How financial incentives could help tackle Britain’s childhood obesity problem

One in three children aged 11 in the UK are overweight or obese. This not only costs the health service millions of pounds, but also affects children’s well-being and makes it very difficult for them to grow into healthy-weight adults. However, despite vast amounts of money spent on research, and many reports published, anti-obesity efforts so far have not made a difference. Obesity rates are still increasing and it is clear that a new approach is needed.

The UK government needs a system which both encourages families to make healthier lifestyle choices, and creates financial incentives for the food industry to respond. This might actually offer the much-needed change to tackle childhood obesity.

Research has shown that financial incentives can encourage healthy behaviour, but for these effects to stick, the incentives also need to remain in place. So what might such long-standing financial incentives look like?

Healthy child vouchers

In the UK, 7m families receive child benefit, costing the UK government up to £11 billion a year. This is currently given as a cash payment. One suggestion is a change to child benefit whereby the government could offer the families of overweight children a “healthy child” voucher instead of cash.

This voucher would be worth exactly the same amount in cash terms – the change would lie in what the child benefit could be spent on. A voucher could restrict spending to include only healthy food sold by registered retailers, healthy meals in participating restaurants, or access to sports clubs.

Vouchers have been tried to a lesser extent, and proved successful at improving the quality of family diets. However, they’ve never been used as part of a wider system, in a way designed to really change behaviours – the “healthy child voucher” might be able to achieve this.

Of course, not all families of overweight children receive child benefit, so the financial incentives would need to differ where a family has a higher income. These households could, for example, make extra tax payments and as children move towards a healthier weight, the tax could be reduced. Taxation has already been shown to be successful to reduce smoking.

A key part of this scheme would be to identify the children who are overweight. In England, all children in reception and year six have their height and weight measured at school and this could be easily scaled up to include children from all year groups. Children identified as overweight could be referred to the scheme in complete confidence, and then monitored more frequently – possibly as part of a GP-incentive scheme, until the child reaches a healthy weight.

Everyone can gain

Schools could also receive incentives to take part. They could be awarded grants funded by the scheme or a healthier school environment could even be linked to Ofsted grading. Older children could receive personal reward vouchers for reaching their weight targets.

Tackling the food industry, however, is a bigger challenge. The food industry is made up of profit-making organisations – it is not enough to just recommend change. Industry needs financial incentives but it also responds to customer demand – and the demand for healthier foods would increase under the voucher scheme.

Much of the scheme would support itself financially, but any additional cost to the UK government would be more than offset by the long-term cost savings from reducing obesity. This system is about using government action to help make families become more aware of their lifestyle choices. It offers the potential for a joined-up approach – one that recognises the influence of the food and retail industry, and also offers financial support to schools and families.

Financial incentives have been shown to work – not just on smoking but also on changing consumption of foods – so much so that the UK government recently announced a sugar tax on drinks which is underway and proving successful in Mexico. The changes suggested here are merely an extended approach to the thinking behind this sugary-drink tax.

A more general approach to childhood obesity requires everyone to take responsibility for the health of children – families and businesses need real incentives to change behaviour. And this could be a positive step towards a solution for society to tackle childhood obesity. After all, we should aim to give children the healthy future they deserve.

Emma Frew is a reader in health economics, University of Birmingham and Bruce Hollingsworth is a professor of health economics, Lancaster University. This article first appeared on The Conversation (theconversation.com)