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Making the case for public health interventions 
Public health spending and return on investment 
These infographics from ...
The importance of public health 
Our health is determined by our genetics, lifestyle, the health care we receive and our w...
Spending and costs 
In 2013/14 the Department of Health spent more than £106 billion on health, 
social care and public he...
£5.48 
BILLION 
Spending and costs 
In 2013/14, the 
Department of Health 
spent around £5.48 
billion on public health – ...
£53 
Blackpool 
Westminster 
£35 
Redbridge 
£133 £38 
Surrey 
Portsmouth 
£126 
£22 
£77 
£33 
Cornwall 
Norfolk 
North 
...
2014 2034 
people aged 65-84 
2014 2034 
people aged 85+ 
Life expectancy 
Over the next 20 years the number of people in ...
76.9 
70.9 years 
years 
83.3 
years 79.4 
years 
Life expectancy 
The average life 
expectancy in England 
has been incre...
Highest region 
(south west) 
Lowest region 
(north east) 
Lowest LA 
(Manchester) 
Highest LA 
(Purbeck) 
Least deprived ...
51.6 
Guildford 
and Waverley 
Bradford 
19.7 
years 
71.3 
years 
Healthy life expectancy 
People living south and 
west ...
Disability-free life expectancy 
According to the latest data (1999 to 2003), people living in the poorest neighbourhoods ...
Health and behaviour 
Latest figures show that 2 in 10 adults are smokers. 7 in 10 men and 6 in 10 women are overweight 
o...
Health and behaviour 
Multiple unhealthy behaviours have a cumulative effect on health. Someone in mid-life who smokes, 
d...
40% of disability-adjusted 
life years lost 
Health and behaviour 
Forty per cent of the 
UK’s overall 
disability-adjuste...
£3.5 
billion 
Health and behaviour 
Unhealthy lifestyles cost 
the NHS across the UK 
billions of pounds every 
year. Smo...
Health and behaviour 
Mental illness is by far the most common illness for people aged 15–44 years. 
The incidence of ment...
Health and behaviour 
As of 2010, musculo-skeletal problems – such as back pain and arthritis – are the most common condit...
2003 2013 
Children aged 11–15 years Children aged 11–15 years 
Ever taken drugs 
Ever smoked at least once 
Ever taken dr...
£671 
million 
450,000 
STIs 
Spending and costs 
In 2014/15 local authorities are committed to spend £671 million 
(almos...
Spending and costs 
The costs of health and care services are not widely known. Some costs can be avoided or reduced throu...
+£76 8 
+£53 9 
Return on investment 
The costs to society of transport-induced poor air quality, ill-health and road 
acc...
Teenage 
pregnancy 
Return on investment 
Every £1 spent preventing teenage pregnancy saves £11 in health 
care costs. 
£1...
£15 
No smoking 
Return on investment 
School-based public health interventions can be good investments. 
For example, smo...
£8 
Dave woz 
ere 
LOL 
Return on investment 
Parenting programmes to prevent conduct disorder pay back £8 over six 
years...
£23 
Gym 
Return on investment 
Birmingham’s Be Active programme of free use of leisure centres and 
other initiatives ret...
Return on investment 
Housing interventions to keep people warm, safe and free from cold 
and damp are an efficient use of...
£3 
Job centre 
Return on investment 
Worklessness costs the economy more than £100 billion every year. Business 
in the C...
£3.75 
Return on investment 
Social support plays an important role in increasing resilience to illness, 
helping recovery...
£5 
Return on investment 
Every £1 spent on motivational interviewing and developing supportive 
networks for people with ...
£2.50 
Return on investment 
Every £1 spent on drugs treatment saves society £2.50 in reduced NHS and 
social care costs a...
Making the case for public health interventions 
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Making the case for public health interventions

In partnership with the Local Government Association, we have produced a set of infographics that describe key facts about the public health system and the return on investment for some public health interventions.

We hope they will be a useful resource for you – please feel free to use them in your office, in documents or presentations.

