By Public Health England (2020)
Reports for local government and their partners to inform their co-ordinated approaches to reduce vulnerability and adversity in childhood.
Category: Infant Mortality
The Lancet Public Health Volume 5, ISSUE 9, e493-e500, September 01, 2020
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Background
Many children are exposed to second-hand smoke in the home and are at increased risk of asthma and other respiratory conditions. In Scotland, a public health mass-media campaign was launched on March 24, 2014, called Take it Right Outside (TiRO), with a focus on reducing the exposure of children to domestic second-hand smoke. In this study, our aim was to establish whether the TiRO campaign was followed by a decrease in hospital admissions for childhood asthma and other respiratory conditions related to second-hand smoke exposure across Scotland.
Methods
For an interrupted time-series analysis, data were obtained on all hospital admissions in Scotland between 2000 and 2018 for children aged younger than 16 years. We studied changes in the monthly incidence of admissions for conditions potentially related to second-hand smoke exposure (asthma, lower respiratory tract infection, bronchiolitis, croup, and acute otitis media) per 1000 children following the 2014 TiRO campaign, while considering national legislation banning smoking in public spaces from 2006. We considered asthma to be the primary condition related to second-hand smoke exposure, with monthly asthma admissions as the primary outcome. Gastroenteritis was included as a control condition. The analysis of asthma admissions considered subgroups stratified by age and area quintile of the Scottish Index of Multiple Deprivations (SIMD).
Findings
740 055 hospital admissions were recorded for children. 138 931 (18·8%) admissions were for respiratory conditions potentially related to second-hand smoke exposure, of which 32 342 (23·3%) were for asthma. After TiRO in 2014, we identified a decrease relative to the underlying trend in the slope of admissions for asthma (−0·48% [–0·85 to −0·12], p=0·0096) in younger children (age <5 years), but not in older children (age 5–15 years). Asthma admissions did not change after TiRO among children 0–15 years of age when data were analysed according to area deprivation quintile. Following the 2006 legislation, independent of TiRO, asthma admissions decreased in both younger children (−0·36% [–0·67 to −0·05], p=0·021) and older children (−0·68% [–1·00 to −0·36], p<0·0001), and in children from the most deprived (SIMD 1; −0·49% [–0·87 to −0·11], p=0·011) and intermediate deprived (SIMD 3; −0·70% [–1·17 to −0·23], p=0·0043) area quintiles, but not in those from the least deprived (SIMD 5) area quintile.
Interpretation
Our findings suggest that smoke-free home interventions could be an important tool to reduce asthma admissions in young children, and that smoke-free public space legislation might improve child health for many years, especially in the most deprived communities.
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.
By Lewer, D. et al. The Lancet Public Health, 2019 doi.org/10.1016/S2468-2667(19)30219-1
Low socioeconomic position is consistently associated with increased risk of premature death. The aim of this study is to measure the aggregate scale of inequality in premature mortality for the whole population of England.
Categories
Accident Prevention Alcohol Cancer Care of the Elderly Community Safety CVD CYP Healthcare Health Protection (Emergency planning Healthy Child including NCMP & CDO Healthy Settings Infant Feeding Infant Mortality Infection Control Library Liver Disease including NHS Health Checks Long-Term Conditions Mortality Respiratory Disease seasonal mortality) Tobacco & Drugs
NHS long term plan case studies
The NHS Long Term Plan will make sure the NHS is fit for the future.
Find out through our case studies and films about how the NHS is already making significant changes and developing to better meet the needs of patients and their families through every stage of life.
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Categories
Accident Prevention Alcohol Cancer Care of the Elderly Community Safety CVD CYP Healthcare Evidence Based Health Protection (Emergency planning Healthy Child including NCMP & CDO Healthy Settings Infant Feeding Infant Mortality Infection Control Library Liver Disease including NHS Health Checks Long-Term Conditions Respiratory Disease seasonal mortality) Tobacco & Drugs
Prescribing cannabis based drugs: response from NICE and Health Education England
I thought I would include this response from NICE and HEE as it is an important message. Click the link below to access the letter or read it below.
https://www.bmj.com/content/363/bmj.k4940
Further to Hamilton’s recommendation that general practitioners consult Google Scholar and ask their colleagues if they are unsure about prescribing cannabis,1 we write to remind readers in England that they have 24/7 access to reliable sources of evidence to inform clinical decisions.
The National Institute for Health and Care Excellence’s evidence search (https://www.evidence.nhs.uk) provides access to authoritative evidence on health, social care, and public health. It focuses on synthesised secondary evidence, including content from over 800 sources, including the British National Formulary, Clinical Knowledge Summaries, SIGN, the Cochrane Library, the royal colleges, Public Health England, and GOV.UK. Information and knowledge specialists at NICE add further good quality systematic reviews. This service is openly available to everyone in the UK; here you will find reviews on the use of cannabis in treatment of epilepsy, neuropathic pain, fibromyalgia, HIV/AIDS, and asthma.
