Without education on labels, some fear scheme could widen health inequalities

Without education on labels, some fear scheme could widen health inequalities

Now that a single form of front-of-pack nutritional labelling has been agreed and embraced by manufacturers and retailers representing almost two thirds of the UK market, attention is now turning to the critical matter of educating consumers about the new scheme. Ben Cooper reports.

The UK launch of a single, hybrid form of front-of-pack nutritional labelling incorporating traffic light colours was enthusiastically greeted by a range of stakeholders. 

NGOs and health campaigners were delighted something they have long been pushing for is now a reality. There is also solid support for the UK government's new voluntary scheme among food retailers and a significant proportion of food manufacturers, with research from the Department of Health suggesting 64% of the market is now on board.

In addition, there is a strong consensus among those supporting the scheme that it must be backed up by a public education campaign about the new labels and what they mean.

Government and other research has shown consumers favour a single form of labelling and that the simple style of messaging embodied by the hybrid approach gives shoppers the best chance to make quick decisions on the nutritional merits of the foods they are buying.

However, while they may have the benefits of greater simplicity and comparative ubiquity, the new labels still include a significant amount of information and technical terms which consumers will need more help in understanding if they are to gain the full benefit of the new system.

At a seminar held on Tuesday (2 July) by the Westminster Food & Nutrition Forum on food labelling policy, a variety of different stakeholders stressed the importance of a consumer education campaign to support the new labelling system.

Opening the seminar, Professor Alan Maryon-Davis of the Department of Primary Care & Public Health Sciences at King's College London welcomed the new hybrid labelling system as "a crucial step forward" but said public education about the new labels was vital for the system to help tackle diet-related illnesses and reduce health inequalities. This echoes similar calls from health NGOs such as the Children's Food Campaign in response to the new labelling scheme.

Professor Maryon-Davis told the seminar audience: "There has to be a proper educational campaign around it so that people understand it and make best use of it. That is absolutely fundamental."

One of the major problems for policymakers with regard to public health is that it is generally harder to reach or influence those individuals who have the greatest need. Typically, public health interventions and preventive health measures are taken up more readily by the better off and have less impact on lower socio-economic groups which tend to have the poorest health. So they can simply add to health inequalities rather than address them. 

This is undoubtedly a risk with the government's new labelling system, Kate Mendoza of the World Cancer Research Fund (WCRF) suggested.

"Looking at labelling from a public health perspective research tells us that traffic lights and percent reference intakes are the best understood labels for all consumers," Mendoza said. "And I think that's a really critical point, because we do need to be a little bit wary that the introduction of these new labels could potentially widen health inequalities. We know from various studies that there is quite a bit of variation between who uses food labels and the people that are least likely to use them are the people who tend to be at higher risk of the type of health conditions that we are concerned with. So I think the education element that should go with the new food labels is absolutely critical."

Mendoza said the WCRF "would like to see a government-led education campaign which targets those who are at most need".

Also speaking at the seminar was Alette Addison, food information and promotions manager at the Department of Health. 

Alluding to the calls by Professor Maryon-Davis and Kate Mendoza for consumer education, Addison said: "We've already heard about the fact that we need to do some education. Yes we do, and we will do that. And the first thing to do is for us is to actually work out what our common messages are going to be so that whoever talks about the scheme, whether it be government, whether it be those companies who are pledging under the Responsibility Deal to do some public education work or the NGOs, we're all saying the same thing about the scheme."

Addison said the Department of Health was starting to work on establishing a "consistent framework" for messaging. 

Much has been made of the importance this government attaches to the engagement of companies in achieving public health objectives, most notably through the Public Health Responsibility Deal (PHRD). The PHRD now includes two pledges directly related to the new labelling scheme. Under Pledge7 (a), companies undertake to "adopt and implement" the government's recommended Front of Pack Nutrition Labelling Scheme, and under Pledge 7(b), they commit to "promote and explain" to consumers how to use the new labels.

It also appears some communication about the scheme may be undertaken through the government's Change4Life multi-stakeholder healthier lifestyles platform.

When asked for more information about the timetable for an education campaign, a Department of Health spokesperson appeared less definitive than Addison had been, declining to make any firm commitment about when or even whether a public education campaign would take place. 

The spokesperson said it was "very early days" with regard to a public education campaign, that one "brainstorm" meeting had been held on the subject and "nothing concrete" had been decided.

In slight contradiction to Addison's comments on Tuesday, the spokesperson would not confirm definitively that a consumer education campaign would be mounted. "I couldn't say right now because we're still in discussions about having one. So I couldn't say concretely whether there is going to be one or not. It's very early days in terms of the discussions that are taking place," the spokesperson told just-food.

In conclusion, the spokesperson said the Department's position is that there are "early discussions about the possibility of doing something" but "there's nothing set in stone". The spokesperson also alluded to the possibility of companies engaging in their own communication work under Pledge 7(b) but could not provide further details.

The spokesperson said work was ongoing to set out a standard way of explaining what the labels mean. "As part of our links to industry through the Responsibility Deal and our Change4Life campaign we will shortly set out messaging to be used as a standard way to explain what the consistent front of pack food label is and how people can use it," she said. "We are currently planning this and hope to publish it later in the year."

Given the difficulties in reaching precisely the consumers at most risk, a degree of deliberation about how a consumer education campaign might be best structured appears justified.

The Department of Health is clearly in good odour right now with the public health community on front-of pack labelling. Professor Maryon-Davis pointed out that some have been campaigning for colour-coding for almost thirty years. However, the government is likely to be afforded only limited indulgence on the further question of public education. The message from medical professionals and health NGOs is clear. Backing up the new scheme with a public education campaign is crucial and needs to be an immediate priority.