FOREWORD

Julia Golding
Award-winning author

Dystopian fiction has a way of holding up a mirror to our own times. It sends a chill down the spine – a sense that, if we don’t do something in the here and now, then we might (or our children’s children might) find the world is living through the prediction.

What we see in dystopian fiction is never comfortable because it seems so possible. We are all familiar with the evergreen 1984 by George Orwell that finds new relevance for every generation with its Big Brother surveillance and Newspeak. More recently, The Hunger Games, Divergent and Maze Runner have dissected reality TV and genetic selection for a Young Adult audience. As young people have the greatest stake in what is their future, it is no surprise that this is a genre they are drawn to, so they can work out their anxieties and their hopes in the safe zone of a story.

A well-written tale also has the possibility to turn us away from the very thing we fear. Cries of ‘fake news’ can be challenged as political Newspeak. The push for designer babies can be questioned by reference to Huxley’s Brave New World. Or, to put it another way, by revealing what might happen in fiction, the bomb is defused in time, perhaps with the clock at 00:01 in best thriller fashion. It doesn’t explode as predicted because we become aware of the problem and take action.

So it was very exciting to hear that the Royal Society for Public Health and the Health Foundation had decided to take an unusual path to raise awareness about current health issues and their causes, ranging from obesity to poor housing and social inequality, and where they might lead us in the future. How better to engage young people in the issues than by dramatizing what happens if we don’t act? We can’t let these problems start the clock on their countdown to ruining lives.

It was an honour to be invited to sit on the judging panel with other creative and health professionals. The invitation came because I already have a track record of writing for children and young adults. I’ve tackled big issues in fiction, from climate change, to religious bigotry, to economic collapse. I also have a professional background working as a policy adviser for Oxfam so I have given thought to poverty related-issues. Health was not something that had yet been on my radar and I thoroughly enjoyed reading the entries that made the final cut.

Picking a top three was difficult because the subject matter is vast and the approaches so different. Each story had its merits. Our judging panel had diverging views but, after a morning’s discussion, we settled on our winners. They form a group that covers a wide variety of issues, but they all share strong and engaging writing, a thrilling plot and thought-provoking content. Sky Park deals with health inequalities in a clever twist that I won’t spoil here, and caught my attention for its wonderful ending. The Surgery is a chilling insight into a world where weight control operations are performed like backstreet abortions – gritty and memorable. The overall winner, What You Want, is a brilliantly funny and well-imagined story about a world where only the rich can protect themselves from a diet of unhealthy advertising. It’s so original and I, and everyone on the judging panel, loved it.

Please read and enjoy these wonderful stories. I hope they make you laugh, shiver and, finally, think about where we are going as a society. Don’t forget: the clock is ticking…

ABOUT THIS PROJECT

The Health: From Here to Where? short story competition was launched in April 2017 by the Royal Society for Public Health and the Health Foundation.

Too often when people talk about health, their thoughts jump to issues around health care. But the picture is much bigger than this. We want to change the way we talk and think about our health, and steer the conversation towards the other factors that have an impact on health and wellbeing. These factors are largely outside of our individual control and include things like good work, housing, education, money and resources, our surroundings, and our family and friends.

To do this, we launched a dystopian short story competition. Writers were invited to fast forward 10, 20, 50, 100 years and imagine what the future might look like if we don’t take action now on the factors that shape our wellbeing and health. After receiving almost 100 entries, our judging panel selected one exceptional winner and two highly commended runners up, which you can read or listen to on this website.

Royal Society for Public Health  I  The Health Foundation

Project funded by the Health Foundation

Design and development by Soapbox

Privacy policy

SYNOPSIS

In the near future a boy is kept from his homework by an interactive advert in the shape of a virtual dog intent on selling him unhealthy snacks. Adverts invade the home. Automation and distance working mean families struggle with low income, interrupted supervision of children, poor quality housing, poor physical fitness and unsafe streets. Monstrous hacked adverts threaten the boy’s financial future though his wealthy peers are safe. Before his school closes down, to be replaced by ‘cost-effective’ distance learning, his teacher finds a way to help him to think about what he really wants.

Listen to What You Want on Soundcloud — voiced by BAFTA-nominated actor Michael Sheen — or read on below...

