"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 

Are We Eating Enough Variety of Fruit and Veg?

We are often being reminded of the many health benefits derived from eating our five portions of fruit and vegetables a day, especially in helping to prevent cancer.  However, The European Prospective Investigation into Cancer and Nutrition (EPIC) study has revealed that in relation to lung cancer, the important thing is not just the quantity but also the variety of fruit.  By consuming a wider variety fruits and vegetables, we can reduce the risk of lung cancer by 23%.    

The EPIC study involves 23 centres from 10 European countries (Germany, Denmark, Spain, France, Greece, Holland, Italy, Norway, the United Kingdom and Sweden, working with a sample of 500,000 European subjects (41,000 of whom live in the Spanish regions of Asturias, Granada, Guipúzcoa, Murcia and Navarre).  The results of the study, which have been published in the journal Cancer Epidemiology, Biomarkers & Prevention, demonstrates that eating "more than eight sub-groups" of vegetables cuts this risk by 23% compared with eating "less than four sub-groups". In addition, this risk falls by a further 4% for each unit added to the diet from another sub-group.  This link was found only in smokers. 

Lung cancer is considered to be the most common type of cancer in the developed countries.  Statistics from Cancer Research UK indicate that lung cancer is also the most common cause of death from cancer for both men and women.  Thus, despite the encouraging evidence produced by the study,  Sánchez Pérez, director of the Granada Cancer Registry at the Andalusian School of Public Health, concludes that "the most effective way of preventing it (lung cancer) continues to be reducing the prevalence of tobacco consumption among the populace".

The Need to Improve the Health of Prisoners

There are currently around 10 million people incarcerated worldwide and over the past decade this number has increased by a million.  Research indicates that mental disorders, infectious diseases, higher suicide rates and increased mortality are more prevalent in prisons than in the general population.  Prisoners are often from the poorest sectors of society and as a result already suffer from greater health inequalities.

A review published today in The Lancet examining "The Health of Prisoners" reports that there is insufficient health care in prisons.  The evidence suggests that more needs to be done to help improve the health of millions of young, marginalised individuals, who are often beyond the reach of community health services.     

It is argued that reforming the medical service within prisons could improve public health, because as prisoners are released and return to their communities, they will be in a better sate, both mentally and physically, to contribute to society.   Seena Fazel from the University of Oxford, UK, and Jacques Baillargeon from the University of Texas Medical Branch, USA, argue that the importance of prison health care to public health needs to be recognised: "Prisoners act as reservoirs of infection and chronic disease, increasing the public health burden of poor communities."
They add: "For these individuals, prison provides an opportunity for diagnosis, disease management education, counselling, and treatment that they would not receive in the general community."

The authors of the review propose that there should be a universal screening of prisoners for physical and mental illness by trained individuals along with community-based aftercare for released prisoners.  Additionally, they call for national prison-specific policies and guidelines incorporating minimum standards and goals for improvement in the health care of women, older adult prisoners, and juveniles.

RSPH - Supporting Offenders on a Pathway to Health

At present, the RSPH is working with the National Offender Management service as part of the South East Innovation Project - Health and Physical Education.  The project focuses on improving the health and well-being of offenders, through the expansion of the Health Trainer model within the prison and community settings.  The RSPH also offers the Level 2 Award in Understanding Health Improvement course, which can be undertaken in communities, local authorities and prisons. 

Our recent sucess stories include the Sheppey cluster of prisons, initiated by Gary Lyttle and Brian Greig.  These events have been commissioned by the Sheppy Cluster of prisons to support the further roll out to other offender units and interested organisations locally.  The project was also undertaken by theYorkshire and Humberside cluster of prisons, led by Geof Dart.  A recent end of year report published by Yorkshire and Humber Improvement Partnership, Offender, Health and Social Care: Health Trainers in the Criminal Justice System, highlights the many benefits of training and empowering prisoners about health 

In addition, NHS Devon's health promotion team in partnership with Age Concern (now Age UK) created the Age Concern Older Offenders' Project, with the aim of improving the health of older offenders within Devon prisons.  NHS Devon's story can be viewed in the October archive of the blog.


