The United Kingdom’s health looks increasingly frayed and unequal. Even prior to the pandemic, people were living more years in poor health, gains in life expectancy had stalled, and inequalities were widening. This has a costly impact on individuals, communities, public services, and the economy.

There are stark warning signs that government needs to shift its approach to improve health. Rates of childhood obesity have risen sharply in recent years and inequalities have widened. Smoking remains stubbornly high among those living in more deprived areas. Alcohol-related hospital admissions and deaths have increased and rates of harmful drinking have gone up. Physical activity levels also remain low and appear to have declined during the pandemic. 

This report reviews government policies to address these risk factors in England between 2016 and 2021. The authors assess the government’s approach and identify future policy priorities, finding that:

• government has relied heavily on policies aimed at changing individual behaviour  
• the approach has been uneven across risk factors, with particularly weak action on alcohol  
• decision making across departments has been disjointed, undermining health improvement targets.