What methods of communication and what further measures can we implicate as a nation to efficiently utilise the NHS’ resources and ensure its future is secure? Providing free health care at the point of delivery has granted the United Kingdom triumph and pride since 1948, promoting a manifesto aiming to to “create comprehensive health and rehabilitation services for prevention and cure of disease" (Beveridge 1942). Yet, today the National Health Service is being stretched to spending an extortionate £2 billion per week, which simply cannot continue to deliver in the future if changes are not implemented urgently. A large percentage of the NHS budget is being absorbed by conditions that arise from undertaking poor lifestyle choices, for example addiction and withdrawal from substance use, heart, lung conditions and cancers as a result of smoking, and the most alarming, obesity due to lack of exercise and an unhealthy diet. This is a problem that is spiralling out of control, as Meike (2015), states that ‘advances in medical treatments and less people smoking are being undermined by lifestyles, fuelling big increases in the number of overweight or obese people and those with type 2 diabetes’, in response to the ONS survey that found that 23% of deaths in England and Wales were potentially avoidable. Reflecting on the growing volume of treatment that is required as a result of these lifestyle-related conditions, naturally a large percentage of UK citizens as well as health care professionals and members of Parliament are aware that the money could be utilised in more significant, and genuine areas of health care, which would ultimately relieve both laborious and financial pressure from the NHS. In order to amend this growing crisis, we must identify exactly why the NHS needs to retain such an extortionate budget in order to continue running as a service. Why are people becoming addicted to substances such as drugs and alcohol? Why are more people being diagnosed with mental illnesses? Why is the level of obesity spiralling out of control? The most vague and most obvious answers would be those that come under the umbrella of corruptions in our society. Two writers in particular have commented on how a pressure-surrounded environment can affect our mental health; writing for the Social Forces journal, Schnittiker, Freese and Powell (2000) state that ‘Some see mental illness as routed primarily in environmental factors such as family upbringing and social stressors’. Demond (1968) enlarges on this point by stressing that ‘Mental illness has the dubious distinction of serving as a mirror for the complexities and demands of the surrounding society’, all writers commenting on how vulnerable we can become when the environment that we are accustomed to can change and develop so rapidly. Some of these external pressures include an ageing population, growing air pollution, increased competition for jobs, negative implements resulting from the Government Defecit and so on. Writing for the Left Foot Forward political blog, Bennett (2015) summarises the current Government as, ‘A society in short that’s failing its people’. Does this mean that we should blame the state of our surrounding environment for the reasons that people engage in activities that are harmful to their health? Not entirely, although stress related illnesses are often triggered by external pressures. When under stress, the body’s natural response is to find a source of ‘comfort’ as a relief or method of coping. This often involves engaging in habits that are harmful to our health, such as drinking, smoking and over/under eating. Stress of this kind can also lead to feeling insecure, lacking self esteem and becoming desperate to feel accepted and valued in society, which could eventually lead to the neglect of self-care and wellbeing. Whilst the Government is frantically trying to prevent these negative conditions from developing, the food industry seems to be encouraging them. The most obvious offenders that come to mind are global fast food chains and soft drinks companies such as Coca-Cola, Pepsi and McDonalds, the latter being symbolised as ‘the worst of today’s world: trampled rainforests, genetically modified foods and cultural homogenisation’(Greenberg,J & Naím,M, 2001), which reflects the unethical, unhealthy and un-environmentally friendly nature of these corporations, and that is only one part of the problem. Companies like McDonalds and Coca-Cola have a reputation of producing products that are highly unhealthy, and simultaneously having a budget large enough to mask this with various methods of advertising. Due to their global success, these companies are able to sell their
