Are unfair and avoidable obesity inequalities being addressed or worsened? A review of UK and Scottish Government policy

Abstract

Obesity is a complex condition that embodies a myriad of health problems. While
physical inactivity and poor diet can lead to obesity, it cannot explain obesity inequalities
which exist over a social gradient, with lower socioeconomic groups more likely to be obese
than higher socioeconomic groups. As social determinants of health contribute to barriers
and facilitators to good health, the obesogenic environment contributes to the barriers and
facilitators of obesity. This environment is unfair as it disproportionately affects lower
socioeconomic groups across physical, economic, political and sociocultural factors. The
political factor also demonstrates that obesity inequalities are avoidable as they have
widened as a consequences of policy action and inaction. To suitably address these issues,
upstream, structural policies are needed to tackle the obesogenic environment, as opposed to
simpler behavioural policies. Using discourse analysis over a variety of Government
documents, primarily policy plans, this paper shows that Scottish and UK Governments are
now addressing the unfair obesity inequalities, thus making them less avoidable. While this is
not done so without flaws, both governments have taken large strides in the last decade to
ensure obesity inequalities are not worsened.