I admit I may be prejudiced. I don’t wear suits, (well, very, very rarely) and I’m not a bloke.
But I’m here to warn you.
Beware meninsuits at public health conferences.
These dapper-dressed salesmen traverse the conference circuit, ready to pounce on exhausted commissioners with their eye-catching presentations and glittering brochures.
If you’ve ever attended a public health conference, you’ll know what I’m talking about. As these meninsuits approach the lectern, you sit back, ready to be entertained, amazed, interested for the next ten minutes. It’s not a lecture about obesity, it’s not a plea for you to fund research into this or that disease. Instead, the meninsuits turn on their presentations, look up with a dazzling grin, and brandish their ‘solutions’.
Their presentations are full of smiling people – smiling obese kids exercising, smiling alcoholics not drinking, smiling pregnant mothers not smoking – and the audience smiles too, relieved. It’s the relaxing bit of a public health conference; no need to worry, no pressure. A time to relax and allow their enthusiasm to wash over you, until the next speaker asks again why nobody wants to fund prevention.
Why we love them…
Why do we love to listen to them?
They have answers.
They have solutions.
Sometimes, they come with evidence (although more commonly it is promises of evidence) – they are smart enough to know that we expect that now.
In a world where we often concentrate on problems (the increase in obesity, the smoking figures that stubbornly refuse to fall to zero, the wicked health inequalities that persist despite our years of work to address them), meninsuits bring clarity and optimism. They bring panaceas.
The problems we face – inequalities, obesity, smoking, mental health, loneliness, social capital – are complex. Yet these meninsuits tend to tell us that there is one cause of <insert public health problem> and therefore one solution (theirs, if you buy it!). This is palatable, easy to digest – but let’s be realistic. You will not, to pull an example out of thin air, increase children’s exercise by funding a one-off six-month programme. Guaranteed. You might increase a few children’s exercise for those six months. But long-term, population-level change – the kind of change that’s needed to reduce obesity in any meaningful way – will not happen with these discrete off-the-shelf solutions.
The meninsuits are smart, they know now that we expect evidence. But evidence of success – even objective, trustworthy numbers – can be easy to construct. And, even when the evidence is rock-hard, too often these programmes have just targeted the ‘low-hanging fruit’ (those who are the easiest to target, i.e. middle class and well-educated families). Inequalities are not a priority.
Who’s thinking long term? Not them!
The meninsuits are not interested in sustainable change. They and their organisations come in, carry out their project, demonstrate success to the local NHS, then leave. They have little interest in building sustainable programmes that can carry on when they leave – that would simply put them out of business.
I worry they are simply selling us snake oil.
I worry we’re falling for it.
I worry for the NHS.
I worry for public health.
Remember rule #1 of public health – there are no panaceas.
Image of Parker’s Tonic – source: John and Jane Adams Trade Card Collection, Digital Projects at SDSU Library
Image of snake oil bottle – source: Russell Davies