Bradford Nov 2015 rutter distribution - Ecosystems Knowledge · Bradford Nov 2015 rutter...

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What%works%for%obesity?

Harry%Rutter%%@harryrutter

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Source:%The%Lancet, Volume%378,%Issue%9798,% Pages% 1202% I 1203,%1%October%2011

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Evidence.trajectories

Time

Hunch:based

Level.o

f.activity

Evidence:based

All%possible%interventionsEvidence%of%costIeffectiveness

Evidence%of%effectiveness

The.dangerous.olive.of.evidence…

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Source:%Swinburn et%al,%Lancet%2011

Evidence.base

Public/media/political.discourse

Political.mandate

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Source:%Swinburn et%al,%Lancet%2011

Evidence.base

Public/media/political.discourse

Political.mandate

Conclusions

• Obesities,.plural

• Structural,.societal.drivers:.obesogenic environment

• Avoid.excessive.focus.on.individual. level.behaviour

• Evidence.base.is.limited.and.skewed

• Conceptualise as.a.complex.system.problem

• “Does.it.contribute,.if.so.how?”.not.“Does.it.work?”

• Jigsaw.puzzle,.not.just.single.pieces

• Local.level.action.essential,.but.can’t.succeed.alone