products for extremely low prices, which can damagingly influence consumers to purchase fastfood and fizzy drinks over healthy alternatives which are higher in price. We might ask ourselves, ‘If large companies selling unhealthy products and food have the power and eligibility to persuade the nation to subconsciously make choices that will have negative health consequences, why haven’t the Government used their power in a similar way to persuade us to make the right choices?’ This essay will outline and evaluate the actions currently being taken to help save the NHS and whether or not they could realistically make a positive change. It will also investigate and analyse the effectiveness of imagery and language used in a synthesised manor as method of persuasion, both in a positive and a negative context to try and identify the most powerful and effective means of communicating the importance of choosing healthy decisions over poor choices. To put things into perspective, The Kings Fund has stated that the NHS has faced its ‘biggest financial squeeze in history with the budget effectively being frozen since 2010, increasing by just enough to cover inflation’ meaning that there simply is not sufficient funds available to provide treatment for all patients who require it. The Conservative government promised to annually increase the NHS’s budget in the 2015 general election, giving the public hope that the service will continue to serve its purpose and meet individual needs. However due to other external factors, and the decisions made in the previous Coalition government, between 2010 and 2021 spending will have increased by £356 billion in cash terms, yet approximately £246 billion of the budget will be absorbed by inflation. This will result in a real increase of £116 billion, which only accounts to a 0.9% increase on an annual basis. In summary, ‘if the NHS is operating in the same way that it is today in five years time, it will be overspending by approximately £30 billion, which it simply cannot afford to do’, (Panorama, NHS: The Perfect Storm 2015) putting further emphasis on the point that if immediate action isn’t put into place, the NHS will be diminished. When it comes to finding an effective way to tackle this epidemic of poor health, unfortunately there is no straight forward solution to such a complex issue. The vast majority of the public seem to be pointing fingers towards the Government who have the power and authority to implement changes that will benefit the Nation. As promises are being broken and services are being cut, their somewhat deceiving manifestos are jeopardising our health. Many writers have commented on this and expressed their opinions about potential solutions that would improve the health of the nation. Bennett, (2015) and Freeman, (2007) have both outlined a number of factors that the Government could invest in to benefit our health, ‘that would of course mean reversing the disastrous policy of austerity thats seeking to make the poor, disadvantaged and the young pay for the errors and fraud of the bankers’. For instance, Freeman states that combating the food oppression would require activists to ‘lobby the government to create meaningful, sustainable change through education, regulation, taxation and redistribution’, which involves moving money around in a more ethical way and investing into worthy causes like education that will have a long term benefit of our understanding and awareness of our health. Similarly, Bennett mentions investing money into eradicating poverty, highlighting fundamental needs including ‘everyone can put healthy food on the table’ as well as ‘keeping an energy efficient roof over heads’ which result in less people becoming unwell due having higher quality diets and more insulated and energy efficient homes. Comments from both writers emphasise investment into methods of prevention, something in which the current Government is not taking into consideration enough. The Government may have the power to set down rules and regulations on behalf of the UK, yet they do not have the power to influence the behaviour and the decisions made by its people, nor can it control the rate of growing long term conditions such as dementia, cancer and depression. The Public Health Sector, charities and a range of other health organisations have all been frantically campaigning to combat the epidemic of poor health and highlight areas where money could be saved and better spent to benefit the efficiency and sustainability of the NHS. In 2009, the Department of Health launched a large-scale public health campaign called ‘Change4Life’. Change4Life is the UK’s first social marketing campaign aiming to prevent obesity by emphasising the importance of leading a healthy and active lifestyle. It is mainly targeted at
families with young children to prevent poor lifestyle choices developing, but also appeals to teenagers and adults. Reflecting upon the slogan ‘eat well, move more, live longer’, Change4Life encourages six healthy behaviours, which include: eating 5 portions of fruit and vegetables a day, reducing the level of salt intake, cutting back on fat, swapping sugary snacks for healthier options, cutting down on alcohol consumptions and taking part in regular exercise. In its first year over 400,000 families joined the campaign and over 1 million families claimed to have made changes to their children’s behaviour as a result. (Change4Life One Year On, 2010) More recently, in March 2016, a bill passed through parliament implementing a new sugar tax on the soft drinks industry to help fight childhood obesity, which arose from a campaign led by TV chef and campaigner, Jamie Oliver. The chancellor George Osborne predicts that this will raise and estimated £520 million per year, which will be spent on increasing the funding for sport in primary schools. The