Category: Mortality

Categories
Accident Prevention Alcohol behaviour change Community Safety Health Protection (Emergency planning Healthy Settings Long-Term Conditions Mortality Nutrition Obesity Oral Health Physical Activity seasonal mortality) Tobacco & Drugs

Tackling multiple unhealthy risk factors: emerging lessons from practice

By The King’s Fund (2018)

Click here to view this report

  • Previous research by The King’s Fund has shown that unhealthy behaviours cluster in the population. Around seven in ten adults do not follow guidelines on tobacco use, alcohol consumption, healthy diet or physical activity, yet most behaviour change services address these behaviours separately, not reflecting the reality of people’s lives.
  • This report shares learning and insight from services that are using innovative ways to address the problem of multiple unhealthy risk factors in their populations. It draws on interviews and information from eight case studies in local authorities and the NHS and updates the evidence base on tackling multiple unhealthy risk factors.
  • Most services included in the report are local authority led and are integrated health and wellbeing services. These provide behavioural advice and support to people across a range of different behaviours, including smoking, weight management and physical activity.
  • The NHS is also addressing multiple unhealthy behaviours. We set out learning from two hospitals supporting individuals with multiple risk factors.
  • The evidence for these behaviour change services to draw on, in the context of multiple unhealthy risk factors, remains limited. These services are in a position to develop the evidence base on how best to address multiple unhealthy behaviours.
  • The report makes recommendations on how services can develop and share evidence, and for how the Department of Health and Social Care and Public Health England can support further innovation in such services.
Categories
CCGs Finance Healthy Settings Licensing Mortality Patient Experience Planning Public Health Advice to NHS Commissioners

Right care: wrong answers

Dropkin, G. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx136

Published: 03 November 2017

Click here to view this article

Background

NHS RightCare is an NHS England programme describing itself as ‘a proven approach that delivers better patient outcomes’. It identifies opportunities for savings and quality improvements, comparing each Clinical Commissioning Group (CCG) with the ‘Best 5’ of a fixed set of ‘Similar 10’ CCGs chosen using equally weighted demographic and deprivation indicators. This article tests whether these indicators are sufficient and equal weighting is appropriate, and evaluates significance.

Methods

Robust public data on lung, colorectal, and breast cancer mortality is modelled using the indicators and incidence. Peers chosen using the preferred models are compared with the Similar 10. Confidence intervals are obtained for comparator group averages. RightCare significance is simulated.

Results

Preferred models have unequally weighted covariates. Incidence is the strongest predictor of lung cancer mortality. The ‘Similar 10’ are inappropriate comparators. RightCare significance ignores variability of comparator outcomes, causing 12% Type I errors. Whilst RightCare shows 1842 annual avoidable lung cancer deaths in 80 CCGs, only 168 deaths in 8 CCGs appear exceptional using appropriate peers and CIs.

Conclusion

CCGs cannot expect to match the average performance of the RightCare ‘Best 5’. Until the methodology is examined with data of known quality, claims that RightCare is a ‘proven approach’ are unsubstantiated.

 

Categories
Finance Healthy Settings Long-Term Conditions Mortality Stroke

Current, future and avoidable costs of stroke in the UK – Societal costs of stroke in the next 20 years and potential returns from increased spending on research

By The Stroke Association (2017)

This report estimates that the current cost of stroke to the UK is £26 billion every year, a threefold increase from the previous estimated cost of £9 billion. The figures also predict that a growing and ageing population, increasing numbers of stroke survivors, and rising care costs are crucial factors behind the increasing financial burden of stroke over the next 20 years.

Click here to view this report

Categories
Alcohol Mortality Statistics

Local alcohol profiles for England: mortality indicators, 2016 annual data update

By Public Health England (2016)

This quarterly update includes:

  • the addition of 2014 deaths to the 4 mortality indicators
  • an adjustment to mortality values across the previous years (because of a change in ICD10 coding for the most recent year)
  • a new drink driving indicator

Click here to view these stats

Categories
Alcohol CYP Healthcare Infant Mortality Mortality Smoking Tobacco & Drugs

Maternal smoking and the risk of still birth: systematic review and meta-analysis

Marufu, T.C et al (2015) BMC Public Health, 15: 239

Click here to view this article

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
Alcohol Mortality Young People

OECD outlines action for governments to tackle heavy cost of harmful drinking

By OECD (2015)

Harmful drinking is on the rise among young people and women in many OECD countries, partly due to alcohol becoming more available, more affordable and more effectively advertised, according to a new OECD report. Click here to view this report
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

Categories
Mortality Obesity

Obesity and fitness: the relation between obesity, cardiorespiratory fitness and mortality

By Public Health England (2014)

This paper presents recent evidence on the relationship between obesity, cardiovascular fitness and mortality, and briefly explores the main public health implications.

Click here to view this briefing paper

Categories
Healthy Child including NCMP & CDO Mortality

Health Profiles

By Public Health England (2014)

These profiles bring together existing information into one place to provide a snapshot of health and wellbeing across each local authority in England. They contain data on a range of indicators for local populations such as the proportion of children in poverty, adult smoking rates, levels of child and adult obesity, hospital stays and early mortality rates. The profiles are designed to provide local government and health services with ‘conversation starters’ to highlight local issues and priorities, and discuss how to tackle these. They show potential problems and opportunities by making comparisons with other areas and with the national average.

Click here to view these profiles

Categories
Cancer Care of the Elderly CYP Healthcare Healthy Child including NCMP & CDO Healthy Settings Infant Feeding Infection Control Library Long-Term Conditions Mortality Public Health Advice to NHS Commissioners Public Mental Health Sexual Health

Public Health England marketing strategy

By Public Health England (2014)

Our new national public health system represents a once in a lifetime
opportunity to improve people’s lives. In this document Public Health England’s
national health marketing team outlines how it will support this new system
to deliver.

Click here to view this strategy