The Royal Society for Public Health (RSPH) has today released an end of year list revealing the top 20 UK public health achievements of the 21^st century so far, as voted for by public health experts.  

To accompany the results, RSPH has produced a video counting down from 20^th to first place (see the full ranking below). The top three positions were won by:

1. The smoking ban
2. The Soft Drinks Industry Levy (‘Sugar Levy’)
3. The Marmot review into health inequalities and understanding of the social determinants of health

The smoking ban claimed a landslide victory in our polls. Following the Health Act in 2006, the ban on smoking in enclosed public spaces and workplaces was introduced in the UK and came into full force across all four nations by July 2007. The ban has had a profound impact not just in reducing harm from passive smoking, but also in driving the de-normalisation of smoking in public. It set a new precedent for the rights of individuals not to be poisoned by second-hand smoke, and this has been reflected by increasing public support for the law – it is now even backed by a majority (52%) of those who smoke every day.  

In second place was the Soft Drinks Industry Levy (SDIL), otherwise known as the Sugar Levy. Introduced as part of the government’s childhood obesity plan in April 2018, the levy is a tax on the soft drinks industry based on the sugar content of their products, such as Coke and Irn Bru. The levy has so far encouraged product reformulation, with the Public Health Minister reporting at the time of its launch that nearly half of the soft drinks market had been proactive in reducing sugar in their products to avoid charges. The levy also signalled a shift towards greater recognition of the role to be played by the food and drink industry in enabling healthier choices. 

Coming in third was the 2010 Marmot review into health inequalities, which made a strongly evidenced case that health inequalities have social determinants, and that health and wellbeing were just as important measures for society as economic growth. While not being as well-known among the public as other entries to the ranking, the Marmot Review marked a real agenda shift for those working in public health. It reframed the narrative around determinants of health, and established a political imperative to tackle inequalities from a health perspective.

The full results are:

1. The smoking ban
2. The soft drinks industry levy (‘sugar levy’)
3. Marmot review into health inequalities and understanding of the social determinants of health
4. Sure Start children’s centres (2000-2010)
5. Minimum Unit Pricing on alcohol in Scotland
6. HPV vaccination for boys and girls
7. Congestion charge and ultra-low emission zone
8. Decriminalisation of abortion in Northern Ireland
9. Wellbeing of Future Generations Act in Wales
10. Tobacco advertising bans
11. Traffic light labelling on pre-packaged food
12. Transferral of Public Health into Local Authorities
13. Scores on the Doors food hygiene ratings
14. The Time to Change Campaign, run by Mind and Rethink Mental Illness
15. Fixed-odds betting terminals stake limit reduced to £2
16. Introduction of childhood flu vaccine
17. Reduction in homelessness between 2003 and 2009
18. Junk food advertising ban during kids TV and across London transport network
19. Drug safety testing at festivals and nightclubs
20. Cancer screening improvements

Shirley Cramer CBE, Chief Executive of RSPH said: “As we head into the 2020s, this festive period we wanted to look back and celebrate the major public health achievements of the first twenty years of the century. We spend so much time discussing what needs to be done – and rightly so – but sometimes it is also important to reflect on how far we have come. This ranking really shines a light on the fantastic and inspiring progress that has been made through public health in the last two decades, and unambiguously makes the case that prevention is better than the cure.

“In the Health Secretary’s first ministerial speech under the new Government, he declared an intention to ‘make the 2020s the decade of prevention of ill-health.’ Now is the time to work together, and make this a reality.”