Hoovering – Should it be part of your exercise regime?

Last week news articles reported that doing housework, as a means to clean your home and also keep you physically active, may not be as beneficial to the latter as once thought.

A nationwide study, Sport and Physical Activity Survey (SAPAS) used data collected from over 4000 adults in Northern Ireland, to examine how domestic activities contributed to a person’s total physical activity and whether this was related to their BMI. The researchers found that people, who included housework as part of their regular exercise count, were not burning as many calories or raising their heart rate to a level identified to have a positive impact on one’s health. As a result the researchers pointed out that people could be failing to meet weekly target exercise guidelines, despite thinking they are.  

Those who reported more domestic activity tended to have higher body mass indexes, than those who reported less domestic activity

The Governments guidelines for physical activity in the UK suggests that adults should take at least 150 minutes of moderate intensity physical exercise each week. This could be 30 minutes 5 times a week. To ensure that everyone includes some activity on a daily basis, recommendations have included gardening, housework and DIY projects. As these activities can be carried out in the comfort of one’s home they are more likely to appeal to the majority of the population, who for whatever reason, may face issues or resistance when say going to the gym.

However, although housework is regarded as “exercise” the research demonstrates that we need to be working harder at it to make it count as a workout, so that we can reap the health benefits associated with regular exercise.  

Professor Marie Murphy, who led the study said: “Housework is physical activity and any physical activity should theoretically increase the amount of calories expended. But we found that housework was inversely related to leanness which suggests that either people are overestimating the amount of moderate intensity physical activity they do through housework, or are eating too much for the amount of activity undertaken”    

Physical activity needs to make you out of breath or sweaty to count as moderate to vigorous. The study should be a reminder that the intensity of activity is important as well as the amount and type of activity. It could therefore be said that hoovering and other domestic work, need not be disregarded as ineffective forms of exercise, rather, when domestic work is carried out, extra vigor should be applied to work up a sweat. Additionally, incorporating other forms of exercise into your routine, such as brisk walking, cycling, dancing could help ensure that you stay active and healthy.

For more information on physical activity and the benefits visit the NHS Choices website. Understand the importance of physical activity and learn ways to promote and encourage others to be more active through the RSPH Level 2 Award in Understanding Health Improvement, Level 2 Award in Physical Activity.   

The World Heart Federation calls on all countries to set a target year to end tobacco use

At the Tobacco End Game Conference in New Delhi, India this week the World Heart Federation (WHF) signalled to all countries worldwide to set a target year to end tobacco use in their country. Ending tobacco use implies reducing population smoking levels to five percent or below.

Some countries have already taken the lead and have announced their “target year” to reduce tobacco consumption. These include Finland (2030), Scotland (2034), New Zealand (2025) as well as a few Pacific Island States (2025).  

The Risks

Previous Blogs, “Raising Awareness for Lung Cancer” and “Smoking – a big turn off”  have highlighted the negative impacts of smoking on health, and the evidence continues to affirm that tobacco use is one of the main risk factors for heart disease and is the cause of millions of premature deaths each year worldwide.

Smoking is estimated to cause nearly ten percent of cardiovascular disease (CVD) and is also the second leading cause of CVD after high blood pressure. Further more, it is not just smokers who bear the consequences of tobacco smoke, passive smokers are also placed under unnecessary risk.

Figures indicate that nearly six million people die from tobacco use or exposure to second hand smoke worldwide, every year. By 2030 is it believed that tobacco-related deaths will increase to over eight million deaths a year.

With strong evidence available to the public on the adverse effects of smoking and the efforts to promote these facts, the statistics on tobacco related deaths remain shocking!  

Thus, important questions arise about what else we need to be doing to reduce smoking in adults and prevent children from starting.

Could further changes in marketing be the answer?

Over the past decades the UK has witnessed some significant changes to how tobacco is advertised and this began in the early 1990’s but took greater affect after the millennium.  The 1990 and 1996 Broadcasting Acts prohibited tobacco marketing on broadcast media (television and radio). However, it was the Tobacco Advertising and Promotion Act 2002 (TAPA) that banned most forms of tobacco advertising. This included a ban on print media and billboard advertising (2003) and advertising at the point of sale (2004).

As the UK is a Party of the Framework Convention for Tobacco Control (FCTC) they were bound by agreement to implement the framework into national policy.  The drive to improve population health coupled with the requirement to integrate further restrictions on tobacco advertising, saw a new national tobacco control strategy emerge in 2008 by the Labour Government and later reinforced by the Coalition Government in 2011. The consultation included a ban on the display of tobacco in shops and a ban on tobacco vending machines (2011) both of which were included in the Health Bill.