WHAT YOU WANT

by Tim Byrne

IT was early when the virtual dog appeared in his room. It sniffed and prowled in circles, stepping over Jay’s socks before springing onto his bed and weightlessly creeping over the boy’s sleeping form. It was time for him to wake up. The dog gave a gentle growl. Jay woke with a start, his heart racing.

I haven’t done my homework. He threw off the covers and struggled to sit up. There still might be time before school.

A soft, wet nose nudged his hand. The virtual dog had been scattered into pixels when Jay threw back the covers and it had only just reassembled itself in its place beside his bed. The dog was beautiful, a chocolate brown Labrador with a proud, sensitive face, full of canine intelligence. She nuzzled Jay’s hand, giving him a long look of concern. Jay petted her gently and she reacted to the attention with shudders of delight.

The dog grabbed something from under the bed and held it up helpfully, her eyes full of love. She was holding a fresh bag of Fryzzlies in her mouth and she wagged her tail. The brightly coloured bag crackled invitingly and Jay could almost taste the salty, sweet, spicy flavours on the flat of his tongue.

A tiny, triangular Buy Now flag appeared on top of the dog’s head with the sound of a tiny bell ringing. Jay automatically reached out to touch the flag and buy the snacks but caught himself before it was too late. If he spent all his credit on Fryzzlies he wouldn’t have anything else to eat until tomorrow. The dog saw him hesitate and whined pleadingly, rustling the bag of snacks.

“I’m sorry,” said Jay, “I can’t today.” The dog dropped the snacks, bowing its head in despair. “Don’t be like that,” said Jay. “I’ll buy some more soon, I just can’t afford it right now.” The dog slunk away to curl up in the corner of the room and Jay took a second to shake off a pang of guilt. The dog was only an advert trying to sell him Fryzzlies but its disappointment seemed very real.

I haven’t got time for this, he thought, pushing the covers aside. He had to be careful where he put his feet because another set of ads were busy fighting a battle on his bedroom floor.

A miniature figure of a Roman centurion was organising his troops into a circle on top of Jay’s crumpled trousers, as an army of green muscle-bound monsters charged to surround them. The soldier, no bigger than Jay’s little finger, looked up to Jay and yelled.

“Sir Giant! I beg you to come to our aid! The Shadow Hoard are upon us and we, your very own legion who have been loyal to you these many years, now seek your help...”

“Nope, sorry,” said Jay. He was still a little too fond of the years he’d spent playing The Last Legion to unsubscribe from the ads but he didn’t have time for them either. He shook the tiny screaming soldiers off his clothes, ignoring their pleas for help but making sure he didn’t tread on their Buy Now flags as he got dressed.

Homework, he thought. Do your homework and get to school on time.

Taking his phone from beside the bed, Jay headed for the bathroom. Ads played across the mirror as he washed his face. Tiny arrows pointed out his pimples. His reflected image warped and magnified his spots, even suggesting where he should scrub harder.

The ad in the mirror was for a tube of Zitt-ageddon. Another Buy Now flag appeared and this time it looked like it was sticking out of the biggest, reddest spot, right in the middle of his chin. He kept his hand well away from it and ducked down to splash water on his face.

When he looked up from the sink again he saw dozens of people looking back at him from the mirror. They were all his friends from school and quite a few of his enemies too. It looked as though they were standing right behind him in his own bathroom and all of them were looking at his spots with expressions of horror and disgust. It was so realistic that he looked around to be sure that he was really alone.

That’s a new one, he thought, peering at the ad on the mirror. It’s just stuff from everyone’s Social Channels though; they don’t really see me like that, do they?

As he brought his hand up to hover over the Buy Now flag, the cost flashed before his eyes. If he spent his credit on the spot cream he’d have to do more than just miss a meal to pay it off. Reluctantly, he touched the little flag anyway and the faces in the mirror changed at once, their looks of horror transforming into warm smiles and confident nods of approval.

It’s worth it, he thought.

Grabbing his phone, he headed back towards his room to get his bag but he only managed a few steps before he felt a strange softness underfoot. He stopped. The floor of the hall outside his bedroom was covered with emerald green blades of grass.

