Category: Physical Activity

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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
CYP Healthcare Healthy Child including NCMP & CDO Healthy Settings Infant Mortality Library Licensing Long-Term Conditions Marmot Review Mortality Oral Health Physical Activity Planning Public Health Advice to NHS Commissioners Public Mental Health Social Determinants of Health

Health Equity in England: The Marmot Review 10 years on

By Institute of Health Equity (Feb 2020)

This report, Health equity in England: The Marmot Review 10 years on, was commissioned by the Health Foundation, to explore what has happened to health inequalities and social determinants of health in the decade since the Marmot Review. We provide in-depth analysis of health inequalities in England and assess what has happened in key social determinants of health, positively and negatively, in the last 10 years. Critically, we set out an agenda for the Government and local authorities to take action to reduce health inequalities in England. This agenda is based on evidence and practical action evidence from the Marmot Review, and enhanced by new evidence from the succeeding decade, including evidence and learning from practical experience of implementing approaches to health inequalities in England and internationally.

Click here to view this report

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exercise Guidance Healthy Child including NCMP & CDO Healthy Settings Oral Health Physical Activity

UK Chief Medical Officers' Physical Activity Guidelines

By Department for Health & Social Care (2019)

These guidelines are for health professionals, policy-makers and others working to promote physical activity, sport and exercise for health benefits. They emphasise the importance of building strength and balance for adults, and include recommendations for pregnant women, new mothers and people with disabilities.

Click here to view these guidelines

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exercise Healthy Settings Oral Health Physical Activity school work

Get a move on: Steps to increase physical activity levels in the UK

By BMA (2019)

This briefing examines the wide range of benefits of physical activity, the current low levels of physical activity in the UK and the significant inequalities that exist in levels of physical activity within the population. Policy recommendations across four core parts of people’s lives – travel, leisure, school and work – set out the steps government and policy-makers should take to increase physical activity levels across the UK.

Click here to view this briefing

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
Alcohol CVD Healthy Settings Infection Control Liver Disease including NHS Health Checks Oral Health Physical Activity Public Mental Health Respiratory Disease Tobacco & Drugs

Free e-learning – All our health

By Public Health England (2019)

Public Health England has launched new free bite-sized e-learning sessions, developed in partnership with Health Education England, to improve the knowledge, confidence and skills of all health and care professionals in preventing illness, protecting health and promoting wellbeing.
The sessions cover some of the biggest issues in public health and they contain signposting to trusted sources of helpful evidence, guidance and support to help professionals embed prevention in their everyday practice.
You can access the All Our Health e-learning sessions here

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
Alcohol exercise General Practice Healthy Settings Mortality Oral Health Physical Activity Smoking Cessation Tobacco & Drugs

Going the Distance: Exercise professionals in the wider public health workforce

By Royal Society for Public Health (2018)

This report, written with ukactive, explores how fitness professionals can play an enhanced role in supporting the public’s health. It calls for GP drop-in and smoking cessation services inside gyms and leisure centres to help ease pressure on local health facilities and improve access to health improvement services.

Click here to view this report

Categories
CYP Healthcare Healthy Settings Oral Health Physical Activity Public Health Advice to NHS Commissioners

Physical activity and the environment

by NICE (2018)

This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels. The recommendations in this guideline should be read alongside NICE’s guideline on physical activity: walking and cycling.

Recommendations

This guideline includes recommendations on:
•strategies, policies and plans to increase physical activity in the local environment
•active travel
•public open spaces
•buildings
•schools

Click here to view this guidance

Categories
Alcohol cost-effective economic evaluation Nutrition Obesity Oral Health Physical Activity Smoking STPs Tobacco & Drugs

A systematic review of economic evaluations of local authority commissioned preventative public health interventions in overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation in the United Kingdom

White, P. et al. Journal of Public Health, 2018, doi.org/10.1093/pubmed/fdy026

Click here to view this article

Abstract
Background
Since 2013, local authorities in England have been responsible for commissioning preventative public health interventions. The aim of this systematic review was to support commissioning by collating published data on economic evaluations and modelling of local authority commissioned public health preventative interventions in the UK.

Methods
Following the PRISMA protocol, we searched for economic evaluations of preventative intervention studies in four different areas: overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation. The systematic review identified studies between January 1994 and February 2015, using five databases. We synthesized the studies to identify the key methods and examined results of the economic evaluations.

Results
The majority of the evaluations related to cost-effectiveness, rather than cost-benefit analyses or cost-utility analyses. These analyses found preventative interventions to be cost effective, though the context of the interventions differed between the studies.

Conclusions
Preventative public health interventions in general are cost-effective. There is a need for further studies to support justification of continued and/or increased funding for public health interventions. There is much variation between the types of economically evaluated preventative interventions in our review. Broader studies incorporating different contexts may help support funding for local authority-sponsored public health initiatives.