As I write this conclusion, the UK and US are undergoing major governance upheavals. In the UK, the arrival of the coalition government in May 2010 instigated great debate about the future of public services and, therefore, the kinds of behavioural expectations, rights and responsibilities being placed on citizens. This renewed debate is notable principally because it demonstrates the temporal and spatial pervasiveness of the arguments about the role of sensible behaviour in urban governance regimes put forward in this book, as well as the entrenched and intractable nature of the risks associated with diet, sedentarism and drinking. In the US, Barack Obama has toiled to push health up the agenda, passing the landmark health care reform bill through the Senate in early 2010 and has since faced constant threats from the Right to repeal these advances. His wife, Michelle, has championed the cause of childhood obesity prevention through the Let's Move! programme and the transformation of a part of the White House lawn into a community garden. Yet, despite these efforts, preventing obesity, encouraging greater physical activity and moderating alcohol intake remain what Hunter (2009: 202) has pertinently described as ‘wicked issues’, or those which have ‘complex causes and require complex solutions’. The discussions that have unfolded in this book have spanned the Atlantic and a five-year time period. They have also clearly illustrated this complexity as well as the intractability of the ‘wicked’ and the clear need to interrogate the variegated politicisations and problematisations of health. However, and as Hunter further identifies, the persistence of these wicked issues remains a facet of government ‘preferring to regard such problems as being ones of individual lifestyle rather than being socially and structurally determined’ (2009: 203). The inevitable result of this way of thinking is ‘always to direct interventions to changing individual lifestyle rather than to reducing the health gap between social groups’ (ibid). It is clear that as long as this oversight remains, then wicked issues will remain just so.

On both sides of the Atlantic, therefore, the debate over where the lines of responsibility should be drawn for health and ensuring the uptake of healthy lifestyles continues with little sign of resolution.