Jay could feel the grass beneath his bare feet and he crouched down to touch it. The sense settings for this ad were turned right up to maximum and Jay wondered what it was trying to sell him. He looked closer but instead of a red Buy Now flag there was only a little blue Information flag at the corner of the patch of grass.

Puzzled, Jay touched the flag and immediately heard the sound of a voice: “Remember how good it felt to play outside? It’s good for you too. This moment was brought to you by The Ministry of Health and Wellbeing.”

Jay released the flag with a shake of his head. Like I’m actually going to play out around here, he thought. But he paused, crouching in the grass. A cool breeze of simulated fresh air blew over the virtual patch of greenery.

In the quietness of the moment he remembered his homework once more and without moving he blinked three times to start his Blinkwriter app, winking once to create a new document. An empty white page appeared hanging in the air in front of him complete with a virtual keyboard for writing.

He let his gaze fly over the letters. The system had learned to read the tiny movements of his eyes years ago and now it worked so smoothly and effortlessly that it almost felt like it was reading his mind.

But as he put a title on the new page, the document, the keyboard and the grass beneath his feet all vanished. The breeze disappeared and a mustier, damper smell invaded his nostrils. Underneath his feet the grass was gone and there was only the threadbare carpet of the bathroom passageway once more. He looked into his room. The ads were gone, the soldiers of The Last Legion had vanished and the Fryzzlies dog was nowhere to be seen.

On the ceiling of his bedroom he could see black stains of mould, gathered by the damp. The ads and projections usually covered up anything that might distract him from buying stuff, anything like the filthy ceiling or the ancient carpet.

My bubble’s been popped, he thought.

He looked down at his phone to see what was wrong. His internet connection was still working and the phone’s battery was full. There was no reason why it shouldn’t still be projecting his virtual bubble around him. He looked down the hall at the only other door besides the bathroom and then he realised what was happening.

“Mum!” he called, “Linnet’s using a jammer again!”

Linnet’s door flew open and she glared at her little brother furiously, “Shut up Jay! If you don’t want your bubble popped then stay out of my air space.”

“It’s illegal to jam the internet,” said Jay.

“Actually it’s not,” said Linnet, “it’s just against the Terms of Service.”

“Same thing,” said Jay. “If you get caught jamming they’ll cut you off. You won’t even have email anymore, let alone Social Channels.”

“Listen,” she said, “maybe when you’re a bit older you’ll understand how valuable it is to have a little bit of privacy but for now please take my word for it.” She was doing the big-sister move that annoyed him the most, acting all superior just because of the measly two-year age gap between them.

“I hope you do get cut off,” said Jay, “You’ll have to beg me to message your friends for you. You’ve hardly got any anyway, you’re so extreme about this privacy stuff. Most people think you’re a freak.”

Linnet didn’t move away but she looked down at the floor. Jay knew he’d gone too far. “I’m sorry,” he said, but it was too late. “I didn’t mean that,” he said as she slammed her bedroom door.

After a second the grass reappeared under his feet as the internet came back on. The Fryzzlies dog padded out of his room looking sympathetic and offering a fresh packet of snacks.

Jay grabbed the Buy Now flag, sending the dog into a frenzy of thankful wagging and nuzzling against his leg. Jay picked up the snacks and wolfed them in one go. It would put him into minus credit but Mum and Dad weren’t going to let him starve, no matter how furious they might get about him overspending. Quickly getting his schoolbag, he went through into the kitchen to see why his mum hadn’t answered him.

Jay’s mum was sitting at the kitchen table, busy with work. She’d probably only just got up because she was wearing her old dressing gown and slippers, not that whoever she was talking to would be able to tell. Her face was covered with virtual projections of expensive makeup; a neatly pressed blouse was projected over the top of her shoulders making it look like she was properly dressed. A view of a busy office was projected in the air behind her, covering up the view of the kitchen cabinets. Her phone lay on the table in front of her, controlling the whole illusion.

Jay’s mum worked as a personal attention assistant. Her job was to add human attention to communications when it was needed, usually when a company wanted to deal with a complaint from someone rich. There was huge competition for the kind of work she did so she was on-call day and night hoping for an opportunity. It was a difficult job. If she didn’t respond quickly when a call came in and succeed in soothing the angry client completely, she wouldn’t make any money at all.

