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. 

Why making just two lifestyle changes can have positive and far reaching affects on health

A recent study, at the Northwestern University Feinberg School of Medicine, found that changing one bad habit can have a positive knock on effect on other behaviours.  A simple step such as watching less television, can simultaneously reduce the amount of time one spends snacking on unhealthy foods – as these two behaviours are closely related.   As such, the notion that you must radically transform your life in order to be healthier is not necessarily true and often hard to maintain.  Making just a couple of small changes, as the study demonstrates, can have a real and long lasting impact on people’s health.

The study was conducted by Bonnie Spring, professor of preventive medicine at Northwestern University Feinberg School of Medicine, in an attempt to find out the most effective way to spur people to change common bad health habits.  204 adult patients with unhealthy habits, were given the following treatments; an increase in vegetables/fruit and physical activity and decrease in fat and sedentary leisure.  Over the course of the three weeks, the patients had to record their daily data into a personal digital assistant in order to establish if they met their goals. 

After the three weeks, patients no longer had to maintain their “healthier” lifestyles, but were still required to send data three days a month for six months.

After the completion of the six months, the study found that the patients kept to their new healthier lifestyle changes rather than reverting back to their old habits.  Around 86% of the participants said that once they had made the initial change, they tried to maintain it.  By incorporating fruits and vegetables in their diet empowered them to believe that they were in fact capable of change. 

The results indicated that the most effective way to improve health required two key behaviour changes, namely cutting the amount of time spent watching TV or on the computer and eating more fruits and vegetables.  It is believed that these two simple changes could have long lasting results.   

Spring said, "Just making two lifestyle changes has a big overall effect and people don't get overwhelmed."

The majority of the population, where obesity is most prevalent, often lead unhealthy and sedentary lifestyles, putting them at high risk for heart disease, diabetes and cancer.  Spring argues that it is often hard for doctors to know where to initiate change in unhealthy habits, without discouraging or offending patients.   Thus this “two way” simple approach enables others to make realistic and manageable changes by giving them confidence to carry it out.

“With this simplified strategy, people are capable of making big lifestyle changes in a short period of time and maintaining them”  


Photo by Sina Bahrami http://5127.co.uk/

Why talking is good for our well-being

I'm sure we are all familiar with the expression “a problem shared is a problem halved”.  Now recent research affirms that communicating our thoughts and experiences to others, actually stimulates cognitive and neural mechanisms associated with reward and hence makes us feel better.   

The study, “Disclosing information about the self is intrinsically rewarding” was carried out by Harvard neuroscientist Diana Tamir and Harvard colleague Jason Mitchell and focused primarily on brain functionality associated with talking about oneself.  The evidence demonstrated that self disclosure was strongly linked with increased activation in brain regions that form what is known as the mesolimbic dopamine system. 

This system is recognised as the pathway in which dopamine is carried from one area of the brain to another and is responsible for controlling the brain’s pleasure and reward centers.  It is also associated with the functions of movement, preservation and compulsion. 

An MRI scanner was used to monitor the subjects’ brain by picking up changes in neurons activity as well as blood flow.  As a result, the scientists were able to distinguish the part of the brain that was responding to what the subject was talking about.  The experiment found that when people talked about themselves, which included beliefs and opinions, blood flow to region became significantly prominent. 

The study highlights that humans have a tendency to convey information about personal experience, because of the intrinsic value associated with self disclosure.  Whenever we face a problem, sometimes sharing our concerns or just simply relaying a fond memory to someone, can make us feel better and hence have a positive impact on our mental well-being and health.  Moreover, Tamir points out that by openly discussing our beliefs and opinions with others, has the added value of building social bonds and social alliances between people.

Perhaps we shouldn't underestimate the power of a conversation and the benefits of simply taking the time to listen and talk to someone.

Healthy Man, Happy Man - Simple

Addressing Men's Health

News articles have reported that happiness can help to keep your heart healthy.  Here at RSPH we advocate a similar view, in that by looking after your health and wellbeing, not only will you feel great but you will be happier too.

As Men’s Health Week is only round the corner (11^th-17^th June) we wanted to highlight the issues surrounding the gender health inequalities experienced by many men and why men’s health is a critical issue that needs to be addressed.

The statistics show that 22% of men are dying before the age of 64 compared to 13% of women.  Men are more likely than women to die from cancer, have heart problems, be obese or overweight, smoke, drink high levels of alcohol and have poorer diets.  Additionally, men are also 20% less likely than women to seek health services or visit GPs.

In the challenge to improve men’s health and to continue the ethos that a healthy heart really does equal a happy man, family and community, the RSPH have developed an innovative Men’s Health programme to be held on Tuesday 12^th June.

