Sunday, 20 January 2013

UK public health - a troubling trend

Following on from my correspondence with Dr Phillip Lee MP and the previous blog post Doughnuts for Breakfast, his Senior Parliamentary Researcher has kindly sent some further information, as follows:

Alcohol misuse
Percentage of adult population affected
Impact on health and wellbeing**
Increased risk of chronic disease. Reduces life expectancy by up to 10 years
Causes% burden of many chronic diseases and 17% of all cause mortality
Increased risk of chronic diseases. Reduces life expectancy on average by 10 years.
Increased risk of  medical conditions and significant social impact
Estimated cost to the English economy per year*
£15.8 billion
£8.3 billion
£5.2 billion
£20 billion
Estimated cost to the NHS per year*
£4.2 billion
£1-1.8 billion
£2.7 billion
£2.7 billion

 * Department of Health Chief Medical Officer Annual Report 2009;
** Estimates by The King’s Fund based on Department of Health, Chief Medical Officer Annual Report 2009

Just take a moment to digest the figures in the table.  Aside from the actual cost to the NHS of billions being spent on treating "lifestyle" health conditions, just consider of the impact such conditions have on the people concerned.  Those lives that have been shortened unnecessarily through diseases that may often be avoided, it's actually quite shocking.

Consider also, the social impact of alcohol misuse, just for a moment.  Apart from the health risks associated with alcohol misuse, alcohol misuse is a major factor in crime.  Like most professions, in the criminal justice system has its own language which inclues "criminogenic needs" and these are the difficulties people have in their lives that directly lead to offending behaviour.  So just think of all of the fights and anti social behaviour taking place in our town / city centres.  The "night time economy" often features punch-ups where people get seriously hurt and there is often a fine line between Common Assault, ABH, GBH, Manslaughter and Murder.  Think of the alcohol fuelled violence that largely takes place in private, in family homes. You can never quantify the human cost of such misery, fright, abuse in terms of a monetary value.  I have met many offenders who have committed dreadful offences and yet, many are themselves victims in one way or another.  This is a poignant thought.

As I climb down from my soap box, let me make a few points:

Personal responsibility?

While it is easy to see the influences that lead people into various lifestyles that may cause health problems, for each of us we have constant opportunities to make decisions for ourselves.  Each time someone buys a packet of cigarettes, that is a decision.  Sure, giving up is not easy but making the decision to quit should be easy.  Knowing support is there, particularly in those early days, is helpful for many.

I question whether it can be right to knowingly lead a lifestyle which is undeniably wrong and then simply drift into the Doctor's surgery and expect it to be treated, as if our body's are like cars needing a 12,000 mile service at the local garage.  However, life is more complex than simply keeping a car on the road.  Situations such as addiction, poverty, family attitudes, parental examples, dysfunctional thinking and many others are all factors which but we (as a nation) need help in a) knowing what we need to do and b) help in following it through.

Does the Government have a role?

Yes, of course it does.  Surely it is the Government which provides the NHS for us to remain healthy and be treated wherever necessary.  It is the NHS itself with it's army of agencies and departments which deliver the various services.  The whole Public Health agenda is, in my view, very important and yet no election will ever be won or lost on the issue of Public Health.  Why?  Preventative services aren't very tangible, people may not feel as if they have personally benefited by seeing an anti-smoking campaign and yet surely these things must be seen as being for the "greater good" and worth investing in?  Knowing why life expectancy is higher or lower in this or that post code area is one thing, but following it through is another.

Does any of this make sense?

The horrendous spectre of UK obesity
Why I'm tee total
How to give up smoking in one easy step

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