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: CYP Healthcare
The Lancet Public Health Volume 5, ISSUE 9, e493-e500, September 01, 2020
Click here to view this article
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.
The Lancet Public Health Volume 5, ISSUE 7, e404-e413, July 01, 2020
Click here to read the full article
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.
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.
By Public Health England (2019)
This report, and associated documents, summarises the evidence for the effectiveness of universal approaches to improving children and young people’s mental health and wellbeing. The documents are intended for strategic and operational leads, working on children and young people’s mental health.
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.
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.
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.
View case studies by topic:
Cancer
Cardiovascular
Diabetes
Digital
Integrated care
Learning disabilities
Maternity
Mental health
Personalised care
Primary care
Stroke
Urgent and emergency care
View case studies by life stage:
Starting well
Better care for major health conditions
Ageing well
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