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CHOOSING HEALTH
Making healthy choices easier
Executive Summary
Working in partnership across government with people, their
communities, local government, voluntary agencies and business
1
CHOOSING HEALTH EXECUTIVE SUMMARY • 2004
EXECUTIVE SUMMARY
Introduction
1. England has a proud history of improving the
health of its people. Over the past three centuries,
the combined impact of individuals, families,
communities, national and local government,
education, business and industry, and voluntary,
faith and charitable bodies has seen unthought of
progress in the health of the people of England.
2. Some of that progress has been driven by wider
social, economic, environmental and cultural
trends as England benefited from economic
growth, improving education, better housing and
better sanitation. In the twentieth century health
services also began to make a significant impact,
gathering pace after 1948 as the establishment
of the NHS enabled free universal provision of
immunisation, screening and treatment to make
inroads into ill health and premature death.
3. The role of Government in the prevention of
illhealth during this time was often a topdown
approach, reflecting the cultural and political
relationships of the times. In the post war era of
deference in a homogenous society, ‘Public Health’
was often seen as something that was done to the
population, for their own good, by impersonal and
distant forces in Whitehall and the public bodies
and professionals that it directed, with varying
degrees of success.
4. As rapid progress was made on the big killer
infectious diseases of the past, more intractable
issues and conditions such as cancer and coronary
heart disease came to the fore. The absence of
obvious simple, quick solutions to these diseases
and the increasing preoccupation of the NHS in
coping with rising demand for treatment, meant
that too often public health was diverted into
better analyses of the