The one day event, which is supported by the Men’s Health Forum, aims to increase health and community practitioners’ understanding of how gender socialisation and masculinity can affect male health beliefs and behaviour.   The course will seek to increase awareness of the main health problems affecting men and barriers men face in using health services.   By identifying appropriate ways to engage men in healthy lifestyle initiatives and increasing male service access, we become closer to reducing existing gender health inequalities.  For further information or to book onto the course please click here or contact Nicolette Boustaoui

*Promotion of the month* To help you with any financial situations you may be experiencing, we are now offering the Men’s Health programme at a discounted rate of £175.  

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.

Research into attitudes to children’s food and obesity prevention 

RSPH is working with The School Food Trust to investigate how public health professionals view the issues around children’s food and obesity prevention. As the landscape for public health is changing, it is vital that children’s health and wellbeing continues to attract focus and funding, and for this reason we are keen to hear from colleagues who are responsible for commissioning children’s healthy eating programmes including school meals.

Please take a few minutes to complete this short survey (http://www.surveymonkey.com/s/CFT_health) about attitudes to children’s food and obesity prevention and one organisation will win a free training programme from The School Food Trust.

We will share the results of our work over the coming months, and if you are responsible for commissioning these services and would be prepared to take part in a more detailed telephone interview, please email Gina Mohajer (gmohajer@rsph.org.uk) or phone her on  020 7265 7327

Are we drinking too much? New report shows rises in death due to Liver Disease

Today a new report warns that the number of people dying from liver disease in England is on the increase, with the most common factor for mortality being attributed to unhealthy lifestyles and consequently preventable.

The report “Deaths from liver disease: Implications for the end of life care in England” the first ever national report on the statistics published by the National End of Life Care Intelligence Network, shows that between 2001 and 2009 there has been a 25 percent rise in liver disease deaths (from 9,231 to 11,575 people).

Figures indicate that although the numbers of deaths from cancer, vascular and respiratory disease still remain significantly higher, liver disease disproportionately kills people at a much younger age.

Alarmingly 90 percent of people who die from liver disease are under 70 years old and more than 1 in 10 are in their 40s.  The report also highlights that more men (60 percent) than women (40 percent) die from liver disease.

Lifestyle and Liver disease

Although there are many reasons for liver disease, the most common cause is alcohol related.

The British Liver Trust says that a healthy liver should contain little or no fat.  Fatty liver, where the liver contains too much fat, is regarded as the most common forms of liver disease.  The effects of having fat in the liver over a long duration of time may lead to inflammation causing swelling (hepatitis) and then scarring (fibrosis).  Where the condition may be the result of excess alcohol, it is referred to as alcoholic liver disease.

Alcoholic liver disease is the most common and preventable type of liver disease.  It accounts for over a third of all liver disease deaths and kills 3,880 people annually.  The figure for men is considerably higher at 2,588 deaths compared to that of women 1,292 deaths.  Regionally, the report demonstrates that alcoholic liver disease death is most prevalent in the North West, South East and West Midlands.  However, for both male and female the highest mortality rate is in the North West, approximately double that of the lowest in the East of England.

The Chief Executive of Alcohol Concern, Eric Appleby, said: "This report shows that loss of life through alcoholic liver disease remains as big a problem as ever, with a worrying tendency for those with the highest deprivation to suffer most, leading to a distinct north/south divide.

Cause for Concern

Liver disease is regarded as a challenging area for public health.  With over 70 percent of people with liver disease dying in hospital, patients tend to be younger, from poor socio-economic backgrounds (although this is not always the case) and often come from either isolated or ethnically diverse subcultures.  Those dying of alcoholic liver disease may have mental health problems drug dependency issues, which could further isolate them socially.  Additionally, people may feel stigmatised by their disease because of its degenerative nature.

Professor Martin Lombard, National Clinical Director for Liver Disease, said: "The key drivers for increasing numbers of deaths from liver disease are all preventable, such as alcohol, obesity, hepatitis C and hepatitis B. We must focus our efforts and tackle this problem sooner rather than later."

What can you do?

One of the key objectives of the Government’s White Papers Liberating the NHS and Healthy Lives, Healthy People, was to reduce mortality in people under 75 years of age.

The report shows that death from liver disease can affect any one of us and is largely the result of our lifestyle.  Rises in alcohol consumption and obesity are clearly huge areas for concern.  Therefore, in order to tackle the issues and reduce mortality rates, advocates believe we need to address the underlying causes of liver disease.  It becomes essential that we help to educate people about the consequences of unhealthy living and ways to improve their lives, as well as, reaching out to the most deprived and isolated people in society.

Prof Julia Verne, lead author of the report and clinical lead for the National End of Life Care Intelligence Network, said: "It is crucial that commissioners and providers of health and social care services know the prevalence of liver disease in their local areas, so that more people can receive the care they need to allow them to die in the place of their choosing."

RSPH Training Solutions offer a number of low cost training programmes on health improvement, JSNA’s, and provide training on key aspects of health to help you, help others and people in your community to lead longer and healthier lives.  For more information click here.