Category: Obesity

Categories
CYP Healthcare Healthy Child including NCMP & CDO Healthy Settings Nutrition Obesity

The effect of food taxes and subsidies on population health and health costs: a modelling study

The Lancet Public Health Volume 5, ISSUE 7, e404-e413, July 01, 2020

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Background
One possible policy response to the burden of diet-related disease is food taxes and subsidies, but the net health gains of these approaches are uncertain because of substitution effects between foods. We estimated the health and cost impacts of various food taxes and subsidies in one high-income country, New Zealand.
Methods
In this modelling study, we compared the effects in New Zealand of a 20% fruit and vegetable subsidy, of saturated fat, sugar and salt taxes (each set at a level that increased the total food price by the same magnitude of decrease from the fruit and vegetable subsidy), and of an 8% so-called junk food tax (on non-essential, energy-dense food). We modelled the effect of price changes on food purchases, the consequent changes in fruit and vegetable and sugar-sweetened beverage purchasing, nutrient risk factors, and body-mass index, and how these changes affect health status and health expenditure. The pre-intervention intake for 340 food groups was taken from the New Zealand National Nutrition Survey and the post-intervention intake was estimated using price and expenditure elasticities. The resultant changes in dietary risk factors were then propagated through a proportional multistate lifetable (with 17 diet-related diseases) to estimate the changes in health-adjusted life years (HALYs) and health system expenditure over the 2011 New Zealand population’s remaining lifespan.
Findings
Health gains (expressed in HALYs per 1000 people) ranged from 127 (95% uncertainty interval 96–167; undiscounted) for the 8% junk food tax and 212 (102–297) for the fruit and vegetable subsidy, up to 361 (275–474) for the saturated fat tax, 375 (272–508) for the salt tax, and 581 (429–792) for the sugar tax. Health expenditure savings across the remaining lifespan per capita (at a 3% discount rate) ranged from US$492 (334–694) for the junk food tax to $2164 (1472–3122) for the sugar tax.
Interpretation
The large magnitude of the health gains and cost savings of these modelled taxes and subsidies suggests that their use warrants serious policy consideration.

Categories
Accident Prevention Community Safety Healthy Settings Infection Control Licensing Long-Term Conditions Mortality Nutrition Obesity Oral Health Physical Activity Planning Working-age population

Population-based estimates of healthy working life expectancy in England at age 50 years: analysis of data from the English Longitudinal Study of Ageing

The Lancet Public Health Volume 5, ISSUE 7, e395-e403, July 01, 2020

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Background
Retirement ages are rising in many countries to offset the challenges of population ageing, but people’s capacity to work for more years in their later working life (>50 years) is unclear. We aimed to estimate healthy working life expectancy in England.
Methods
This analysis included adults aged 50 years and older from six waves (2002–13) of the English Longitudinal Study of Ageing (ELSA), with linked mortality data. Healthy working life expectancy was defined as the average number of years expected to be spent healthy (no limiting long-standing illness) and in paid work (employment or self-employment) from age 50 years. Healthy working life expectancy was estimated for England overall and stratified by sex, educational attainment, deprivation level, occupation type, and region by use of interpolated Markov chain multi-state modelling.
Findings
There were 15 284 respondents (7025 men and 8259 women) with survey and mortality data for the study period. Healthy working life expectancy at age 50 years was on average 9·42 years (10·94 years [95% CI 10·65–11·23] for men and 8·25 years [7·92–8·58] for women) and life expectancy was 31·76 years (30·05 years for men and 33·49 years for women). The number of years expected to be spent unhealthy and in work from age 50 years was 1·84 years (95% CI 1·74–1·94) in England overall. Population subgroups with the longest healthy working life expectancy were the self-employed (11·76 years [95% CI 10·76–12·76]) or those with non-manual occupations (10·32 years [9·95–10·69]), those with a tertiary education (11·27 years [10·74–11·80]), those living in southern England (10·73 years [10·16–11·30] in the South East and 10·51 years [9·80–11·22] in the South West), and those living in the least deprived areas (10·53 years [10·06–10·99]).
Interpretation
Healthy working life expectancy at age 50 years in England is below the remaining years to State Pension age. Older workers of lower socioeconomic status and in particular regions in England might benefit from proactive approaches to improve health, workplace environments, and job opportunities to improve their healthy working life expectancy. Continued monitoring of healthy working life expectancy would provide further examination of the success of such approaches and that of policies to extend working lives.

Categories
Alcohol Healthy Settings menopause Nutrition Obesity performance management pregnancy Substance Misuse Tobacco & Drugs

New Evidence Briefings from Public Health England

There are 4 new Evidence Briefings available to download on the KLS Briefing webpage: click here to view all briefings 

Are healthy weight management interventions effective before, during and after pregnancy? (under Reproductive Health)

What can employers do to support women going through the menopause? (under Work and Health)

What approaches to performance management and performance appraisal in the workplace are effective for improving organisation outcomes or staff attitudes to the process? (under Performance Management).

What research has been done to understand substance misuse within the UK student population, and what interventions have been introduced as a result? (under Substance Misuse).

Categories
Alcohol CVD CYP Healthcare Health Protection (Emergency planning Healthy Settings Licensing Liver Disease including NHS Health Checks Long-Term Conditions Mortality Nutrition Obesity Oral Health Physical Activity Planning Public Health Advice to NHS Commissioners Public Mental Health Respiratory Disease seasonal mortality) Sexual Health Tobacco & Drugs

What good looks like

By The Association of Directors of Public Health (2019)

The Association of Directors of Public Health (ADPH) and Public Health England (PHE) have co-produced a series of ‘What Good Looks Like’ (WGLL) publications that set out the guiding principles of ‘what good quality looks like’ for population health programmes in local systems.