Since April 2012 it has become illegal to display tobacco products at the point of sale in large stores and this ban will come into force in smaller stores from 2015. Although in 2010 the Coalition government agreed to review the evidence for plain packaging as part of its national strategy, this has still not come into affect, despite pressing evidence that branding of tobacco packets and higher consumption rates exists. Read the RSPH press release here on our disappointment of not introducing standardised packaging on tobacco products.

“Research shows that Point of Sale (PoS) display has a direct impact on young people’s smoking. In 2006, almost half (46%) of UK teenagers were aware of tobacco display at PoS and those professing an intention to smoke were more likely to recall brands that they had seen at the point of sale.”

Tobacco companies invest large amounts of resources in branding their products and making them appear as attractive as possible. They know that brand imagery is much more important to younger age groups, thus standardised packaging would reduce brand appeal and reduce the inclination to smoke.

Next Steps

Clearly, measures have been made to reduce smoking in the UK, tighter restrictions on tobacco advertisement and the implementation of the smoking ban in public spaces 2007/2008 have sought to reduce appeal for smoking. However, there remains more to be done to ensure we are able to align ourselves with the World Heart Federations’ aim to reduce tobacco use below 5% and prevent thousands of avoidable deaths a year (in England the current ambition is to reduce smoking prevalence to 18.5% or less by 2015; to 12% or less among 15 year olds by 2015). 

The World Heart Federation President Professor K Srinath Reddy said: "There is no hiding from the deadly effects of tobacco on heart health....There are many countries across all incomes making great strides in tobacco control and it should be possible for each of these nations to further bolster their tobacco control efforts by setting themselves a target year for reducing tobacco use below 5%. So the World Heart Federation would hope to see these countries, followed by those around the world, following the brave lead set by the countries that have announced target dates."

Visit RSPH Training Solutions to see programmes and courses that can give you the confidence and skills to help people make key lifestyle choices to improve their health.

For further information on UK regulations click here to read the ASH Briefing: UK Tobacco Control Policy and Expenditure.

For more information on the negative effects of tobacco use and how to quit please click here and NHS Choices website. 

The Vicious Cycle Between Poor Mental Health and Unemployment

A recent report by the BBC titled “mentally ill people hit hard by recession” argued that between 2006 and 2010 unemployment rates for people with mental health problems rose significantly.

The news item was reporting on a research study which sought to discover whether people with mental ill health are more likely to be discriminated against both in the job market and in society.  

The study which was carried out by researchers from King’s College London, the London School of Economics and Political Science, and John Hopkins Bloomberg School of Public Health, looked at data on the rates of employment and mental health problems from 27 EU countries.

The researchers focused on data derived from 2006 (prior to the 2008 economic crisis) and 2010. From both years, a consistent pattern emerged that people with mental health problems were more likely to be unemployed. Interestingly however, the study found that by 2010 the gap in unemployment rates between people with and without mental health problems had increased.

The researchers proposed that people with a mental health condition suffered more by the economic recession of 2008, and will have been more vulnerable to discrimination and unemployment. Download the published report in the peer-reviewed open access medical journal PLOS One.

Taking a deeper look

The researchers used data from two surveys: The Eurobarometer Mental Wellbeing 2006 and the Eurobarometer Mental Health 2010 survey. 30,000 citizens from 27 EU countries took part in the survey and information was collected through face to face interview.

From the 2006 and 2010 surveys it was found that compared with the general population people with mental health problems were:

1.     More likely to be female

2.     Significantly older

3.     More likely to have finished education before 20 years of age or had no formal education

4.     More likely to be unemployed/retired and unable to work

5.     Less likely to be in paid employment

The study also revealed that although females were more likely to have a mental health problem, males were more likely than females to be unemployed. In 2010 22% of men with mental health problems were unemployed compared with 14% in 2006. For women these were 17% and 12% respectively.

Interestingly, the researchers also found that in 2010 (but not in 2006) people with mental health problems were more likely to be unemployed if they lived in countries where the majority of people agreed with the statement “people with mental health problems are a danger to others”.

The (vicious) cycle

People with mental health problems are less likely to be in employment. This can however perpetuate their condition by causing them to become further isolated and anxious about their financial circumstance.

During periods of economic hardship, this may become more apparent as people with mental health problems may be more susceptible to losing their job and are unable to find a new one in a competitive labour market.

