Episode 30 - Public Health, Prevention and Who Shapes Our Health?
Summary In this episode, Ollie is joined by Greg Fell OBE, Director of Public Health for Sheffield and President of the Association of Directors of Public Health, to explore one of the biggest questions in health today: how much responsibility for health sits with individuals and how much is shaped by the systems around us? The conversation explores the relationship between personal agency, health coaching and public policy, challenging the idea that behaviour change alone is enough to improve population health. Greg shares why creating environments that make healthy choices easier is just as important as supporting individuals to make change. Together they discuss obesity as the "new tobacco", the growing influence of the commercial determinants of health, and what can be learned from decades of successful tobacco control. They also reflect on why prevention often goes unnoticed, despite quietly improving lives over many years through policy, community action and healthcare. The discussion moves beyond healthcare into workplaces, employment, lifestyle medicine and physical activity, highlighting how health is shaped by much more than medical care alone. Throughout the conversation, a recurring theme emerges: lasting change happens when individual support and system-level action work together, rather than being seen as competing approaches. Whether you work in healthcare, public health, leadership or simply have an interest in creating healthier communities, this episode offers a thoughtful and balanced perspective on what it really takes to improve health at both an individual and population level. Takeaways Health outcomes are shaped by both personal choices and the systems people live within. Health coaching and public health are complementary approaches, not competing ones. Creating healthier environments makes behaviour change more achievable. Obesity is becoming one of the biggest public health challenges of our time. The commercial determinants of health play a major role in influencing behaviour. Prevention often goes unnoticed because it prevents problems before they happen. Long-term public health successes, such as reducing smoking rates, have relied on sustained policy alongside individual support. Work, housing, income and transport all have significant impacts on health and wellbeing. Supporting people's agency is important, but so is creating environments that enable healthy choices. Physical activity remains one of the most powerful tools for improving health across a population. Lasting change requires collaboration across healthcare, communities, employers and policymakers. Further Reading During the conversation, Greg references the following report from Nesta on obesity policy: A Blueprint to Halve Obesity in the UK