RSPH In Conversation With… Professor Susan Michie

The Royal Society for Public Health (http://www.rsph.org.uk), with support from the Philipp Family Foundation, continues its series of podcasts, investigating key issues facing Public Health, with an international perspective.

In our interview with Professor Susan Michie, the topic is Behaviour Change, and how ”Western” lifestyles are storing up long term problems for the general population. With illustrations from the UK and around the world, Professor Michie discusses the huge economic cost of ill health, and the circumstances required to support people in making change to their lifestyles.

As the cost of health care continues to rise, and the UK Health Service is required to make substantial savings, this topic is of crucial importance. The majority of causes of ill-health are linked to people’s behaviour, whether through their lifestyle choices, their take up of vaccination and screening programmes or the way in which health care is delivered, so it is vital to learn lessons from other countries and from previous behaviour change campaigns.

You can listen to the interview with Professor Susan Michie, and previous podcasts with Professor Richard Parish and Professor Sir Michael Marmot now on the About Us page of the RSPH website or by clicking here. 

RSPH In Conversation With… Professor Sir Michael Marmot

The Royal Society for Public Health (http://www.rsph.org.uk), with support from the Philipp Family Foundation, has launched a series of podcasts, designed to tease out some of the key issues facing Public Health today, not just in the UK, but around the world.

In the first interview, RSPH is In Conversation With Professor Sir Michael Marmot, who discusses how a health-centred approach to policy-making results in a fairer society for all, illustrated with examples from across the world.

Sir Michael is Professor of Epidemiology and Public Health at University College London and is perhaps best known as author of the influential report on health inequalities, Fair Society, Healthy Lives. In this interview, he discusses his research into how social processes impact on the causes of illness, and illustrates how anyone who works with the public can have a positive effect on Public Health.

This series of interviews comes at a time of critical importance, with rates of obesity rising, more stress-related illness than ever before and severe pressure on budgets in all areas of healthcare. Professor Richard Parish, Chief Executive of RSPH, introduces the interviews, setting out the key themes and the interconnection between them. “We are delighted that so many eminent people have been prepared to share their views through these podcasts, and we all believe it is vitally important for the issues around Public Health to be discussed and understood by the widest possible audience. As Local Authorities take on responsibility for this area, there is an enormous opportunity to put health at the centre of policy making, and use scarce funds wisely to improve the health of every community.”

You can listen to the interviews with Professor Richard Parish and Professor Sir Michael Marmot now on the About Us page of the RSPH website. http://www.rsph.org.uk/en/about-us/podcasts.cfm. The next podcast, RSPH In Conversation With Professor Susan Michie, on the subject of Behaviour Change, will be released on July 3rd. 

Good Mental Health holds the key to long term wellbeing

The Royal Society for Public Health (RSPH) has brought together experts from across the whole field of Mental Health in a thought provoking seminar on the role of Mental Health in the New Public Health System.

The passing of the Health and Social Care Act, the drive towards localism, and the Government’s approach to improving the population’s health through promotion of preventative measures, have begun to place mental health in the spotlight. 

The purpose of the seminar was to examine the impact of mental health on public health and wellbeing and its place within public health policy. The evidence shows that mental health and overall wellbeing can no longer be treated as separate challenges; they are closely interlinked and poor mental health affects a wide range of social and broader health issues.

The panel of speakers brought together statistics to show how poor Mental Health affects communities, and encouraging examples of effective methods and guidance tools, being used to assess the impact of change on the mental wellbeing of all stakeholders. 

Professor Richard Parish, Chief Executive of RSPH commented, “Mental health must be a top priority for Health and Wellbeing Boards.  Poor mental health has a huge impact on local communities and is a heavy cost to the NHS and local authorities.  The RSPH is delighted to have run a seminar designed to improve the effectiveness of local mental health strategies. We believe that positive changes can be achieved by sharing good practice and better collaboration between local councils, Third Sector organisations, and the NHS".