Beth Murphy, head of information at mental health charity Mind, said the findings were worrying “Losing your job is a sudden change and there can also be financial implications through loss of income, which in itself can cause anxiety”

“Specifically redundancy is known to trigger depression and suicidal thoughts”.

Conclusion:

Undeniably, the research paints a very bleak picture of the reality of people who have poor mental health. Not only do they have to live with and tackle their own mental health condition, but their problems are further heightened by the fact that they are more likely to loose their job or be unemployed.

What we have to remember is that no one is exempt from experiencing a mental health problem - it can happen to anyone of us. Statistics reveal that at least one in four people will experience a mental health problem at some point in their life, therefore, it is essential that a) society does not stigmatise/discriminate against people with mental health conditions and b) that we learn techniques on how to protect ourselves and improve our mental health and wellbeing. 

It is imperative that Governments, Local Authorities and communities ensure that they promote social participation of individuals with mental health problems (particularly during recessions) and that efforts are made to target the most vulnerable people in society. Evidence reveals that participation in meaningful activity is associated with improved self esteem and good mental health. Having strong social relationships/networks can reduce isolation and help to improve mental health and recovery as well as preventing mental health problems.

We know that improved mental health and wellbeing is associated with a range of better outcomes, from physical health to higher education achievement. Thus in a strategic attempt to improve the whole population’s mental health and wellbeing the Five Ways to Wellbeing has been developed by nef (new economics foundation) which is a set of evidence based public health messages that can be utilised by everyone.

For more information on how you can get trained to improve and protect your mental health and the community you serve click here.

Let us know what simple things you do to help improve your mental health and wellbeing?

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. 

Men's Health Week 2013: breaking the mental health stigma  

This year Men’s Health Week, led by the Men’s Health Forum, aims to tackle the stigma attached to men’s mental health and encourage more men to seek professional help.

It is understood that although equivalent numbers of men and women suffer from mental ill health, men are far less likely to receive diagnosis and treatment, because of their reluctance/hesitance to seek professional health advice.  Statistics from the Men’s Health Forum highlighted that in the UK, three in four suicides are committed by men and that around 4,500 men kill themselves each year.

The distressing truth is that men are not as comfortable talking about their feelings and are even more ashamed to admit that they may be feeling depressed/stressed/anxious, in fear that they will appear weak amongst their peers. As a result, men often suffer alone or indulge in high risk behaviour such as drinking and drugs as a coping mechanism, which can be equally as detrimental to their health.

Martin Tod, CEO of the Men’s Health Forum said; “If all men could talk about how they were feeling with confidence, I don’t think we’d be looking at horrific figures like these. Whatever the problem, your GP has heard it before. Don’t bottle it up”.

Shirley Cramer CBE, Chief Executive RSPH, says “the messages being raised in Men’s Health Week are vital, mental health is too often seen as a taboo subject especially amongst men. Good mental health is more than just the absence of mental illness and in addition to preventing and treating mental illness we should be actively promoting positive mental health. A key aspect of this is individuals feeling they can discuss their feelings and can ask for help.”

At the RSPH we strongly advocate the importance of maintaining good mental health. In our Mental Health report, we outlined the many harmful affects that poor mental health can have on the individual, on their family and society as a whole. In order to understand the importance of good mental health and ways this can be achieved, we have developed a new qualification in Understanding Mental Health and Wellbeing Level 2 Award. The interactive training day promotes the positive impacts of good mental health, as well as providing practical skills and knowledge of the measures that can be taken to prevent and protect against mental ill health. For more information on our training programme, click here or contact Gina Mohajer gmohajer@rsph.org.uk.  

For more information on men's health week see the Men’s Health Forum and to view the statistics on men’s mental health click here.  

Can a stressful job be harmful to our health?

A certain amount of stress/pressure can “supposedly” be beneficial to us, by making us more productive. However, too much stress over a long period of time can have negative impacts on our health. A recent study from Spain sought to examine what these negative effects were and to what extent could stress increase the risk of developing cardiovascular diseases and coronary heart problems. 

The research was carried out by the insurance company Ibermutuamur, and two universities in Spain and the findings were published in the peer reviewed Scandinavian Journal of Public Health.

The purpose of the study was to determine whether a correlation exists between stress (from work) and abnormal levels of fat (lipids) in the blood. Worryingly, high levels of bad cholesterol known as LDL cholesterol – caused by fat in the blood - can block arteries which in turn may lead to coronary heart disease and other cardiovascular diseases.

