Ce diaporama a bien été signalé.
Nous utilisons votre profil LinkedIn et vos données d’activité pour vous proposer des publicités personnalisées et pertinentes. Vous pouvez changer vos préférences de publicités à tout moment.
Prochain SlideShare
A health and wellbeing board for Leicestershire
Suivant
Télécharger pour lire hors ligne et voir en mode plein écran

0

Partager

Télécharger pour lire hors ligne

Clustering of unhealthy behaviours over time: implications for policy and practice

Télécharger pour lire hors ligne

David Buck introduces the findings of our new report which looks at how four key risky behaviours - smoking, excessive drinking, poor diet and lack of exercise - cluster in the English population and how that is changing over time.

Livres associés

Gratuit avec un essai de 30 jours de Scribd

Tout voir

Livres audio associés

Gratuit avec un essai de 30 jours de Scribd

Tout voir
  • Soyez le premier à aimer ceci

Clustering of unhealthy behaviours over time: implications for policy and practice

  1. 1. Clustering of unhealthy behavioursover time: implications for policyand practiceDavid Buck and Francesca FrosiniThe King’s Fund
  2. 2. The number of multiple lifestyles hasincreasing impact on healthSource: EPIC-Norfolk cancer studies ...but more on mortality than reported quality of life.
  3. 3. Research, policy and practice questions What has been happening over time? – How has the distribution of multiple risk factors changed? – Have multiple risk factors been polarising between socio-economic groups? What might this mean for policy? – Looking beyond single issue behaviour strategies – Design of incentives and guidance such as public health tariffs, Quality Outcomes Framework, the Public Health Outcomes Framework and NICE public health guidance What might this mean for practice? – Are we wasting resources and increasing resistance by hitting the same people with separate interventions and messages? – Joint Strategic Needs Assessments, joint strategies, how to reap the health premium cost-effectively, role of health and wellbeing board partners?
  4. 4. What we did Cross-sectional analysis of the Health Survey for England 2003 and 2008 – Adult sample (>=16), 14,607 individuals in 2003 and 14,912 in 2008 – Four key risk factors: smoking, alcohol consumption, fruit and vegetable consumption and physical activity levels – Based on whether meeting government guidelines Analysis of – Changes in prevalence over time – Whether changes in prevalence are related to socio-economic position, education, gender or age
  5. 5. We found real improvements over time Consistent with movements ‘down ladder’ – Shedding three and four risky behaviours, maintaining one and two – Overall about a 20% drop in three+ behaviours for men and women – But, 70% of the population still have at least two risky behaviours
  6. 6. Within this there are 16 possible risk factorcombinations Combinations of risk factors in 2003, by gender Note: S=Smoking; D=Drinking; F= Fruit & Vegetable; P=Physical activity; 0 = no risk factors
  7. 7. We found significant changes over time insome of these combinations... Change in prevalence of combinations of multiple lifestyle risk factors between 2003 and 2008 by gender Percentage point change in prevalence btw 2003 -2008 4.0 3.0 2.0 * 1.0 ** * * ** 0.0 ** * ** * ** -1.0 Men -2.0 Women -3.0 -4.0 SdFp Sdfp SdfP sDfP SdFP sDFP sDfp sDFp sdfP sdFP sdFp SDFp SDfp SDfP SDFP Combinations of lifestyle risk factors Note: S=Smoking; D=Drinking; F= Fruit&Vegetable; P=Physical activity; Capital letters= presence of risk factor; * = significant change
  8. 8. ...but improvements come from some sectorsof the population and not others Change in prevalence of multiple lifestyle risk factors between 2003 and 2008 for men in professionals and unskilled manual households 110 100 4 * 4 * 4 90 80 3 * 3 * 3 70 60 50 2 2 2 40 30 20 * 1 * 10 1 1 * 0 0 * 0 * 0 2003 - All pop 2008 - All pop 2003 - 2008 - 2003- 2008 Professionals Professionals Unskilled Unskilled
  9. 9. A public health success story with a worryingtwist A real improvement in multiple health behaviours – In 2003, about one in three of us weren’t adhering to government guidelines on three or four of the behaviours – this had dropped to about one in four of us by 2008 Most of the improvement came from higher socio-economic and educated groups – Poorer groups saw little improvement, widening relative inequalities, ie, people with no qualifications were more than five times as likely as those with higher education to engage in all four unhealthy behaviours in 2008, compared to three times as likely in 2003 ‘Improving the health of the poorest fastest’? – Putting this right will be required if one of the coalition’s own criteria for the success of its reforms is to be met
  10. 10. Implications for policy Single behaviour approaches are necessary, but are they sufficient? – An approach based on people as well as ‘issues’ – Case for more targeted public health policies – Little current integration between public health and inequalities policy Public health and NHS reform – Multiple behaviours in the Public Health Outcomes Framework, informing the health premium, Quality Outcomes Framework and design of behaviour tariffs? – Research and guidance on multiple behaviour change from NIHR, PHE and NICE
  11. 11. Implications for practice Health and wellbeing boards – Most local areas undertake similar surveys, re-analysis on these lines will tell them what: • they need to prioritise in their Joint Health and Wellbeing Strategy • local authorities should take into account in their new public health role • the NHS should prioritise as it rolls out ‘Every Contact Counts’ Services – The development of wellness services – Role of health trainers and community health champions – Training for staff delivering interventions
  12. 12. But, we need to know more Pushing the analysis further – Correlation with other behaviours and mental health – Longitudinal analysis, to assess the impact of life events – Understanding role of social capital, norms and networks In order to intervene successfully we need to know – If having multiple risks makes behaviour change easier or harder? – Is it more effective to tackle risks in sequence or in tandem? – From a population health perspective, should there be a focus on one risk rather than another? – How cost effective are different approaches to multiple risk from a commissioner’s perspective?

David Buck introduces the findings of our new report which looks at how four key risky behaviours - smoking, excessive drinking, poor diet and lack of exercise - cluster in the English population and how that is changing over time.

Vues

Nombre de vues

3 280

Sur Slideshare

0

À partir des intégrations

0

Nombre d'intégrations

1 815

Actions

Téléchargements

12

Partages

0

Commentaires

0

Mentions J'aime

0

×