levy may also see the decrease in the number of children being admitted to hospital for tooth decay, which costs the NHS an extortionate £35 million per year. (Jamie’s Sugar Rush, 2015) Both of these campaigns have fantastic intentions that are grafting to vast lengths to help inform and encourage the public about how to lead a healthy and active lifestyle, as well as sourcing funds to be spent on areas that will actually benefit our health, and potentially save the NHS a huge amount of money from having to treat conditions like obesity and type two diabetes. If the Government and health campaigners were the only two higher powers in society, this epidemic wouldn’t be such a massive task to battle. However they are not the only two, as they are outnumbered by the likes of McDonalds, KFC, Coca-Cola and many more fast food and soft drinks corporations.The success of these corporations over the years has created global and financial stability, which also comes with a great deal of power and control. A number of writers have considered how we can be negatively influenced by the advertising and the power of the food industry. The Centre for Media (1997), Lawrence (2003), Stegemen (1991) and Berger (1972) all discuss the detrimental impact on individuals and society as a whole. For example Berger (1972) states that “publicity is the culture of consumer society”, which closely relates to Stegemen’s view that “critics portray advertising as a socially pointless attempt to capture market share through psychological manipulation”. These two statements highlight how easily it is to be influenced via exposure to media in a society revolving heavily around consumerism, and the ways in which we mindlessly subject to the status quo in order to feel a sense of belonging. The Food industry takes consumer vulnerability in their stride within their methods of advertising and the way that they operate in general. Lawrence (2003) expresses ‘money and influence will be used in a manner that will support continued viability of the industry’, suggesting that the content of the ethical principles are not as heavily prioritised as the level of profit generated. For example ‘Children who watch lot of TV have a greater risk to obesity than those who watch less TV’ (Centre for Media 1997) highlights the fact that the children who are less active in the first place, will be repeatedly exposed to these methods of advertising, increasing their desire to consumer unhealthy food and drink, threatening their health even further. In summary, all of these writers outline how simple it is for members of the public to be persuaded by these fast food corporations, rather than listen to their own logic, or lack of. One of the principles of advertising is that the company will use selective language and imagery to persuade the customer that they need to buy their product or service. Due to the external pressures of modern-day living, the accessibility to replenish some of our basic needs has become increasingly difficult. If we look at Maslow’s Hierarchy of Basic Needs [fig.1] the top two sections of the pyramid contain aspects that aren't completely essential to survive, such as morality, creativity and achievement. However the bottom three sections of the pyramid contain factors that we cannot survive without. Excluding physiological needs, (the bottom section) it is common that a lot of us do not own or have some of these factors for example employment, property and good health, ultimately causing a personal sense of insecurity, and pressure on external powers and services to have these factors provided, e.g. council houses provided for those with low incomes and health care provided for the sick.
O’Shaugnessy and O’Shaugnessy (2004) state that ‘persuasion deliberately aims to mould beliefs,values and actions of others in a direction favoured by the persuader’. A good example of this would be this McDonalds advert [fig.2] showing a happy, smiling family sitting around together enjoying a meal. The image displays the needs that are contained in the first,second and third sections of Maslow’s hierarchy; food being the first physiological need, family being associated with the basic need of safety, as well as a sense of love and belonging. Therefore, we subconsciously create an association that ‘eating at McDonalds will provide happiness’, which will persuade us to go and eat at their restaurants. O’Shaugnessy and O’Shaugnessy then add that ‘persuasion appeals can provide a new perspective on a brand and create a whole new aura for it’, highlights how McDonalds masks all of their bad qualities and how unhealthy their products are in general by painting a happily deceptive image to its target audience that is far from the truth behind the brand. McDonalds isn't the only company that is guilty of deceiving consumers. Coca-Cola’s slogans such as ‘Open Happiness’, ‘Life tastes good’ and Kellogs’ use of friendly mascots on children’s cereal boxes are all masking how much sugar these products contain, and ultimately how unhealthy they actually are. We are being suffocated in a consumerist society by methods and exposure of advertising. Everything from adverts on bus shelters, vouchers in newsagents and product placement in supermarkets, the question of why our