The speakers at the seminar included Professor Lord Patel of Bradford, Gregor Henderson, advisor to the Department of Health England on Mental Health and Wellbeing, Dr Jonathan Campion, Consultant Psychiatrist at South London and Maudsley NHS Foundation Trust, Tony Coggins, Head of Mental Health Promotion at South London and Maudsley NHS Foundation Trust, Graham Rushbrook FRSPH and Professor Richard Parish, Chief Executive of RSPH.

If you would like more information on the seminar, please contact Nelly Araujo at RSPH.

Email naraujo@rsph.org.uk or telephone 020 7265 7322.

Shaping a Quality Approach to Health Literacy in Primary Education - Seminar Overview

A group of senior public health, policy and education practitioners from across many different sectors came together in June to discuss the importance of health literacy in primary education.  This was a highly interactive event and well supported by all participants. 

 
Professor Richard Parish, Chief Executive of RSPH, welcomed everybody to the session and conveyed the RSPH’s support for developing a practical approach to health literacy. He was joined by Dr Selwyn Hodge, Chairman of the Society, who explained why he has adopted health literacy as the theme for his chairmanship. He clearly articulated his personal passion for health literacy and the need to develop a high-quality practical approach to embedding the concept in primary school education. 
 
After hearing from Andrew Carter OBE (head teacher and national adviser on head teacher leadership) about the role and purpose of primary education,  the participants were encouraged to consider  the many different ways of thinking about health literacy. This included decoding information, the acquisition of knowledge and tools, skills, keeping healthy and well, and personal development, nurturing.  The challenge for participants was to discuss whether it was possible to articulate a practical definition of health literacy including some or all of these elements. 
 
The concept of a health literacy ‘journey’ was also discussed, as were the key health, social, educational and economic benefits of early health education. It was agreed that our understanding of the meaning of health literacy and context determine our beliefs about its benefits and also how we as a society value it.
 
Participants were asked to suggest benefits under these category headings and propose additional categories, based on the following discussion questions:
 
a) What does your organisation believe are the benefits of early exposure to health education? Why?
 
b) Are you aware of any evidence or research to measure the impact of early exposure to information about health and well-being determinants on future health choices? Is your organisation involved in any work to determine or evaluate the benefits of health literacy?
 
The seminar then looked at the current policy context and the potential opportunities and challenges for health literacy in primary education:
 

1. The Health and Education White Papers
2. Recognition of the need for joined up working on public health and education
3. The Curriculum and PSHE reviews
4. The focus on teacher quality and employment based training and teaching schools

 
Participants were also asked to consider the challenges in developing a national approach to health literacy at primary level as well as considering what health literacy projects are already underway.
 
The group finally agreed that going forward the immediate actions included the need to understand some of the policy drivers in more detail and evaluating the available opportunities and/or forming a campaigning alliance.  A meeting was also suggested for early 2012 to look at progress.  For further details or to contribute to our work in supporting health literacy in primary education please contact Nelly Araujo on 0207 2657 322.

Loneliness – A Public Health Issue?

“Friendship is a lot like food. We need it to survive” –  Hara Estroff Marano, Psychology Today.

We humans have an inherent need to be part of a group, to form friendships, to interact and to socialise with people.  Evidence suggests that these are all necessary in order for us to maintain good health and wellbeing.  However, what happens when we only have part or none of the above, when we are unable to socialise, when we don’t feel like interacting, when we loose touch with friends and family?  It is likely that we will feel a sense of loneliness, and this, the experts say, can be detrimental to our health.

Since the 1990’s an increasing number of studies measuring the impact of loneliness suggest it is an important public health concern.  The evidence reveals that the risk of developing and dying from heart disease can depend on the strength of one’s social network of friends and family.

What is Loneliness and how does it arise?