Despite making careful apologies to the person at the other end of the line she managed a glance in Jay’s direction. Out of sight from the video caller she pushed a plate with a few slices of slightly burnt toast across the table towards him. The call must have come in when she was about to have breakfast but there was no way she could eat anything now until after she was done. Jay picked up the toast thankfully and squeezed her hand.

“I understand completely, Mr Corvus,” said Jay’s mum. “Of course, we’re so sorry for any inconvenience, please let me look into that matter for you.”

Dad will be back at the weekend, Jay thought as he left, closing the front door behind him. That’s something for us all to look forward to.

Jay’s dad worked in a part of the city that was so rich they still employed human street cleaners instead of robots. He had to stay overnight, six nights a week, sleeping in a mobile van full of bunks that was moved around to be close to the streets the team had to clean. The rich seemed to think it was kind to hire actual human beings to clean up after them but Jay’s dad said they just liked seeing poor people do their dirty work. It made it easier for the rich to think that they were so much better than everyone else.

Out on the street Jay thought about his homework again but he didn’t dare open his Blinkwriter while he was walking. He didn’t really have anything anyone would want to steal but that didn’t mean that people wouldn’t try to rob him. The best way of avoiding trouble was to stick to pavements that had full surveillance. This meant that he had to walk straight through the crowds of ads projected under every streetlight. They could be annoying but that was a small price to pay for staying safe.

Street adverts came in all shapes and sizes but usually they looked like people with beautiful smiling faces because they only had a few seconds to capture your attention before you could get away. Some of them were programmed to act in more dignified ways and wished him a cheery good morning as he passed by, but there were always a few that would shamelessly do anything to get noticed. Sometimes they tried to block your way, yelling at you or whispering urgently about whatever special offer they were selling as though they were passing on an exciting secret.

The virtual dog bounded ahead of Jay barking at the other ads, trying to scare them off. Jay smiled grimly at this; he knew the dog was only trying to make sure he saved his credit for buying even more Fryzzlies later on, but he couldn’t help feeling grateful to it for trying to clear the way.

He was more than halfway to school when all the ads suddenly froze, glitching and shimmering before restarting and restoring their cool charming smiles. Jay stopped and looked around warily. Something was wrong.

There was an enormous roar. Shock and terror rippled through the ads on the street and looks of panic crossed the faces of both the virtual creatures and the few real-life human beings they were targeting.

With a deep-throated bellow, a giant virtual monster burst from the projectors that surrounded the armoured corner shop at the end of the road.

It looked like a hideous combination of a Tyrannosaurus Rex and a World War II tank. Glowing red eyes glared all around, picking out pedestrians with red beams of virtual light. Its muscular animal body rolled along on a base of metal tank treads. Dozens of long, sinuous arms lashed out, hurling innocent ads out of the way while the humans ran for cover. The monster threw back its enormous, crocodile-shaped head and roared.

Its long grasping claws were bristling with hundreds of tiny red Buy Now flags and Jay watched in horror as the monster thrust its talons straight through the bodies of a group of boys up ahead of him, draining them of their credit and leaving them shocked and penniless.

“It’s hacked!” someone shouted, “Run for it!”

Jay turned and fled with the others as the monster’s treads spun into life and it thundered rapidly down the street towards him. Normal ads couldn’t defend themselves as the hacked code of the virtual monster invaded them and stole their credit as well. Orange Error Warning flags popped up all over them like needles sticking out of pincushions.

Jay had grabbed the dog as he ran. Carrying the terrified virtual creature in his arms made it harder to run. Not that running came easily to him. The last time Jay had run at all was in primary school, before his asthma diagnosis meant that he could get out of sports and PE. He was wheezing and panting after a hundred metres. His chest was burning from the effort of running and the dog whimpered pathetically in his arms. Even in its desperation it produced a bag of Fryzzlies and waved them in Jay’s face.

“Not now, stupid!” whispered Jay, but he was running out of steam and the screams of the ads behind him were getting closer. His vision blurred. I’m going to have my credit drained! he thought in panic. I’ll be paying this off for the rest of my life! He crouched down, shielding the Fryzzlies dog in his arms, as if that mattered. There was nothing he could do to defend himself or the dog against an attack like this. He closed his eyes.