Just over 90,000 people took part in the study which was conducted through questionnaires. Participants were asked questions relating to how they felt they coped in their job: “During the last year, have you frequently felt that you cannot cope with your usual job?". Participants who answered "yes" were considered to have job stress.

The questionnaire also included eleven questions relating to anxiety and depression symptoms, such as "Have you felt keyed up, on edge?" and "Have you had difficulty relaxing?” The researchers took fasting blood samples from participants measuring levels of total cholesterol, and then examined whether abnormal lipid levels were linked to job stress. The study did take into account age, sex, smoking, obesity, alcohol consumption and also type of job (blue or white collar occupation).

Results

Around 8,000 (9%) of participants are reported to have job stress; in addition these individuals also reported higher levels of anxiety and depression symptoms, and were found to have a 10% increase in abnormal lipid levels and higher levels of LDL cholesterol, than those who did not consider their job stressful.

Although these findings have been regarded as generally strong in understanding the relationship between stress and bad cholesterol, what the study did not take into account is that, individuals who suffer from stress or poor mental health, may indulge in high risk behaviour as a coping mechanism. This could increase their risk of developing higher levels of “bad” cholesterol as they may be more accustomed to unhealthier diets and/or consume higher levels of alcohol. Therefore, rather than the stress itself, these other “risky behaviours” may play a fundamental role in causing peoples “bad” cholesterol to rise.

Nonetheless, what this research highlights is that stress (too much of it) and poor mental health is detrimental for our wellbeing and for society as a whole. Whether it causes our cholesterol to rise or whether it causes us to indulge in health risk behaviour – the message remains clear that improving ones mental health should be paramount in order to tackle many of the other health related problems that exist in today’s society.

What can you do?

The RSPH believe that we all have a responsibility to ourselves and to others, to help prevent, protect and promote good mental health practices. As such a one day programme on Mental Health and Wellbeing has been developed, to provide people with practical skills and knowledge to understand the measures they can take to improve not only their own mental health, but also help the wider community. Click here to download the report on Mental Health in the New Public Health System and click here to find out more about our programme.   

The Seven Golden Rules for a Healthy Life

If we follow these simple steps, can we really reduce our risk of heart disease?

Cardiovascular disease (CVD) still remains the biggest killer in the UK.  In 2010, around 180,000 people died from CVD and 80,000 of these deaths were from coronary heart disease (CHD).  Although over the past decade, there has been a decline in death rates from heart disease in England, there still remains regional and socioeconomic differences in both incidence and case fatality, along with behaviour inequalities.

In 2010, the American Heart Association (AHA) proposed seven factors to help people understand the most effective ways of avoiding CVD and lowering the risk of developing cancer. 

The findings came from a long term study carried out by researchers from Northwestern University (Chicago), the University of Minnesota, and a number of other US research institutions; their findings were published in the peer-reviewed journal Circulation.  The cohort study followed 13,253 white and African American participants for between 17 and 19 years, to establish if maintaining ideal levels of the seven health factors could reduce heart disease and lower the risk of cancer. 

The Seven Simple Steps

• 1      Not smoking (never smoking or quitting more than 12 months ago
• 2      Maintaining a healthy body weight (that is a healthy Body Max Index (BMI)
• 3      Eating Healthily (diets rich in nutrition, fruits and vegetables)
• 4      Physical Activity (at least 75 minutes per week of vigorous physical activity, or 150 minutes per week of moderate or moderate plus vigorous activity
• 5      Having low cholesterol levels
• 6      Healthy blood sugar rates
• 7      Healthy blood pressure

The Findings

From the study, researchers found that the health benefits were higher among people who met the ideal levels for each of the seven factors.  For example, people who achieved ideal levels for six of more factors had a 51% reduced cancer risk and those who met the ideal levels of four factors had a 33% reduced rate of developing cancer.

While the findings have been welcomed, it is worth noting that smoking appeared responsible for the majority of the associations seen between the seven factors and cancer risk. This once again exemplifies how smoking has a direct correlation with your heart, blood pressure, circulation and individual risk of lung cancer.

What more can be done?

As highlighted above, CVD and CHD continues to be a major health concern in the UK, with health issues being more prevalent among low income earners. Those from lower socioeconomic groups are more likely to have poorer diets, lead sedentary lifestyles, suffer from mental health issues and partake in health risk behaviour, including smoking and alcohol abuse. These factors have a major impact on heart disease.

Type 2 diabetes and obesity are also some of the main contributors leading to CVD.  In England alone, a quarter of adults are obese and the prevalence of diabetes in the UK is around 5% for women and 6% for men.  The financial cost to society can also be detrimental.  The statistics reveal that in 2009, CVD cost the UK economy £19 billion – putting further strain on the health care system.

