A common approach to
linked avoidable non
communicable diseases
Manchester 25 March 2014
Purpose
• Avoidable NCD’s – the huge challenge for the health and
social care system and the economy
• Common causes, path...
Non communicable diseases
• Grammatical as well as a public health challenge
• Nonsense term- “non” , communicable! etc
• ...
Avoidable NCD’s and conditions
• CHD and Stroke
• Circulatory diseases
• Cancers
• Respiratory diseases
• Liver disease
• ...
PowerPoint presentations as major risk factor
Population level determinants of risks to health
• Social
• Environmental
• Economic
• Cultural
• Commercial and market
• ...
NCDs – a major global burden
• Globally – almost two-thirds of all deaths in 2008
from NCDs (36 million)
• WHO European Re...
UN High Level meeting on NCD’s 2011
• Second ever UN high level meeting on health
• Political Declaration- 191 countries
•...
Macroeconomics
• Estimated at $47 trillion over the next two decades.
• Approximately 75% of the 2010 global gross domesti...
Non Communicable Diseases - The Big Challenge
• Major causes of avoidable mortality, morbidity and
disability and inequali...
Non Communicable Diseases- The Big Challenge
• Industrial epidemics- commercial determinants
• Major risks from consumptio...
Comorbidities: Our current understanding
• Comorbidity is expected to;
• grow in prevalence (1.9 to 2.9million 2008-2018)
...
NCD’s are a cause and manifestation of health
inequalities in current and future generations
An integrated model of
the relationships and
levels of intervention
Health
improvement
& protection
Tertiary
prevention
Secondary
prevention
Behavioural
risk factors
Poor diet
Low intake of ...
Humans are endowed
with an ANCIENT
PHYSIOLOGY
moulded by famine ...
… especially when we do so little!
.... and ill equipp...
Tackle environmental factors
Agenda for the Long Term
• Threats posed by business as usual
• Generated most of the externalities
• Existing structure b...
Tackle the “Inverse (Public) Health Law”
• Poor utilisation of evidence of impact
• Avoidance of high impact upstream publ...
Public health organisations– sectors of operation
Leadership
Everything you wanted to know about the UK
Health Forum and more
UKHF strategic focus- avoidable chronic diseases
(NCD’s)
• Upstream- international, national and local
• High impact
• Sys...
How we work
Business areas
1. The Forum
2. Interdependent policy focused business areas:
• Policy development and research
• Modelling...
The UKHF’s information niche
web-based resource
Information services
Prevention Information
and Evidence eLibrary
(P.I.E) UKHF website
ukhealthforum.org.uk
NHS, local authority/gov, VCS,
gove...
Strategic Partners Portal
The Voluntary Sector Health and
Care Strategic Partners Portal
website was launched on the 17
Oc...
Concluding threads
• NCD’s major continuing cause of health inequalities -
between population groups, countries and genera...
The end!
12.45 paul lincoln obesity event
12.45 paul lincoln obesity event
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Obesity and Related Conditions 25 March Manchester

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12.45 paul lincoln obesity event

  1. 1. A common approach to linked avoidable non communicable diseases Manchester 25 March 2014
  2. 2. Purpose • Avoidable NCD’s – the huge challenge for the health and social care system and the economy • Common causes, pathologies and solutions • Ways forward with impact • Implications for the public health system • UK Health Forum raison d’etre • UK Health Forum work and resources
  3. 3. Non communicable diseases • Grammatical as well as a public health challenge • Nonsense term- “non” , communicable! etc • Unfriendly • Answers on a post card to the UK Health Forum please
  4. 4. Avoidable NCD’s and conditions • CHD and Stroke • Circulatory diseases • Cancers • Respiratory diseases • Liver disease • Type 2 Diabetes • Kidney disease • Obesity • Vascular Dementia
  5. 5. PowerPoint presentations as major risk factor
  6. 6. Population level determinants of risks to health • Social • Environmental • Economic • Cultural • Commercial and market • Global/EU • Civic • POLITICAL
  7. 7. NCDs – a major global burden • Globally – almost two-thirds of all deaths in 2008 from NCDs (36 million) • WHO European Region - 86% of deaths and 77% of the disease burden • United Kingdom - the leading cause of death in 2008 (518,400)
  8. 8. UN High Level meeting on NCD’s 2011 • Second ever UN high level meeting on health • Political Declaration- 191 countries • WHO Global action plan 2013 • UN Agencies • MDG review links
  9. 9. Macroeconomics • Estimated at $47 trillion over the next two decades. • Approximately 75% of the 2010 global gross domestic product (GDP). Source: World Economic Forum / Harvard School of Public Health. 2011 • Diseases that “break the bank “ • Lancet – 2% reduction per annum, 36 million lives saved,$9 billion • Austerity • No new global fund
  10. 10. Non Communicable Diseases - The Big Challenge • Major causes of avoidable mortality, morbidity and disability and inequalities • Common risk factors and wider determinants • Linked chronic conditions- many manifestations • That’s Life! • Risk factors and protective factors • Decades lag period throughout the life course • Genotype and phenotype interactions
  11. 11. Non Communicable Diseases- The Big Challenge • Industrial epidemics- commercial determinants • Major risks from consumption of tobacco, alcohol and ultra processed foods • Habitual and addictive behaviours • Social and environmental patterning of behaviour • Dose and duration • Changing intergenerational risks • Avoidable or delayable components of morbidity, disability and ageing • Solutions predisposed to have considerable ideological bias
  12. 12. Comorbidities: Our current understanding • Comorbidity is expected to; • grow in prevalence (1.9 to 2.9million 2008-2018) • grow in cost (currently £8-13billion/year in England) • Because of; • an ageing population and younger cohorts • increasing health inequalities • Poor management of the physical health of people with mental illness • Poor management of the mental health of people with LTCs • Fragmented disease driven not people centred system, services and guidelines etc