To view a copy of the Yorkshire and Humberside report please contact Gina Mohajer email: gmohajer@rsph.org.uk.
For more information on the RSPH Level 2 Award in Understanding Health Improvement please contact Nicolette Smith email: nsmith@rsph.org.uk.

Pressure At Work Can Increase Risk Of Heart  Problems for Women

Previously cardiovascular disease and stress in the workplace has been centred around men's health.  However, in a study examining the health of women,  researchers found that women who reported high job strain, were forty percent more likely to suffer from cardiovascular disease, high blood pressure, increased cholesterol and excess body weight.

Job strain, a form of psychological stress, is defined as having a demanding job, with little to no decision-making authority or opportunities to use one’s creative or individual skills.  Job insecurity, fear of loosing ones job, was also a factor leading to stress in the workplace.

Researchers from the Women's Health Study, analyzed job strain in 17,415 healthy women over a 10 year period.  The women were primarily Caucasian, with an average age of 57 and provided relevant information about heart disease, job strain and job insecurity.  The  findings were presented at the American Heart Association’s Scientific Sessions 2010. 

   

The study discovered that the 40 percent higher risks for women who reported high job strain included heart attacks, ischemic strokes, coronary artery bypass surgery or balloon angioplasty and death. The increased risk of heart attack was about 88 percent, while the risk of bypass surgery or invasive procedure was about 43 percent.

Natalie Slopen, Sc.D., lead researcher and a postdoctoral research fellow at Harvard University Center on the Developing Child in Boston, noted that; “Women in jobs characterized by high demands and low control, as well as jobs with high demands but a high sense of control are at higher risk for heart disease long term,” 

As such, from a public health perspective, it is vital for employers to monitor perceived employee job strain and initiate programs to alleviate and manage stress, in order prevent ill health in the workplace. 

The RSPH Training Solutions offers a course on Mental Health First Aid in the workplace. The course focuses on the personal impact of poor mental health, and on the importance of appreciating good mental health, for both ourselves and others.  For further information on this, please click here or contact Nicolette Smith nsmith@rsph.org.uk

Last chance this year to attend our Foundation Programme in Health Improvement

As the debate about the future of our health service hots up, it is becoming increasingly clear that much more responsibility will have to be taken on by the voluntary sector and Local Authorities. Do you and your team have the right knowledge and expertise?

The Foundation Programme in Health Improvement is designed to give a firm grounding in Public Health to key individuals who will be part of these changes.

This two day programme takes place on December 6^th and 7^th in our Head Office in London. It costs just £350 per delegate for two full days and includes lunch, refreshments and full course materials. Contact Nicolette Smith to make your booking, on 020 3177 1625 or email nsmith@rsph.org.uk.

What we will cover:

1. The three key lifestyle choices affecting personal health, and their impact on your community
2. The practical implications of these choices for our public health
3. First principles for promoting good health
4. Three ways to improve community health, and how to communicate them
5. The critical barriers to improving health in the community and how to overcome them
6. Proven techniques for encouraging changes in behaviour
7. How to handle confidential information securely
8. The most effective ways to evaluate your results

“The journey starts here. Educational, enjoyable, empowering.”

Delegate on Level 2 Understanding Health Improvement

How you will benefit

After this programme, you will be equipped to play your part in improving the health of your community by identifying opportunities to improve health and well being, and evaluating what has worked best. This programme leads to the nationally recognised Level 1 qualification in Health Awareness and Level 2 qualification in Understanding Health Improvement. Delegates will be able to take a multiple choice test at the end of the two days to achieve these two RSPH qualifications.

Health Service Reform - Concerns for the third sector?

The care services minister, Paul Burstow, has admitted that the period of change brought about by health service reform is worrying for voluntary organisations.  However, the minister pointed out that the voluntary sector will play a vital role in the future of the NHS contributing to health and care.

