Public Perspectives on healthy living in Richmond

Healthwatch Richmond was commissioned by Richmond Council’s Public Health Division to undertake research to influence the local authority’s healthy lifestyle offer and public health campaigns to support good health and reduce ill health in the population of Richmond. Furthermore, the findings will inform the work of the Public Health division and other council teams, and other health and care partners in Richmond. They undertook a survey and focus groups, receiving 815 responses.

Results indicated that interpersonal relationships such as social networks and family can influence a person to adopt healthier lifestyle behaviours. Another common influence on peoples’ behaviour was the advice of a healthcare professional.

Residents reported their motivations such as preventing disease and healthy ageing, maintaining or improving their health, or improving their appearance as the main reasons why they would consider making changes. Social factors, such as avoiding modelling unhealthy behaviours or reducing future caring burdens on family were also mentioned.

A common barrier to adopting a healthier behaviour was the limited access to and affordability of healthier food and gyms. Cost and access were also factors for alcohol consumption with limited availability of non-alcoholic alternatives at social events.

Time and cost required to prepare healthy food or to being physically active was also frequently cited as a barrier. Cost was most frequently cited as a barrier to being physically active and eating healthily by people who struggle to fund their basic necessities compared to people with a ‘fair amount of disposable income’.

People spoke about lacking motivation due to habits and cravings, in particular with regard to food choice, alcohol use and smoking. Lastly, respondents reported a lack of opportunities to socialise without the social pressure to drink alcohol and/or smoke.

Residents offered potential solutions that would help them adopt the healthy living behaviours asked about in the survey. The most common solutions were around social motivations. People would listen to family, friends or co-workers encouraging the behaviour, whether it was healthy eating, physical activity, modifying their alcohol consumption or not smoking. Another solution was shifting their self-belief or motivation to be able to adopt a certain behaviour. The other common solution cited was receiving adequate and/or scientific information on the benefits of different foods and not drinking excessive alcohol.

Solutions related to cost and affordability were proposed by respondents in relation to healthier eating and structured physical activity, particularly by those who were financially disadvantaged. Often cost and access were linked, for example better availability of lower priced alcohol free alternatives, easier booking of cheaper council exercise facilities, or easier access to affordable groceries.

The findings reported by at-risk groups indicated that barriers to accessing, or the availability of, healthier food were more frequently cited by people who were financially disadvantaged. Financially disadvantaged people came from a range of demographics, employment, and occupational statuses. A quarter of people from minority ethnic groups, including a third of people describing themselves as Asian, disproportionately referenced cost as a barrier to adopting a healthier diet.

People with disabilities reported more often that they faced emotional and psychological difficulties in changing their diet to be healthier compared to people without a reported disability. They also more frequently cited disability and fatigue as a barrier to being physically active. Despite these barriers, they reported that they are motivated to change their physical activity to maintain or improve their health.