Healthcare staff in England can access a vital, core collection of healthcare databases and full text journals for no charge at https://hdas.nice.org.uk. Purchased by Health Education England on behalf of the NHS in England, these are provided online in partnership with NICE. You simply need an NHS OpenAthens account. Register at https://www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases/OpenAthens.
NHS funded librarians and knowledge specialists are skilled in helping colleagues find information and search for evidence. They can offer summarised evidence searches and help teams keep up-to-date.
Health is a knowledge industry. We encourage practices to contact their local healthcare library. Check http://hlisd.org for details. Health Education England is committed to work with NHS organisations to ensure that all staff can access knowledge for healthcare23 and benefit from the expertise of healthcare librarians. We know that only a third of Clinical Commissioning Groups currently have such arrangements in place for their staff and member practices. For advice on improving your organisation’s access to knowledge services please contact your regional Health Education England library lead.3
Marufu, T.C et al (2015) BMC Public Health, 15: 239
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Abstract
Background
Smoking in pregnancy is known to be associated with a range of adverse pregnancy outcomes, yet there is a high prevalence of smoking among pregnant women in many countries, and it remains a major public health concern. We have conducted a systematic review and meta-analysis to provide contemporary estimates of the association between maternal smoking in pregnancy and the risk of stillbirth.
Methods
We searched four databases namely MEDLINE, EMBASE, Psych Info and Web of Science for all relevant original studies published until 31st December 2012. We included observational studies that measured the association between maternal smoking during pregnancy and the risk of stillbirth.
Results
1766 studies were screened for title analysis, of which 34 papers (21 cohorts, 8 case controls and 5 cross sectional studies) met the inclusion criteria. In meta-analysis smoking during pregnancy was significantly associated with a 47% increase in the odds of stillbirth (OR 1.47, 95% CI 1.37, 1.57, p < 0.0001). In subgroup analysis, smoking 1-9 cig/day and ≥10 cig/day was associated with an 9% and 52% increase in the odds of stillbirth respectively. Subsequently, studies defining stillbirth at ≥ 20 weeks demonstrated a 43% increase in odds for smoking mothers compared to mothers who do not smoke, (OR 1.43, 95% CI 1.32, 1.54, p < 0.0001), whereas studies with stillbirth defined at ≥ 24 weeks and ≥ 28 weeks showed 58% and 33% increase in the odds of stillbirth respectively.
Conclusion
Our review confirms a dose-response effect of maternal smoking in pregnancy on risk of stillbirth. To minimise the risk of stillbirth, reducing current smoking prevalence in pregnancy should continue to be a key public health high priority.
Categories
Accident Prevention Alcohol Cancer Care of the Elderly Community Safety CVD CYP Healthcare Health Protection (Emergency planning Healthy Child including NCMP & CDO Healthy Settings Infant Feeding Infant Mortality Infection Control Library Liver Disease including NHS Health Checks Local Government Long-Term Conditions Respiratory Disease seasonal mortality) Tobacco & Drugs
Health and social care priorities for the Government: 2015-2020
By The Nuffield Trust (2015)
This briefing outlines ten possible key health and social care priorities for the new government, covering funding and finance, quality of care, new models of care and workforce.
By Royal College of General Practitioners (2015)
Children make up more than a quarter of emergency department attendances in the UK and in England alone there has been a 28 per cent increase in admissions for children to hospital over the last ten years. Healthcare professionals are warning that unless there is an overhaul of unscheduled care services, there is a risk that growing demand will result in poorer outcomes for children. This set of standards says that in order to deal with these pressures, and to improve child health outcomes, not only do unscheduled care services need more investment but there also needs to be a shake-up of how services are designed, with more children being cared for outside the hospital, in the community and closer to their home.
Categories
Accident Prevention Alcohol Cancer Care of the Elderly Community Safety CVD CYP Healthcare Health Protection (Emergency planning Healthy Child including NCMP & CDO Healthy Settings Infant Feeding Infant Mortality Infection Control Library Liver Disease including NHS Health Checks Long-Term Conditions Mortality Respiratory Disease seasonal mortality) Tobacco & Drugs
NEW EBOOKS FOR PUBLIC HEALTH LANCASHIRE STAFF
20 ebooks relating to Public Health have been purchased and are all freely accessible to all Public Heath Lancashire staff with an Athens username and password.
To view these books and apply for an Athens username click on the ‘New eBooks’ tab on the blogs homepage