The WGLL publications are based on the evidence of ‘what works and how it works’ including effectiveness, efficiency, equity, examples of best practices, opinions and viewpoints and, where available a return on investment.

Click here to view these publications

Categories
CYP Healthcare Healthy Child including NCMP & CDO Nutrition Obesity

A recipe for action: using wider evidence for a healthier UK

By Health Foundation (2019)

  • A selection of essays written by individuals from a diverse range of industries and specialisms, reflecting on the case study of child obesity.
  • Together they illustrate how different disciplines and professional practices conceptualise evidence and how they reason about moving from evidence to taking action.
  • They also show that a broad range of disciplines and professional practices share similar goals.

Click here to read this report

Categories
Cancer Healthy Settings Nutrition Obesity

Paying the price: New evidence on the link between price promotions, purchasing of less healthy food and drink, and overweight and obesity in Great Britain

By Cancer Research UK (2019)

The study, which looked at the habits of more than 16,000 British households, found that people whose shopping baskets contained around 40-80 per cent of goods on special offer have more than a 50 per cent increased chance of being obese.

Click here to view this report

Categories
Healthy Settings Licensing Long-Term Conditions Mortality Nutrition Obesity Oral Health Physical Activity Planning Public Health Advice to NHS Commissioners

Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Steel, et al. Lancet 2018; 392: 1647–61

Click here to view this systematic review

Background

Previous studies have reported national and regional Global Burden of Disease (GBD) estimates for the UK. Because of substantial variation in health within the UK, action to improve it requires comparable estimates of disease burden and risks at country and local levels. The slowdown in the rate of improvement in life expectancy requires further investigation. We use GBD 2016 data on mortality, causes of death, and disability to analyse the burden of disease in the countries of the UK and within local authorities in England by deprivation quintile.

Methods

We extracted data from the GBD 2016 to estimate years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and attributable risks from 1990 to 2016 for England, Scotland, Wales, Northern Ireland, the UK, and 150 English Upper-Tier Local Authorities. We estimated the burden of disease by cause of death, condition, year, and sex. We analysed the association between burden of disease and socioeconomic deprivation using the Index of Multiple Deprivation. We present results for all 264 GBD causes of death combined and the leading 20 specific causes, and all 84 GBD risks or risk clusters combined and 17 specific risks or risk clusters.

Findings

The leading causes of age-adjusted YLLs in all UK countries in 2016 were ischaemic heart disease, lung cancers, cerebrovascular disease, and chronic obstructive pulmonary disease. Age-standardised rates of YLLs for all causes varied by two times between local areas in England according to levels of socioeconomic deprivation (from 14 274 per 100 000 population [95% uncertainty interval 12 791–15 875] in Blackpool to 6888 [6145–7739] in Wokingham). Some Upper-Tier Local Authorities, particularly those in London, did better than expected for their level of deprivation. Allowing for differences in age structure, more deprived Upper-Tier Local Authorities had higher attributable YLLs for most major risk factors in the GBD. The population attributable fractions for all-cause YLLs for individual major risk factors varied across Upper-Tier Local Authorities. Life expectancy and YLLs have improved more slowly since 2010 in all UK countries compared with 1990–2010. In nine of 150 Upper-Tier Local Authorities, YLLs increased after 2010. For attributable YLLs, the rate of improvement slowed most substantially for cardiovascular disease and breast, colorectal, and lung cancers, and showed little change for Alzheimer’s disease and other dementias. Morbidity makes an increasing contribution to overall burden in the UK compared with mortality. The age-standardised UK DALY rate for low back and neck pain (1795 [1258–2356]) was higher than for ischaemic heart disease (1200 [1155–1246]) or lung cancer (660 [642–679]). The leading causes of ill health (measured through YLDs) in the UK in 2016 were low back and neck pain, skin and subcutaneous diseases, migraine, depressive disorders, and sense organ disease. Age-standardised YLD rates varied much less than equivalent YLL rates across the UK, which reflects the relative scarcity of local data on causes of ill health.

Interpretation

These estimates at local, regional, and national level will allow policy makers to match resources and priorities to levels of burden and risk factors. Improvement in YLLs and life expectancy slowed notably after 2010, particularly in cardiovascular disease and cancer, and targeted actions are needed if the rate of improvement is to recover. A targeted policy response is also required to address the increasing proportion of burden due to morbidity, such as musculoskeletal problems and depression. Improving the quality and completeness of available data on these causes is an essential component of this response.

 

Categories
CYP Healthcare Healthy Child including NCMP & CDO Healthy Settings healthy weight Nutrition Obesity

Promoting healthy weight in children, young people and families: A resource to support local authorities

By Public Health England (2018)

This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach. The briefings help to make the case for taking action to reduce childhood obesity, give examples of actions that can be taken, and provide key documents that form the evidence base and other useful resources. Practice examples are also given to illustrate what local areas are doing.

Click here to view this resource

Categories
Long-Term Conditions Mortality Nutrition Obesity strategies

Tackling obesity: what the UK can learn from other countries

By 2020 Health (2018)

2020health’s third report on obesity since 2014 highlights the fact that strong and mandated central policy, supporting bold, holistic local action, is still needed to impact what is arguably the greatest health challenge of the 21st century. The report examines topical obesity intervention strategies from around the world to frame the question: can the UK learn from policy abroad?

Click here to view this report

Categories
Children CYP Healthcare Nutrition Obesity

Childhood obesity: time for action

By House of Commons Health Committee (2018)

The government is expected to publish shortly a refreshed version of the childhood obesity plan first published in summer 2016. This report calls for an effective childhood obesity plan with a joined-up, whole systems approach and one that focuses particularly on tackling the ever-widening health inequality due to childhood obesity between the richest and poorest area.

Click here to view this report