the obesity of
the population in France in check.
Ways to evaluate a public health intervention
The public health intervention can be done by four types of evaluation that includes:
clinical reviews, program reviews, clinical trials and program trials.
Clinical reviews
The clinical reviews are very subjective as the reviews are done by the clinicians and they
are very difficult to be impartial. For the need of the rapid decisions the review can be based
upon the incomplete data. The review makes available the full and direct measures of the
treatment effects. It is difficult to know that the effects are because of the treatment until the dose
effect has the evidence that is convincing or the effects are highly specific or time efficient
relationships. The criteria used for effectively appraising the formulated specifically and this can
differ with different clinicians (Michie and et.al, 2017). When different clinician appraises the
care received by same patient or the comparison between the appraisals and patients appraisals
are done than frequent disagreement arises. Instead of all these short comings the, in the clinical
work the clinical review is indispensable tool.
Clinical trials
The general and for the patients of differing characteristics, the clinical trial has main
issues that are the effectiveness as well as the harmlessness. The efficiency can also be focused
that can be explained by the comparison in the costs of doing in different ways to achieve the
same benefit. The outcome is not satisfactory as the appraisals of performance, satisfaction,
facilities, compliance and setting are seen as subsidiary. For the evaluation of the feasibility or
the acceptability of the process these appraisals are kept as the central feature. The clinical trials
need to be designed and conducted with the meticulous detail of attention, accurate measurement
with the rigorous attention and the biasness need to be avoided for yielding convincing

conclusions (Liu and et.al, 2019). The prime aim of the clinical trial is to demonstrate the cause-
effect relationship.
The outcomes that are used as the criteria are for the effectiveness in the clinical trials are
usually the change in the health status or health characteristics that are regarded as the desirable
for the favourable consequences.
Program trial
The questions in the program trials are same as that of the clinical trials. The central issue
is the casual relationship between the outcomes and the care. Economic efficiency can be given
the attention. The trial specifically aims for the appraisals of performance, satisfaction,
compliance and facilities for explaining the effectiveness or the lack of it, feasibility or the
acceptability. The effectiveness is appraised when the outcomes that are used as the criteria are
clearly desirable as the end result or the stepping stone for the end result (Rokicki and et.al,
2017). An instance where there is no doubt of the benefit from the activity is expected then the
measure of performance can be used as the effectiveness criteria.
Program reviews
The question in the program review can be efficiency as well as the quality or both. The
focus can be made on the requisiteness in the long established program on the satisfaction of
people as well as on the differentiation between the groups of people and categories of patient
with the care needs, use of services and coverage. The three characteristics determines the
method used in this type of evaluation. The main purpose of the evaluation is to provide the basis
for the concerning decision for the service or the program in the setting. The first is assumption
and the validity that are underlying the program. Second is the evaluation need to be rapid, and
on-going for the maximum value. The rapid appraisals can provide early warning for the
inadequacies along with this it can provide factual basis for the up-to-date decisions (Rogers and
et.al, 2017). Third is in the service oriented setting the program review is carried out. The
evaluation is not seen as the central aim and for the information collection procedures the time
and resources are available.
Program review can be used by the UK government for evaluation of the public health
intervention because is particularly made for the evaluation of the program like the one initiated
by the government.

CONCLUSION
It can be concluded from the report that the concept of the public health take in account
of the psychological, physical and social well-being of the people. The principles of the public
health on the basis of which the practices are implemented are equity, inclusiveness, fairness,
effectiveness, evidence-based practise and empowerment. The public bodies are required to
understand the importance of their duty and how their actions affect the people. They are able to
eliminate the discrimination for encouraging the people having good relations and develop trust
in the bodies for providing opportunities in the activities. EDS is a system that is used to deliver
the best quality services to the people. The new obesity strategy of the government has main
focus for reducing the rates of obese people by implementing two rules for the advertising and
restaurant menus for food. Along with this initiate a Better Health Campaign. The key elements
of the intervention by the UK government are given. The evidence that support the government
intervention is provided by three research papers. The replication of the intervention of UK
government is discussed for France people. The ways of evaluation of the public health is
discussed for the intervention and they are: clinical reviews, clinical trials, program trials and
program reviews, from which the program review is the best fit for the evaluation of the obesity
intervention.

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Books and Journals
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The Better Health Campaign
Tyrrell and et.al, 2017. Gene–obesogenic environment interactions in the UK Biobank
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