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UK health advances slowing, with yawning gaps in health outcomes

Move away from diagnosing and treating sickness towards promoting wellbeing and prevention

Louise Prime

Tuesday, 27 November 2018

The UK is experiencing a slump in improvements in life expectancy, adult obesity rates among the worst in the developed world, and a widening gap in health outcomes between rich and poor, The King’s Fund warned this morning. The charity called in its latest report for a radical new approach that moves away from diagnosing and treating sickness towards promoting wellbeing and preventing ill health.

In A vision for population health: Towards a healthier future, the charity reported that people are living longer, healthier lives than ever before, with substantial improvements in life expectancy over the past 100 years. But it added that England lags behind other countries on many key health outcomes; improvements in life expectancy have stalled; and health inequalities are widening. It noted, for example, that the “yawning gap in health outcomes between rich and poor areas is widening again” as a woman in Wokingham can now expect to enjoy nearly 17 more years of healthy life than a woman in Manchester. It found that:

  • Improvements in life expectancy are grinding to a halt – although this is happening elsewhere, the slump is more pronounced in the UK than most other countries.
  • There has been little or no improvement in how long people live with illness and disease since 1990. 
  • Infant mortality rose in 2015 and 2016, as the UK slid further down the international rankings on child health.
  • According to the OECD, our adult obesity rates are among the worst in the developed world.

The authors argued that the NHS cannot tackle these challenges alone. They said: “To address this, we need to move away from a system just focused on diagnosing and treating illness towards one that is based on promoting wellbeing and preventing ill health.”

They called for action at national, regional and local levels, which must include:

  • ambitious and binding national targets for improving health, backed by a new strategy to reduce health inequalities;
  • bolder use of tax and regulation to support public health, learning lessons from the successful approach to cutting smoking and the recent levy on soft drinks
  • strong political and system leadership to ensure that improving the population’s health and reducing health inequalities are priorities across government, as well as the health and care system;
  • local politicians championing population health by working with the NHS and other agencies to improve the health of their constituents.

Lead author David Buck, senior fellow at The King’s Fund, commented: “After a century of improving health, progress on key outcomes are [sic] grinding to a halt. Life expectancy is stalling, our health outcomes are mediocre compared with similar countries and health inequalities are widening.

“A new vision for the population’s health is needed that pays more attention to the wider determinants of health and the role of people and communities. The NHS long-term plan is important to this, but can’t do it alone. The Government must also reverse cuts to local government public health budgets and make tackling health inequalities a central aim. Our new report provides a framework for charting a new course towards reducing inequalities and achieving health outcomes on a par with the best in the world.”

The BMA said it welcomed the report’s call for a comprehensive approach that tackles the underlying social and domestic drivers of ill health for so many people and pointed out that it has long urged the Government to make the population’s health a priority by investing in services to reduce smoking and alcohol consumption, and those that promote physical activity and a better diet.

Its public health committee chair, Dr Peter English, said: “Failure to focus on prevention can cost people their lives. … People living in the most deprived areas are too often subject to a higher prevalence of preventable illnesses. It is vital therefore that the wider societal factors that influence people’s health behaviours are addressed. We need to see greater provision of services in communities that can positively impact a person’s health and wellbeing such as youth clubs and green spaces.”

He added: “Significant investment will be needed to fund the ambitious action required to reduce inequalities and improve prevention.”

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