He waited for the roar of the hacked advert but there was nothing but the sound of his own breathing. In the distance he heard the sound of a bird chirruping.

“Hey,” said a voice, “are you alright?” Jay looked up. It was Robin, one of his friends from school.

“What happened?” asked Jay weakly.

“I connected you to my private internet service instead of your free one. Looks like there was a hacked ad on the loose but I’ve got ad-blocking so it doesn’t affect me.” said Robin.

“Why am I not surprised?” said Jay. Robin was a rich kid whose parents only sent him to Jay’s school because they didn’t believe in private education. Of course his parents could afford to pay for ad-blocking.

Jay looked around at the street. There weren’t any ads at all, just a few people in various states of panic as they talked to their friends on their Social Channels about the hacking attack. “This is what the world looks like for you?” he asked. Robin shrugged and helped Jay back to his feet.

“Um...yeah. What else would it look like?”

“Busier,” said Jay. “More dangerous and a lot harder to do your homework in.” He tried to sound casual about the hacked ad but his heart was still racing from the panic and he was out of breath from running. The Fryzzlies dog had vanished.

“Walk in with me,” said Robin, helping his friend up. “Maybe I can help you with the homework thing too. I’ve got Ask-All Pro, if you need to research something, it gets me access to news sites, the real ones, not just ads pretending to be news.” A plain text search box appeared in the air in front of them along with a Blinkwriter keyboard.

“Thanks but it’s not that kind of homework,” said Jay. “It’s something for Miss Swift. She set us this dumb writing thing. I want to do it but I just can’t seem to get around to it.”

“What is it?”

“She just told us to write about what we want.”

“What, like what you want for your birthday?”

“No like what we really want, like what do we want to do with our lives.”

“Maybe you can finish it at lunchtime?” suggested Robin.

“Maybe,” said Jay, his tummy growling at the mention of lunch.

They arrived at the school gates and Jay breathed a little easier. There wasn’t any internet access allowed on school grounds except for the stuff managed by teachers.

As soon as Jay’s phone separated from Robin’s internet access and connected to the school system it buzzed with a notification: he was late.

Jay’s first lesson was art where Mr Martin had them using pencils and real physical paper instead of virtual tools and projections. Jay found himself just as frustrated as everyone else that there was no way to completely undo anything that you’d done. It was horrible in some ways but the pencil felt good in his hand and Jay didn’t want to stop. Mr Martin let them carry on through lunchtime if they wanted to. Jay couldn’t afford lunch anymore anyway.

The school was overcrowded and it was getting pretty run down. Without ads there were no projections to hide the sorry state of the building. There was a basic timetable for lessons but there was no system to help you manage your friendships and contacts so you always ended up mixing with random people. Despite it all, Jay liked it. The school had a busy energy to it that was fun in its own way. He still didn’t manage to do his homework but there was no point worrying about it anymore, he was too busy.

Miss Swift’s English class was the last one of the day. The chatter in the classroom stopped as she arrived and everyone sat up. Most teachers couldn’t really compete with gossip about the stuff on the Social Channels but Miss Swift was always interesting

Today however she looked unusually tired and went straight to her desk at the front to sit down. Usually she stood at the front and talked for a bit then walked around looking over people’s shoulders and chatting to them while they worked. Today was different though; she stared up at them and forced half a smile.

“How many of you managed to do your homework?” she asked. “Wait, don’t answer that. It was a little unfair of me to ask you something like this. Working out what you really want is probably one of the hardest things in the world. Most people never really come up with an answer, not one that is true for more than a couple of hours anyway.” There were some smiles around the room and sly looks of relief.

“I’m not going to ask you to share anything you wrote or even to talk about it,” she said. “If you managed to write something down then you’re way ahead of the game and what you’ve written might be the most important thing in the world to you. It doesn’t mean that it will help anyone else though, not necessarily.”

“If you weren’t ready to write about what you want, then that’s OK too,” she continued. “But these days we get asked about our desires more than ever before. Every time an advert offers you something, someone is trying to take control of what you want and dealing with that can take your choices away from you. So as far as I’m concerned, everyone who managed to even think about this homework at all gets top marks for it. I don’t even need to see it. This one was just for you.”

Miss Swift shook her head sadly. “Every homework was always just for you, actually, though I’m sure it didn’t always seem that way. Our job here was just to try to help you.”

