Could health-related interventions reduce overweight and obesity and increase employment?

This blog discusses the ASPIRE study, registered at the ISRCTN registry, which aims to help people who are unemployed or living with overweight or obesity to grow fresh produce, learn new skills, and improve their diet, physical activity and wellbeing.

Being obese or overweight and unemployed may result in a vicious cycle where individuals are unable to find and/or keep jobs and/or are unable to afford healthy nutritious food. The combination of obesity and unemployment is associated with an increased risk of serious illness, early death, low self-confidence, poor wellbeing and lower quality of life.

The recent COVID-19 pandemic has worsened the situation and highlighted the risks of being overweight or obese and unemployed. Obese individuals are at an increased risk of hospitalization and mortality and more people have become food insecure as a result of losing their jobs. Therefore, the significant social, health and economic impact of both conditions highlight the need for public health interventions and strategies to address obesity and unemployment together.

Physical inactivity and unhealthy diets are the main drivers of obesity in unemployed individuals. Unemployment has an immediate effect on food expenditure because people try to prioritize their essential needs when they have less money to spend. Fresh, local, healthy food is often expensive and requires more skills for preparation and cooking and specific resources for storage.

Female runner running in the park
Female runner running in the park
© Cultura / Arno Images / mauritius images

People living with lower income, poverty, or unemployment are also more likely to live in areas with limited safe spaces for physical activity and a higher density of food outlets selling energy-dense (high fat and sugar) but nutrition-poor foods.

Obese/overweight and unemployed individuals may be blamed for their condition due to the perception that the situation is controllable. A person struggling with their weight or wellbeing can have difficulties finding work due to a lack of self-confidence and feeling the pressures of stigma. A person who is sedentary and out of regular work may also struggle to maintain a healthy weight.

While obesity and unemployment are clearly linked, existing interventions and policies do not address obesity and employment concurrently using holistic approaches. More interventions and policies that support individuals with obesity to find and keep work are required. This will enable these individuals to afford healthier food options.

In addition, interventions that focus on improving the long-term living standards of low-income individuals have to be implemented with the added effect of reducing food-related health inequalities.

What is the ASPIRE model and why is it unique?

The Adding to Social capital and individual Potential In disadvantaged REgions (ASPIRE) project is an innovative project which will co-create a holistic model to reduce unemployment and obesity at the same time.

The model will be created and tested by a collaboration of 15 partner organizations in France and England with expertise in health, wellbeing and employment services. The project will target adults who are unemployed or living with obesity/overweight and will be implemented in seven sites in France and England.

The overall goal of the ASPIRE project is to give participants the support, skills and confidence needed to make healthier lifestyle choices for themselves and their families. The project will help participants grow fresh produce, learn new skills, improve their self-confidence, diet and wellbeing. By practicing a healthy lifestyle and learning new skills, individuals will be able to improve self-confidence, wellbeing and:

  • Reduce their weight
  • Increase activity levels
  • Obtain employment, volunteer or get into training
Fruit and vegetables arranged in a heart shape
Fruit and vegetables arranged in a heart shape
© lassedesignen /

How will we measure the impact and effectiveness of the ASPIRE project?

In order to determine the effectiveness of the ASPIRE model, researchers from Bournemouth University will carry out an evaluation using an approach known as ‘Realist Evaluation’ methods. The evaluation will examine which aspects of the ASPIRE model are working, for which participants or subgroups and in which circumstances. This will help to identify which activities within the model are effective, test approaches for scaling up, sustainability and how to adapt the model to different contexts.

Understanding how and why the ASPIRE model worked in different contexts is very important. This is because it will help stakeholders including local and national authorities, employment services and health service providers make better decisions about which ASPIRE activities are useful for supporting individuals who are unemployed or living with obesity.

What will the findings from ASPIRE mean to individuals, communities and the wider society?

The ASPIRE project will help to address social and economic stressors that underlie unemployment, overweight and obesity. The project will also support individuals, increase access to healthy food choices, promote regular exercise and build social interaction and trust. It will also create a network of food-based centers tackling unemployment and obesity.

In addition, by involving community members, any community looking to make healthy lifestyle changes will be able to adapt the ASPIRE model to help their community. Finally, the results from ASPIRE could help improve current health and employment services and inform local and national policies for reducing obesity and health inequalities.

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