Burstow believes voluntary organisations could strengthen public and patient engagement through their knowledge and understanding of local people's needs.  As such the Department of Health are particularly keen for primary care trusts to engage with stakeholders.

Burstow added; "This includes working in close partnership with all organisations that they hold funding agreements with through both grant and contract arrangements, recognising the principles of the Compact."

Do your health improvement projects need a health check?

The focus on improving community health continues to dominate the political agenda, and the voluntary sector is already working in partnership with Local Authorities to develop innovative ways to improve public health.

But how often do these projects deliver the benefits you hope for? How can you guarantee that they’ll run to time and on budget? And has the team lost sight of the original goals?

In short, do you and your team have the knowledge and expertise to deliver results?

“We can lead healthier, more productive lives but many need help in creating the environment where this is possible. This task is everyone’s business.” 

Richard Shircore. Course Leader.

Developing and Managing Health Improvement Projects

Developing and Managing Health Improvement Projects is one of our most popular courses, designed to prepare project managers to run effective programmes, on time, on budget and in harmony with their partner organisations.

This one day programme takes place on November 23^rd in our Head Office in London.There are just three places left, so book yours now. It costs just £175 per delegate for a full day and includes lunch, refreshments and full course materials. Contact Nicolette Smith to make your booking, on 020 3177 1625 or email nsmith@rsph.org.uk.

What we will cover:

1. How to identify realistic aims and objectives
2. How to ensure that the outcomes of your project meet your expectations
3. Theory and best practice for planning and execution
4. Three critical barriers to successful project management and how to overcome them
5. The most effective ways to evaluate your results
6. How to identify problems before they arise and respond positively

How others have benefited

“Excellent! I was worried that this may be too theoretical, however I have learnt so much on this one day training course, thank you RSPH.“ Delegate on Developing and Managing Health Improvement Projects

Ways of Tackling Obesity - Fat Tax, Better Labelling and Restricting Advertisements

A team of researchers from the Organisation for Economic Co-operation and Development, and from the World Health Organization (WHO), published a paper in The Lancet Series on Chronic Disease and Development.  The paper explores and highlights ways to tackle the rise in obseity in nations of all incomes.

The paper studied obesity rates in seven countries: Brazil, China, India, Mexico, Russia, South Africa, and,  England.  The researchers found that in all seven countries, obesity posed a big health problem.  Statistics reveal that the UK is the fattest country in Europe and this is set to rise by 10% over the next decade.  Seven in ten Mexican adults are now considered obese or overweight.  Similarly China now has the same rates of diabetes as the USA (92 million).    

As such, the paper concluded that in order to tackle rising obesity levels, a combined approach needs to be implemented nationally.  Taxing unhealthy foods, (or reducing tax on healthy foods), restricting advertisements on unhealthy foods and improving labeling, is among the most cost effective ways to promote healthy eating.  It is estimated that these measures would add nearly 7 million life years in good health over the next two decades in seven countries covering almost half of the world population.

Clearly authors of the paper provide some clear actions that need to be seriously considered to help drive down obesity levels.  However, what other ways and initiatives can be introduced to encourage people to make healthier lifestyle choices?
 



World Diabetes Day "Eye Lights" The Global Diabetes Panademic

The 14th November is World Diabetes Day (WDD) which was created to raise awareness and understanding of the global diabetes pandemic.  Currently in the UK the number of people affected by diabetes is over 2.8 million and this figure is expected to rise.  By 2025 it is estimated that over 4 million people will suffer from diabetes due to aging populations, increasing rates of obesity and sedentary lifestyles. 

To mark WDD, Andrew Lansley, Secretary of State for Health, will be the guest speaker at a reception this evening.  The event will bring together members of the diabetes community and will address key issues facing patients, healthcare professionals and policy makers throughout the UK.  To coincide with tonights reception and the 14th November, the Merlin Entertainments London Eye will be illuminating blue to respresent the WDD blue circle logo.