Although the AHA’s seven steps to improving health helps people to understand where to make the changes in their life (healthy eating, exercising), the problem is how to make these changes?  For most people, breaking old habits and changing behaviour can seem like an impossible task, and for some, change is not always welcomed. How do we engage with people and offer advice on sensitive issues that could potentially save their lives?

The RSPH, having recognised the fundamental importance of behaviour change to improve health, has developed a qualification in Understanding Behaviour Change, Level 2 Award, to provide an understanding of communication styles and practical skills to help individuals implement lifestyle changes. The one day programme will also aim to give learners knowledge and confidence to offer brief advice and engage in brief interventions.  Sometimes, having the right conversation with someone can have far reaching positive affects.   For further information on the qualification please click here or contact Gina Mohajer.

For further information on heart disease visit the British Heart Foundation here

International Women’s Day 2013

– Celebrating achievement and looking at what more can be done

Every year International Women’s Day is celebrated on the 8^th March. This monumental day seeks to highlight the extent to which equal rights of women have progressed, as well as emphasising the economic, political and social achievements women have and continue to make.

Each year there is a thought provoking theme, to not only celebrate achievements, but to also raise awareness of the issues and discrimination women still experience in the 21st Century. This year the United Nations (UN) core campaign is to end violence against women “A promise is a promise: Time for action to end violence against women”.

Ban Ki-moon, United Nations Secretary said “Violence against women is always a violation of human rights; it is a crime; and it is always unacceptable.  Let us take this issue with the deadly seriousness that it deserves”.

Violence against women continues to be a huge problem in society and can have serious adverse physical and mental affects on the individual and their families.  In the UK, the cost to society totals around £20.1 Billion, which includes human and emotional cost, cost to public services and cost in lost economic output. 

How widespread is the abuse?

The British Crime Survey 2006/2007 established that every year 1.5 million women experience at least one incident of domestic violence abuse, which is nearly 30,000 women a week. Over a lifetime, it is argued that one in four women in the UK will experience domestic violence.

Anyone can be targets of violent domestic abuse, married or unmarried couples, opposite or same sex partners, however, figures show that approximately 77% of the victims are predominantly women. This could be due to a whole range of factors, including cultural differences (i.e. men considering themselves too superior or 50% of men believing that domestic violence is a private affair), life experiences, psychological and emotional issues.

The Home Office Statistical Bulletin: Crime in England and Wales 2006/2007 highlighted that 2000 women are raped a week, resulting in 100,000 every year, and half of these rapes are committed by a current or former partner.

Lesley Abdela, Journalist at the Guardian “Stop looking the other way” wrote that, “Violence against women is a pandemic more extensive than HIV/Aids. It is the main cause of death and disability globally for women aged 15 to 44 – rape and gross bodily violence cause more death and permanent disability than cancer, motor vehicle accidents, war and malaria combined”.

Worryingly, Lesley comments that between one and two women are killed each week by a current or ex partner, and that this number is actually 20% higher than the number of youngsters knifed to death in London or in British cities. 

The affects

Domestic violence against women can have serious implications. As well as the damaging physical health problems that can arise from abuse, there are also notable adverse affects to an individual’s mental and emotional wellbeing; these include post-traumatic stress disorders, depression and anxiety. Moreover, many women turn to taking drugs, alcohol, smoking or overeating as a response to and a way of dealing with the abuse. Statistics reveal that abused women are 15 times more likely to misuse alcohol and 9 times more likely to take drugs than women generally. This can lead to greater physical and emotional problems.

As mentioned above, there is a large economic cost to society as women who are abused often take time off work. Statistics from the Home Office Statistical Bulletin, states that each year one in ten victims of partner abuse takes time off work as a result of the abuse.

Then and now

Until 1990, it was legal for a man to rape his wife.  The idea that domestic violence is a “private family affair” is still widely believed and is one that needs immediate eroding.  Domestic violence is a crime, and if ignored can lead to greater problems for the victim, their families and society as a whole.

International Women’s Day, is a fantastic opportunity for everyone around the world to acknowledge the great achievements of women and the contributions they have made socially, politically and economically, but it also an opportunity to make evident the problems women continue to face world wide.  Through the media, policy makers and the government, we can help to reduce and end domestic abuse and to also ensure a strong support network system is in place to offer advice and guidance to those who have suffered.

For more information on International Womens Day click here

For further information on violence against women click here 

Visit the Women's Health website here