Loneliness, although easy to describe is harder to define because of its many dimensions.  Wikipedia defines loneliness as an unpleasant feeling in which a person experiences a strong sense of emptiness and solitude resulting from inadequate levels of social relationships.  Loneliness is however a subjective experience, in that, if a person thinks they are lonely, then they are lonely whether they are in solitude or in the middle of a crowd. 

The mental Health Charity MIND, believe that loneliness is a very intense feeling and "to feel lonely is to be overwhelmed by an unbearable feeling of separateness, at a deep level”. 

It is likely that many of us will have experienced loneliness at some point in our lives.  For some it may be a temporary feeling, resulting from certain events, while for others, it could feel like a permanent part of life. 

Loneliness can occur for a number of reasons and as highlighted above can depend on a persons state of mind.  However, feelings of loneliness may arise from losing connection with others through death, breakup of a relationship, moving away, being immobile or ill and working longer hours, or from being unable to form new connections due to shyness or lack of confidence.

A report called The Lonely Society? commissioned by the Mental Health Foundation, found that the way in which people now live is impacting on their ability to connect with others. More people live alone: the percentage of households occupied by one person doubled from 6% in 1972 to 12% in 2008. The divorce rate has almost doubled in the past 50 years and the number of lone parent households is rising. People are living longer but many older people are doing so alone. Because of people pursuing careers and education opportunities, many now live further away from their families and the communities they grew up in. 

The Health Implications of Loneliness

Loneliness, although a natural emotion, can be detrimental to our physical and mental health.  One of the main reasons why loneliness has negative implications is because it makes it harder for us to control our habits and behaviour.  A book written by John T Cacioppo and William Patrick entitled "Loneliness: Human Nature and the Need for Social Connection" suggests that loneliness leads to self destructive habits, such as overeating, relying on alcohol and avoiding physical exercise.

In their numerous studies, they reported that not only do lonely people tend to withdraw from society (becoming further isolated) but they express higher levels of stress and difficulties sleeping, leading to diminished restorative processes.  Tests also show that loneliness affects the immune and cardiovascular systems and that there is a strong correlation between loneliness and depression.  The Lonely Society report? found that four in ten people (42%) have felt depressed because they felt alone.

James J Lynch, loneliness expert and writer of  "A Cry Unheard: New Insights into the Medical Consequences of Loneliness" describes loneliness as a silent epidemic that is harming public health, leading to depression and early death.  He proposes that causes of death are notably higher for “divorced, single, and widowed individuals of both sexes and all races."

Cacioppo points out that, “being connected with others is so necessary to survival, that human brains have become hard-wired to seek regular social contact”. 

How Lonely are We - The Statistics

The UK report by The Lonely Society? reveled that 48% of us believe people are getting lonelier in general.  Only 22% of us never feel lonely and one in ten (11%) of us feel lonely often.  A third of us (37%) have a close friend or family member who we think is very lonely and over half of us (57%) who have experienced depression or anxiety isolated ourselves from friends and family.

The pain of loneliness is the sharp end of a milder feeling of social disconnection that research suggests is widespread: a recent Emotional Needs Audit of the UK by the Human Givens Institute, which involved 4,600 online respondents, reported that 24.1% of people did not feel emotionally connected to others; 34.8% did not feel connected to the wider community and 35.4% felt they did not receive enough attention.  The lonelier our society, the more likely we are to experience loneliness.

Coping with Loneliness

Loneliness is clearly a health concern, and we need to seek ways of overcoming it.  Making the effort to spend time with a friend or family can have a two way effect.  It will allow you to socialise and feel good as well as having a positive impact on the other person.

The UK mental health charity MIND, offers several suggestions on how to overcome loneliness.  Some of these include; learning to be with others, joining a class, a local interest group or volunteering for something.  For further information on dealing with loneliness click here to go to the MIND website.

We are interested to hear your opinions.  Are we becoming a lonely society? Has technology played a part or is it the changes in our lifestyles?  How else can we tackle the lonely issue? 