She examined the children sitting at their desks. “Somebody should at least ask you what you really want and tell you that if you don’t decide then all those carefully targeted ads are going to make your choices for you.” She bit her lip.

“I shouldn’t be telling you this but you’re going to find out soon enough anyway and I’d rather you heard it from me.”

A deeper silence filled the room as everyone stared at Miss Swift, waiting. “Our academy’s corporation has voted to change over to fully electronic learning. It’s a lot cheaper, mostly because they won’t need to bother with school buildings or people like me. You’ll still get an education but you won’t get it at a school, you’ll do everything from home with learning software over the internet.”

Whispers broke out, some of them hushed but others frantic with excitement.

Miss Swift spoke up, cutting through the noise: “I’m sure some of you will be delighted because you think it’s going to be like the holidays.” She shrugged. “But I hope some of you can see what’s being taken away from you.”

One of the boys at the back got up and started to walk out. “We’re not finished yet,” said Miss Swift. “Please sit down.”

“Why should I?” he asked with a grin. “It sounds like you’re finished to me.” Miss Swift didn’t answer the boy and she didn’t stop him from leaving either.

Chaos broke out quickly after that as several of the other children also left, eager to get off school grounds so they could reconnect to the internet and spread the message on their Social Channels. Jay wasn’t the first to leave but he wasn’t the last either; some stayed behind to talk to Miss Swift. She was sitting at her desk, looking defeated.

At the front of the school he could see that the news had spread to other classes already. Jay saw Robin standing on a grassy rise well inside school grounds and went to stand beside him.

“School’s out,” Robin said blankly.

Jay could see his sister on the other side of the main path that led to the school gates. Linnet and her small group of friends were watching with disgust as wild celebrations were taking place just outside the school grounds.

Partially blocked by the advert-free zone inside the school, Jay could only see the faint shapes of the ads that had appeared to meet them. They looked like ghostly people with beautiful, smiling faces: cute, friendly animals, mythical creatures and strange new beings, all of them mingling gleefully among the children. Then the school’s protective blocking failed and Jay could no longer tell which of the figures were real and which were not.

He could see the virtual dog, circling just outside the school gate, still afraid to trespass into the zone that had so recently been forbidden. Jay shook his head and sat down to dig for something in his bag.

“What are you doing?” asked Robin.

Jay got out the pencil and paper that Mr Martin had given him and stared at the half-formed self-portrait he’d done that morning. He turned over the paper. On the back, he started to write.

What I really want is...

Tim Byrne is the co-author of The Living Memory with Emma Dyer which was longlisted for The Times/Chickenhouse Children’s Fiction Competition in 2017. He has written for BBC Schools and Channel 4 Learning. He has a background in teaching with a specialism in working with gifted and talented children. He has delivered digital projects for The National Literacy Trust and Macmillan Cancer Support.

Download the first place winner

What You Want (PDF)

Download the runners up

The Surgery (PDF)

Sky Park (PDF)

Royal Society for Public Health  I  The Health Foundation

Project funded by the Health Foundation

Design and development by Soapbox

Privacy policy

In our contemporary world, health inequalities are a big problem. There’s a gap of almost 20 years in how long you can expect to live in good health between people living in the most and least deprived areas of the UK.

So what is it that makes us healthy or unhealthy? Is it having doctors and nurses to care for us when we are ill? Is it our habits around food and exercise? Or is it our surroundings and background; how much money we have, where we live, learn, work and play?

The following blogs offer three different perspectives on how the competition and its winning stories help shed light on these factors, and on what they mean for the future of health and wellbeing. If these stories get you thinking about how to shape that future, share your thoughts on social media using the hashtag #FromHereToWhere.

Shirley Cramer CBE
Chief Executive, RSPH

Shirley is an experienced voluntary sector leader in both the UK and the USA, and has also held non-executive positions in both countries in the public and voluntary sectors.

HOW THE ARTS
CAN HELP TO CHANGE
HEARTS AND MINDS

I am a long-time fan of the Canadian author Margaret Atwood, whose often disturbing books have left me thinking about their meaning long after the final page has been read. Watching the recent, brilliant TV adaptation of The Handmaid’s Tale on Channel 4 left many commentators discussing the likelihood of such a dystopian story becoming a reality as at times it felt truly disquieting. I first read the book almost 30 years ago and then it felt much more like science fiction than it does in 2017.

