Is premature death a postcode lottery?

A new interactive map, Longer Lives, produced by Public Health England (PHE) demonstrates the variation in premature death across England through a colour code technique. The map which ranks 150 authorities by their premature death rates – that is before the ages of 75 – also allows users to view these areas by five of the most common causes of premature (and preventable) deaths.

These include cancer, heart disease, stroke, lung disease and liver disease. The map further enables users to view the areas which are the most socio-economically deprived.

Interestingly, the map clearly identifies the North of England as having large proportions of premature mortality, where deprivation is more prevalent, compared with the South of England where good health is more evident particularly in affluent areas. However, a few exceptions to this do exist in the South especially in London boroughs, Southwark, Tower Hamlets, Newham, where health is regarded as extremely poor and deprivation seemingly high. 

To view the coloured coded map and see how your area rates click here.

Why such a divide between North and South

The reasons as to why such a variation exists could be due to rates of poverty, obesity levels, alcohol consumption and smoking. Historical factors such as decline of the manufacturing industry in the North, may have increased unemployment and hence poverty in the regions. Other factors may include the social and cultural environment as well as access to education, housing and transport.

Nonetheless, what the map does highlight are areas in which local authorities need to pay particular attention to improve health and tackle health inequalities – it is unacceptable in our modern day society for such a disparity of mortality to exist depending on location.

The RSPH has been working with Well London to provide health improvement training and education to people from the most hard to reach and deprived areas of London, more information can be found here.

Regardless of where we live, all of us can take simple steps to improve our health and even positively influence the people around us to make real and lasting lifestyle changes. Our most popular qualification Understanding Health Improvement Level 2 Award, and Understanding Behaviour Change Level 2 Award provide practical knowledge of the benefits of good health and wellbeing. They examine how we can reduce health inequalities  through basic understanding of the concept of health, building confidence in talking about health and encouraging people in the community to seek health services available to them. For more information please contact Gina Mohajer gmohajer@rsph.org.uk. 

UK - Unhealthiest Nation in Europe?
 

Startling figures from the Association of Public Health Observatories reveal that the UK is the fattest EU member with the highest rates of teen pregnancies and the worse rates of female cancer survival and infant deaths. 

The report indicated that the West Midlands, has the highest percentage of obese adults standing at 29% (double the EU average of 14%) and higher than the average in Greater London of 19%.  

Similarly female cancer rate deaths in South East England were reported at 185 per 100,000, with North East England at 174 per 100,000.  Europe on the other hand has an average of 139.5 per 100,000. 

Although these figures may have altered slightly since the data was collected, it still provides a snap shot of the public health issues in England and highlights areas that need to be addressed.

Professor Sir Michael Marmot, public health expert, said the report highlighted "stark differences" in health across the EU.
"The behaviours that lead to obesity and teenage pregnancy, for example, arise from social conditions.
"This knowledge informs what we as a society can do at a local, regional, national and international level to create the conditions for greater health equity."

The Good News

Despite the figures highlighted above, evidence suggests that the picture is not all gloom.  Firstly, due to early smoking interventions, authors of the report point out that this has had a very positive impact on health outcomes.  Additionally, life expectancy rates in the UK are slightly better than Europe and we perform well at treating heart disease. 

Dr Claire Bradford who compiled the report said, "This type of data allows us to compare not just between countries but within countries and to look at what is going well and what is not.

"People that are able to influence which way we are going as a nation should look at this to decide on priorities and actions."

Clearly, there is still much to be done to tackle the obesity rates and social determinants of health in the UK.  Governments, local authorities, communities and individuals need to take responsibility and work together to improve health and bring about a positive change. 

The RSPH currently run a "Foundation Programme in Health Improvement" course, which offers candidates the opportunity of developing a firm foundation in health improvement . The programme is especially useful for those new to concepts of Public Health and Health Improvement who wish to gain a quick grasp and knowledge of this area.  For further information please contact Nicolette Smith

"Nudging" us to a Healthier Lifestyle

The Government is adopting a new approach to health.  There is to be a move away from direct government intervention, to what is known as the "nudge" approach, in an attempt to make the nation think and act in a healthier way.  

One of the steps being taken is to put councils in charge of encouraging healthier lifestyles, by moving local public health directors out of the NHS and into local government.  It is believed that the wider remit of councils in areas such as housing, leisure and transport, will place them in a stronger position to address health issues such as smoking, drinking and obesity in England.   

The Department of Health's White Paper will also propose creating a new public health service, which will provide advice and support on health protection, treatment and nutrition, as well as setting up a health inclusion unit to ensure measures are in place to tackle health inequalities.  

The public health White Paper will also say the key to encouraging healthier behaviour lies in creating the right environment and then "nudging" people into making different choices.   Signifying a move towards less regulation and creating a climate to encourage healthier behaviour.  Some of the schemes that will be introduced in the new year may include, free vouchers for the gym, incentivising children to walk to school and providing more support to nurses and health visitors to encourage new mothers to breastfeed. 

Andrew Lansley, the Health Secretary believes the new system will have a "real impact on improving health"
He added: "Health is not just about the quality of healthcare. It's probably at least as much about the quality of people's lives - the environment, the housing, their education and employment."


To listen to a detailed discussion on the role of the government and the implications of the nudge affect please click here