The government’s new public health strategy for England, Healthy Lives, Healthy People,1 is a welcome commitment to protecting and improving health and reducing health inequalities. Action is clearly needed. Although people are generally living longer, the overall burden of chronic physical and mental ill health is increasing,2 and the poor are worse off than the rich. If, as some have predicted,3 the recent comprehensive spending review affects the poor more than the rich, this is likely to be exacerbated⇓.4

The strategy, which promises to be radical and new, is evidence based and rooted in an approach that engages and integrates the efforts of national and local government, the NHS, charities, schools, higher education, voluntary groups, businesses, and employers. The strategy accepts a place for government leadership and, albeit when other approaches have failed, for regulation. However, it takes the view that the balance of responsibility and action should shift from central government to local communities, and that people should be “nudged” towards taking on more responsibility for their health by living more healthily. A cabinet subcommittee has been established to engage relevant government departments, and the strategy includes an encouraging list of related initiatives.

In the spirit of national engagement, county and unitary local authorities …