At RSPH we have long believed in the power of the arts not only to influence our views on health but to directly improve health and wellbeing. There are many well evidenced programmes such as Singing for Health, Dance for Health, Museums on Prescription, to name but a very few, that are now being implemented in communities across the country.

Last year for our 160th anniversary we commissioned Gin Lane 2016, a modern version of the original Gin Lane by William Hogarth which showed, to the horror of the middle classes at the time, the results of cheap and readily available gin that created a public health crisis in 1751. For Gin Lane 2016, the portrayal of the issue of obesity and unhealthy high streets underlines the crisis in the public’s health today. We did not expect our commissioned piece to change legislation as its original counterpart did (with the Gin Act 1751) but it did help to create new conversations, reach new audiences and highlight the importance of the social determinants of health and our unhealthy environments.

Literature, as we see with The Handmaid’s Tale, has the power to make us think differently about issues and to disrupt our complacency about the status quo. Over the past year, we have been delighted to work in partnership with the Health Foundation on the creation of a dystopian short story competition, Health: From Here to Where? The competition invited authors to imagine the future consequences for society if current trends in the socio-economic determinants of health such as housing, access to employment and health inequalities are not tackled urgently. The sight of the remnants of the Grenfell tower block should propel us into action to address the factors that shape our unequal society.

The shortlisted stories were remarkable for their imagination, style and ability to shock the system and the three finalists were exceptional. The winner, What You Want by Tim Byrne, imagines a boy trying to do his homework with interactive adverts in the shape of a virtual dog selling him unhealthy snacks. As all the stories do, it highlights the differing worlds of the ‘haves’ and ‘have nots’ in sharp and scary definition. The Surgery by Natasha Wynne invites us into a world where obesity has been criminalised and cheap, fake, backstreet weight loss surgery appears to be the only answer. The rationing of bariatric surgery by making access more difficult crossed my mind as I read this dystopian tale. Lis Maimaris’s Sky Park describes, often humorously, the contrasting worlds of two young girls who live in segregated environments, one obesogenic and the other ostensibly health promoting.

One feature of all our three finalists was the glimmer of hope for the future included at the end of each story which showed how we might pursue a different course of action. RSPH and the Health Foundation will be developing learning resources around the stories for use in schools as our prime focus is for young people to be able to interrogate the future and change its current path.

I hope that all those reading these stories will enjoy them but I also hope that it will lead to the understanding that prevention is about creating environments, social and economic conditions where everyone can optimise their health and wellbeing.

Natalie Lovell
Policy Analyst, the Health Foundation

Natalie is a Policy Analyst at the Health Foundation where she contributes towards their strategy to improve people’s health in the UK, through a perspective of the wider determinants of health. She has previously worked at the Department of Health and has a Masters in Health, Population and Society from the London School of Economics.

DISCUSSING THE
COMPETITION WINNER

Tim Byrne’s story is carefully constructed, engagingly written and gives us an insight into a future that may not be so far from reality if we don’t do more to tackle the complex forces that can negatively influence people’s health.

In the opening scene we meet Jay, a young boy who, throughout the story, is constantly being tempted by a series of interactive, virtual adverts trying desperately to sell him unhealthy snacks. Today, the dangers of heavily marketed, processed foods are well known. Although the cute virtual dog in Jay’s world pestering him to buy a pack of ‘Fryzzlies’ isn’t exactly the same, it certainly doesn’t take a huge leap of imagination to juxtapose this virtual, ad–ridden world with our own.

Not only does Jay have the virtual ads to contend with in a largely tech–driven world (the ads wave little flags saying ‘Buy Now! Buy Now!’), but the rest of his surroundings reveal a number of challenges in his life: a house ridden by damp; an unsafe neighbourhood with no green space for him to play; a hard–working father with no choice but to work on the other side of town; social isolation; peer pressure; and not enough money for lunch.

