Executive Summary
According to the NHS website, obesity is “generally caused by eating too much and moving too little.” This seems very simplistic, as does the solution of ‘eat less’ and ‘move more.’ The diagnosis and prognosis are clear. The initiative focuses on getting people to become more active.
Few adults engage in the recommended levels of physical activity, which is a leading cause of public health burdens such as obesity. Financial incentives can promote physical activity and ensure the UK eases the strain on the NHS. A step-count, linked to a financial incentive, will help alter people’s behaviours and ensure that the UK is better equipped to focus on the fight against coronavirus and other leading causes of death.
Initiative
The UK has become acutely aware of how targeted taxation of goods that have negative externalities – such as smoking and alcohol – can change deep-rooted habits and disincentivise consumption. Such fiscal strategy has the added benefit of raising vital funds to treat the diseases that the very goods themselves exacerbate. Tobacco alone accounts for approximately £12bn in direct tax revenue. However, the British Government must consider a more incentivised programme of taxation whereby individuals prosper by making lifestyle choices that we know benefit both them and the wider society.
Obesity is an issue that is firmly on the government’s radar, though their strategies of targeting it have largely focused on banning advertisements for junk food and BOGOF offers. Likewise, sugar taxes and other policies aimed at taxing unhealthy foods have drawn criticism for unfairly targeting lower socio-economic backgrounds as well as being politically unpopular.
The coronavirus has placed a huge strain on people’s well-being and mental health throughout the pandemic. Instead of focusing on raising tax revenues to help the NHS fight against obesity, the focus should be on preventing and reversing obesity. Incentivising the population to exercise will benefit individuals physically and mentally as well as alleviating the strain obesity puts on the NHS. Regular exercise is one of the single most important things one can do to improve mental health. Furthermore, regular exercise will help change the nation’s mind-set towards everyday life. It is medically proven that people who regularly undertake physical activity have: up to a 35% lower risk of coronary heart disease; up to a 30% lower risk of depression, and up to a 50% lower risk of type 2 diabetes.
A new way to incentivise people into exercising more is to link benefits to positive behaviours. If the Government provided an opt-in system that people could submit verified step counts to, on a daily basis, that was ultimately linked to an increase in an individual’s personal allowance (or cash benefit for those below the basic rate threshold), then people may feel incentivised to increase their daily activity and make small changes to their lifestyle.
For example, the government could decide that for every day an individual did 10,000 steps then they would receive a 50p back on their highest rate of tax paid. The incentive would follow the progressive nature of the UK’s current income tax structure. This means that for the following tax bands an individual completing the daily step goal would receive back:
• No income – Personal Allowance: 50p
• Basic rate: (50p x 20%) = 40p
• Higher rate: (50p x 40%) = 30p
By setting the benchmarks as 50p x highest rate of tax, there is inverse correlation between income and the amount of money that you can earn from this scheme. Thereby, this should incentivise those from the lowest socioeconomic backgrounds, where obesity is most prevalent. If, for each of the tax bands, the daily uptake was 2 million (totalling approx. 10% of the population), this would cost the government £712m per year. Obesity in the UK currently costs the government, annually, around £6bn.
Numerous studies by the BMJ have highlighted that there is a direct link between socioeconomic status and obesity, which is why it is important to design a system that is weighted to both target and benefit those most at risk in society.
The above initiative is open to some challenges such as: the cost, the length of time it should be run for and the suitability of the scheme to all individuals. The suggested top incentive amount of 50p a day may be deemed too costly by some and would be open to review. However, the COVID-19 pandemic has hit people’s finances and a scheme that benefits people’s mental health and benefits the poorest in society would be welcome by many. The above proposal could have a time limit in place, for example, to run until the end of 2021. It would be wise to trial it on a small – regional – scale so that its efficacy can be evaluated before a full, national roll out. The aim of the initiative is not just to incentivise people to exercise but also about changing behaviours; running the scheme for this length would allow for this shift in the national psyche when it comes to exercise and hopefully lead to long-lasting change and benefits which will continue long after the scheme, itself, ceases. Finally, some people challenge the fact that certain groups in society may not be able to take part. There should be provisions that allow people who use a wheelchair to have their counts tapered by a similar metric to the 10,000 steps.
The primary aim of the initiative is to shine a light on the benefits that exercise can offer. If British conversations change from talking about the weather, to asking someone whether they’ve done their 10,000 steps then that can only be a cause for celebration.
In a post-coronavirus world, there is an argument that governments should be looking to maximise tax revenues – not indulge in further spending. However, by committing to financially incentivising the population to exercise, the government will, paradoxically, make a net financial gain. In short: spend today to save tomorrow.
712-11