nation is so unhealthy to an extent becomes rhetorical. This brings us back to the question that if unhealthy food and drinks companies can have such a high level of persuasion in terms of consumer choices, why can’t the Government achieve the same theory in reverse? The answer is that they are currently doing a great deal in their power to do so as stated earlier through introducing tax on sugar and promoting healthy life style campaigns, but it still somehow doesn’t seem to be quite enough. For unhealthy choices such as smoking, Government campaigns have been relatively successful through banning all forms of media advertising and display of cigarettes, showing visual health warnings on packaging and their use of shock advertising in the media. Although due to the highly addictive chemicals contained within cigarettes, it is difficult to persuade users to give up unless they first accept the medical principle that links towards ill health. The informative language and disturbing imagery used in [fig.3] is designed to persuade people to stop smoking. Stating ‘every cigarette rots you from the inside out’, and picturing a roll up cigarette containing unsightly rotting flesh creates a rational sense of distress for the viewer in the hope that their perspective on the habit will change. Further difficulties then rise as O’Shaugnessy and O’Shaugnessy (2004) continue to comment that on the fact that persuasion is sometimes not enough to just change peoples beliefs. ‘It may be wrongly assumed, for example that if we put across findings and recommendations endorsed by the ‘hard’ sciences, people will follow such recommendations’, relating to the Platonic fallacy that ‘virtue is knowledge’. Blaxter(1990) also supports this statement, ‘Thus people continue to smoke though surveys show that smokers are more aware of health dangers than non-smokers.’ Both writers culminate the fact that with any sub-culture or group that share similar beliefs, in this case people who adopt unhealthy habits and addictions, denial becomes a main psychological defence mechanism that impels members to reject the consequences of the harsh truth, which summarises the attitude of society today.
This draws to the conclusion that persuasion in the means of comfort is more powerful than persuasion in the means of positive change. Members of the British public who engage in poor habits that could have severe health consequences are becoming increasingly ignorant and resistant to methods of visual communication that specifically target them through the use of informative, truthful and shocking language and imagery. O’Shaughnessy and O’Shaughnessy, Blaxter and Stegemen have all helped draw to this conclusion by highlighting the natural responses and reactions within human behaviour, considering how and why we may respond to different forms of advertising in accordance with our basic and more complex needs. On top of physiological needs, every human being desires a sense of security, belonging and happiness. If eating unhealthy food, smoking, taking drugs or any other bad habit brings an individual happiness, they will seek to sustain that ‘fix’, and reject any unpalatable truths that may be associated with it.
As O’Shaughnessy and O’Shaughnessy state, ‘all persuasion is self-persuasion in that we are unlikely to be persuaded unless we reflect or fantasise on the meaning of the persuasive communication’, meaning that individuals opinions are unlikely to change unless they experience those consequences first hand, which is when it is often too late. If the level of preventable health conditions continue to rise, the sustainability of the NHS will fall. It is all a question of when ‘enough becomes enough’. Will the Government be forced to tax all categories of unhealthy foods and drinks? Will they need to further restrict on how fast-food and sugary drinks companies methods of advertising? Will they resort to displaying threatening warning labels on unhealthy food and drink products? There is no set answer that will provide a successful solution to this vast complexity of life threatening problems, however if the Government, public health committees and ourselves as individuals fully commit to understanding the importance of leading a healthy lifestyle the message may just start to sink in and the power of positive change may succeed. This will result in more money being available to spend in areas such as education and sports activities as opposed to treating the consequences of the initial ignorance. Subsequently, additional pressure will be released from the NHS, increasing its strength, strategies and chances of survival in the foreseeable future.
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Fig.1 Abraham Maslow, (1943), ‘Hierarchy of Needs’ [ONLINE]. Available from <https:// en.wikipedia.org/wiki/Abraham_Maslow >[Accessed 23 April 2016]. Fig.2 Golden Arches Development Corporation, (2012), ‘Kids & Family’ [ONLINE]. Available from <https://www.mcdonalds.com.ph/content/page/kids_family> [Accessed 12 April 2016]. Fig.3Public Health England, (2015), ‘Every Cigarette Rots You From the Inside Out’ [ONLINE]. Available from <https://www.mcdonalds.com.ph/content/page/kids_family> [Accessed 12 April 2016]
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