We feel a rising sense of empathy for Jay, who faces multiple disadvantages in his life, and yet we know that the reality for many young children in the UK is not too dissimilar. Over 60% of­ children living in poverty in the UK are in a household where someone is in work. And we know that children in poor quality housing similar to Jay’s are more likely to suffer from ill health or disability. We also know that access to green space can lead to improved mental health and a higher likelihood of exercising, yet our world resembles Jay’s in that people living in the most deprived areas are 10 times less likely to live in the greenest areas. The happiness of our young people is at its lowest point since 2010, with young people highlighting similar concerns to Jay’s – fear of crime and money worries.

Underscoring the unrelenting barriers Jay faces in his life is the concept of inequality. The disadvantages in Jay’s life are not equally distributed: Jay isn’t protected from the terrifying virtual Tyrannosaurus Rex in the same way Robin, a boy from a wealthier background is; and his father hasn’t had the same education or employment opportunities as the people who live in the wealthy streets he cleans. Despite the notable lack of T–Rex’s, this future resonates jarringly with our own world. In the UK, not all nations and regions benefit equally from our economy, and young people are set to be poorer than their parents. These challenges will affect young people’s ability to have control over their lives and achieve their full potential: factors which have been identified by the Marmot Review as key to reducing health inequalities and improving wellbeing and health.

In the story’s final scenes, Jay’s school, a downtrodden space with few resources, announces its closure. A bleak ending not only to the story itself, but to an institution supposedly symbolic of hope and possibility for young people. This is not an unrealistic portrayal of current UK society, in which only half of young adults believe the education system is adequately preparing them for later life.

Jay’s dystopian world is not unavoidable. Collective action across society needs to be taken on all the things that can help us live a healthy life: our surroundings, housing, money and resources, education and skills, good work, transport, and our family, friends and communities.

How do how to you think we can prompt discussion about the factors that influence the public’s health in a creative way? We’re open to suggestions…

Isla Whateley
Young Health Movement

Isla has been involved with RSPH’s Young Health Movement since sharing her experiences of social media and mental wellbeing for the #StatusOfMind report in May 2017. She is studying for an MA (Hons) in Social Anthropology with Development at the University of Edinburgh. A former member of the Scottish Youth Parliament, Isla is also a writer and blogger with interests in human rights, politics, international development and mental health.

INSPIRING
YOUNG PEOPLE

The creative arts is a hugely under-utilised resource when it comes to tackling social issues. Many think that the way to talk about the pressing issues of the day is through traditional politics, through news media or just general discussion. However, important messages can be conveyed just as well – if not better – through the medium of creative arts.

I had the pleasure of being invited to help judge the Health: From Here to Where? short story competition in July, and I hugely enjoyed reading all of the shortlisted entries. Young people really care about health inequalities and, more importantly, the social factors that affect health. Being such a broad topic, it was great to see the different approaches the shortlisted entries took while still staying relevant to the theme. Whether the story took place in a dystopian wasteland or just a distorted corporate future, they all showed elements of the social aspect of health and how this has affected society in the future.

All of the stories had some kind of message, too. Even if only implied, there was the emphasis that health inequalities need to be tackled now before things get much, much worse. This is something that I completely agree with. Under the current context of increasing poverty, low wages and cuts to our health service, a lot of the scenarios imagined in the stories could become reality in the not-so-distant future. And these pieces can raise awareness of these issues, in a fun and easily-accessible way that may be more appealing to young people than the ‘depressing’ news, or something their parents say. That’s the beauty of using the arts to make a difference in the real world.

Young people need to be more engaged with these issues, and that begins with education. I didn’t learn about social inequality within my own country until I was about 16 at school, and I know people who didn’t learn anything. The news isn’t accessible to many young people, so these things need to be taught in schools to a high standard. This will make young people more aware of the issues, and more willing to act and take a stand against the unfair treatment of the most vulnerable people in our societ

Overall, I thought the shortlisted entries were great. They definitely all appealed to me, and at 20 years old I think I still count as a young person or young adult! But they were the sort of things I would’ve loved to read when I was a teenager in school, and some of them genuinely had me wanting to know more about the characters and the worlds the authors had created. There was such a depth and richness of writing and content, which is an incredibly admirable skill. But the most important part is that they all convey a hugely relevant and important message, and I hope they will help inspire other young people to learn more and, perhaps, take action.

Royal Society for Public Health  I  The Health Foundation

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