Society daily: 10.03.10

Why are the very poorest and most socially excluded people most likely to be unhealthy? Apathy it seems, plays a big part. When asked by researchers in a study published today what were the main barriers to a healthy lifestyle, over half answered: "laziness." The study, Reaching Out, also found "lack of money" was blamed by half the respondents for preventing them getting fit. One in five believed their unhealthiness was genetically inevitable, because all their family were in poor health too. And most didn't see their sedentary lifestyles and poor diet as risks to their health: 84% said "they did not really worry about their health at the moment."

The study of 258 "hard to reach" individuals in the North west of England (where 50% of the population is classified as 'deprived') by ourlife, Pfizer and NHS north west, suggests that this group was unaware that they were in poor health (or in denial about it). While rates of clinical obesity were high (26%) only 7% believed themselves to be overweight. When it came to alcohol there were similar findings: 40% regularly drank to excess; just 6% believed they were binge drinkers. There was slightly more self awareness when it came to nutrition: of the 72% that had an unbalanced diet, 59% realised they were eating badly.

But being unhealthy, suggests the report, didn't feel particularly out of the ordinary to many respondents: over half of those who were clinically overweight regarded themselves "as being as healthy as others in their community."

The NHS has struggled to improve the health of the worst off, and the report suggests it may not be best placed to conduct health promotion campaigns. Respondents felt the health service had little overall influence on their general health and lifestyles: most went rarely to their local health centre, believing the GP to be someone they go to only when acutely ill - not for health advice. Of the 16% who had visited their GP in the past year, the majority went to get certification for illness benefit payments.

Those surveyed were stubbornly ignorant of conventional health promotion campaigns. But they were receptive to the idea that financial incentives could change their lifestyles: the offer of free swimming and fitness classes was popular, as was the concept of fee vouchers for food and vegetables.