  13. 13. NCD’s are a cause and manifestation of health inequalities in current and future generations
  14. 14. An integrated model of the relationships and levels of intervention
  15. 15. Health improvement & protection Tertiary prevention Secondary prevention Behavioural risk factors Poor diet Low intake of vegetables, fruit, nuts, pulses, whole grains & fish High intake of dairy products, red & processed meat, processed foods, snacks and confectionery High intake of salt, saturated fat & sugar Physical inactivity Smoking Alcohol Unhealthy food, Tobacco & Alcohol and their affordability, accessibility, availability, marketing Agriculture & food production Walking, cycling & public transport infrastructure Blood Pressure Cholesterol Obesity Diabetes Asymptomatic (Sub-clinical disease) Symptoms & disability Stroke Some cancers & other NCDs Dementia & Cognitive loss Avoidable death Intermediate clinical risk factors Clinical end- points (single or co- morbidities) Social & Environmental determinants (protective & harmful factors) Heart disease Depression & anxiety Primary prevention Physical & built environment Poverty, income, employment status Education & lifelong learning Parenting, social capital & networks Access to health & social services
  16. 16. Humans are endowed with an ANCIENT PHYSIOLOGY moulded by famine ... … especially when we do so little! .... and ill equipped to handle our modern food environment ….
  17. 17. Tackle environmental factors
  18. 18. Agenda for the Long Term • Threats posed by business as usual • Generated most of the externalities • Existing structure bestows a higher premium on immediate returns on investment • What is owed to future generations? • Revalue the future • Invest in younger generations • Establish a common platform of understanding
  19. 19. Tackle the “Inverse (Public) Health Law” • Poor utilisation of evidence of impact • Avoidance of high impact upstream public health measures • Poor absolute and relative investments in health improvement especially primary prevention • Underutilisation of the third sector- civic and civil society • Commercial freedoms of health damaging industries trump human rights, especially protection of the young and vulnerable
  20. 20. Public health organisations– sectors of operation
  21. 21. Leadership
  22. 22. Everything you wanted to know about the UK Health Forum and more
  23. 23. UKHF strategic focus- avoidable chronic diseases (NCD’s) • Upstream- international, national and local • High impact • Systemic and sustainable change • Take account of equity, inequalities, social justice and sustainable development
  24. 24. How we work
  25. 25. Business areas 1. The Forum 2. Interdependent policy focused business areas: • Policy development and research • Modelling and forecasting • Research and information services • Global health
  26. 26. The UKHF’s information niche
  27. 27. web-based resource
  28. 28. Information services
  29. 29. Prevention Information and Evidence eLibrary (P.I.E) UKHF website ukhealthforum.org.uk NHS, local authority/gov, VCS, government, international organisations, academia Prevention of NCDs: risk factors, determinants & inequalities Collection and dissemination of quality assessed news (media), policy reports, case studies etc. Searchable P.I.E elibrary, subscription briefing service Obesity Learning Centre – Knowledge and innovation network obesitylearningcentre.org.uk NHS, local authority/gov, VCS, government, international organisations, academia, schools, industry, weight management orgs. Obesity, physical activity and nutrition Collection and dissemination of quality assessed news (media), policy reports, case studies and tools. Discussion boards, membership and resources directory, national networks, content geared to specific roles (e.g. local gov.), legacy, elearning Healthy Places – Wellbeing in the local environment healthyplaces.org.uk Public health, local authorities, city/transport planners, VCS Access to healthy food, local alcohol control, active communities, active travel, healthy housing Regulatory and case law, soft policy (e.g. government scheme for local fuel poverty) Case studies, plain language case law, regulatory options, cross-sector links, PDF maker Ncdlinks.org Community of Practice ncdlinks.org Global policy, government, health and care practitioners Physical activity & nutrition (Panacealink), Tobacco (Globalink), Alcohol (Caribapan for the Caribbean; new Alcohol and Health Link). Feeds through topic specific news and content from P.I.E The closed networks function independently, knowledge and information sharing in discussion boards, membership directories Audience Topics Content Functionality Websites, information & knowledge products
  30. 30. Strategic Partners Portal The Voluntary Sector Health and Care Strategic Partners Portal website was launched on the 17 October 2013. • Hosted by the UK Health Forum. • This will be the first site to show the logos of the Department of Health, Public Health England and NHS England together in one place. • The site will be used to promote the works of the Strategic Partners to the public and a closed area for Partners to share information. www.voluntarysectorhealthcare.org.uk
  31. 31. Concluding threads • NCD’s major continuing cause of health inequalities - between population groups, countries and generations • Individual, social, economic disasters • Consider an integrated approach to NCD’s, their common risk factors ,determinants and distribution – including co- morbidities • Address the “Inverse PH Law” – tackle -structural inequalities • A difference will only be achieved by smart investment in publically supported upstream measures especially on the commercial determinants
  32. 32. The end!
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