New Years Resolution - Do More Exercise.....

Exercise keeps the brain from ageing

Research from the University of Florence and other institutions in Italy carried out a study which found that low to moderate exercise can prevent the milder forms of cognitive decline in older age.  The research was published in the Journal of Internal Medicine.

The research pooled the results of fifth teen studies and included the analysis of 33,816 people without dementia, who were followed between one and twelve years.  It revealed that exercise consisting of playing a round of golf once a week or tennis twice a week, was linked to a 35 percent reduction in the risk of cognitive decline.  The researchers believed that physical activity which raises your heartbeat, increases the blood flow to the brain and helps to reduce the mind deteriorating in later years.

The researchers explained that it has been widely acknowledged that physical activity has positive effects on a wide range of health measures, including reducing the risk of heart disease and stroke, diabetes, obesity, hypertension and some cancers.  However, the study demonstrated that attention, memory and concentration (known as cognitive functions) which typically deteriorate with age, can also reap the benefits by maintaining a healthy lifestyle and partaking in regular exercise. 

The analysis of the studies showed that subjects who performed a high level of physical activity were significantly more protected (by 38%) against cognitive decline during the follow up, compared to people who reported being sedentary. 

We all have a responsibility to look after our health and well-being and what a better time than now to include exercise and healthy eating as part of your new years resolutions. 

The Royal Society for Public health through Training Solutions run a Foundation Programme in Health Improvement.  The course offers candidates the opportunity of developing a firm foundation in Health improvement while also making aware the health and lifestyle choices that affect personal and public health.  For more information click here or contact Nicolette Smith. 

    

UK Adult Dental Health Survey Reveals Oral Health Improving

The 2009 Adult Dental Health Survey, which examined the teeth of 6,500 adults from England, Northern Ireland and Wales, shows that adults with visible decay has fallen by a fifth since 1998.

The research which has been running since 1968 and takes place every ten years, was carried out by a consortium led by the Office for National Statistics, to find out how healthy the publics teeth really are and also peoples perceptions and attitude towards dental hygiene.

The survey found that the proportion of adults who had no natural teeth has also fallen by almost a quarter in England and by a third in Northern Ireland and Wales over the past thirty years.   

Dr Nigel Carter, CEO of the British Health Foundation, was impressed by the results and said that the survey indicated that people, now more than ever, care about their teeth. 

“These latest figures confirm the progress which has been made in regards to the improving standards of oral health here in the UK.  We have suspected this to be true for a while now and it is certainly pleasing to finally see this indeed to be the case.”

Dr Carter also noted that the new statistics derived from the survey, come as no surprise.  He believes that the constant influx of new ideas, improved techniques and the advancement of materials appears to be evolving at pace. 

However, despite the positive results, he also pointed out that there was still scope for improvements to be made to ensure more people go for regular check ups. 

Avoiding the Dentist?

The survey also highlighted that one of the reasons why people are reluctant to visit the dentist, is because they suffer from “extreme dental anxiety”.  Nearly one in five women and one in ten men, feel anxious before they even sit in the dentist chair, and hence avoid check ups. 

Dr Carter points out that avoiding the dentist can actually cause further problems down the line, “The 27 percent who claimed to only visit their dentist when they experienced a problem with their mouths could have prevented potentially problematic treatments and unnecessary financial expense by attending regular dental check-ups." 

"Dental techniques have improved so much over the last few years, and modern dental treatment can now be completely painless”.  So people should be not be deterred or feel worried. 

"Keeping our teeth healthy and cleaning twice a day with a fluoride toothpaste, cutting down on how often we have sugary foods and drinks can help us smile with confidence, but more importantly has overall health benefits.  The links between oral health problems such as gum disease and conditions like heart disease, strokes, diabetes and in the case of pregnant women, low birth weight babies, for instance, has all been well documented and is backed by robust scientific evidence" pointed out Dr Carter. 

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