Making the case for public health interventions

  1. 1. Making the case for public health interventions Public health spending and return on investment These infographics from The King’s Fund and the Local Government Association set out key facts about the public health system and the return on investment for some public health interventions. You are welcome to use them in your office, in documents or presentations but please credit The King’s Fund and Local Government Association wherever you do this.
  2. 2. The importance of public health Our health is determined by our genetics, lifestyle, the health care we receive and our wider economic, physical and social environment. Although estimates vary, the wider environment has the largest impact. McGiniss et al (2002) Canadian Institute of Advanced Research (2012) Bunker et al (1995) Health care (15%) Health behaviour patterns (40%) Social circumstances and environmental exposure (45%) Health care (25%) Socio-economic Environmental (50%) (15%) Genetics (15%) Health care (43%) Other factors (57%)
  3. 3. Spending and costs In 2013/14 the Department of Health spent more than £106 billion on health, social care and public health in England. Average NHS spending per head was £1,742, while grants to local authorities for public health averaged £49 per head. £ 1 , 74 2 NHS spending £49 Local authority
  4. 4. £5.48 BILLION Spending and costs In 2013/14, the Department of Health spent around £5.48 billion on public health – around 5.1 per cent of their total spending. Almost half of this – £2.66 billion – was given to local authorities as grants. £2.66 BILLION
  5. 5. £53 Blackpool Westminster £35 Redbridge £133 £38 Surrey Portsmouth £126 £22 £77 £33 Cornwall Norfolk North Tyneside £66 Leicester Spending and costs In 2014/15 the Department of Health allocated £2.79 billion to local authorities in public health grants. These ranged from £185 per head to £22 per head.
  6. 6. 2014 2034 people aged 65-84 2014 2034 people aged 85+ Life expectancy Over the next 20 years the number of people in England aged 65-84 will increase by more than a third, and the number aged 85 and above will more than double.
  7. 7. 76.9 70.9 years years 83.3 years 79.4 years Life expectancy The average life expectancy in England has been increasing. In 1981 it was 70.9 years for men and 76.9 years for women. In 2014, it is expected to be 79.4 years for men and 83.3 years for women. 1981 2014
  8. 8. Highest region (south west) Lowest region (north east) Lowest LA (Manchester) Highest LA (Purbeck) Least deprived 10% in Westminster Most deprived 10% in Westminister 81.6 years 83.9 years 79.5 years 86.6 years 81.4 years 90 years Life expectancy There are wide variations in life expectancy between different populations. For women, the difference between the regions with the highest and the lowest life expectancy is 2.3 years. Across local authorities that difference is 7.1 years. Within a single local authority the variation based on deprivation can be as much as 8.6 years.
  9. 9. 51.6 Guildford and Waverley Bradford 19.7 years 71.3 years Healthy life expectancy People living south and west of London have a far higher healthy life expectancy than people in the north, Midlands and parts of east London. In 2010–12, the healthy life expectancy for women ranged from 52.6 years within Bradford Clinical Commissioning Group to 71.3 years within Guildford and Waverley Clinical Commissioning Group.
  10. 10. Disability-free life expectancy According to the latest data (1999 to 2003), people living in the poorest neighbourhoods in England will, on average, die 7 years earlier than those in the richest. They also live their lives with more illness. The average difference between the poorest and richest neighbourhoods in disability-free life expectancy is 17 years. 7 years less life 17 years more illness
  11. 11. Health and behaviour Latest figures show that 2 in 10 adults are smokers. 7 in 10 men and 6 in 10 women are overweight or obese. A third of people have drinking patterns that could be harmful. Half of women and a third of men do not get enough exercise.
  12. 12. Health and behaviour Multiple unhealthy behaviours have a cumulative effect on health. Someone in mid-life who smokes, drinks too much, exercises too little and eats poorly is four times as likely to die over the next 10 years than someone who does none of those things. Inequality in this area has increased: the rate of multiple unhealthy behaviours has decreased overall but not within the poorest parts of society. 4 VS
  13. 13. 40% of disability-adjusted life years lost Health and behaviour Forty per cent of the UK’s overall disability-adjusted life years lost are caused by tobacco, high blood pressure, overweight and obesity and low physical activity (2010 figures). This is through their contribution to diseases such as heart disease, stroke and lung cancer.
  14. 14. £3.5 billion Health and behaviour Unhealthy lifestyles cost the NHS across the UK billions of pounds every year. Smoking costs £5.2 billion, obesity £4.2 billion, alcohol £3.5 billion and physical inactivity £1.1 billion. £1.1 billion £5.2 billion £4.2 billion
  15. 15. Health and behaviour Mental illness is by far the most common illness for people aged 15–44 years. The incidence of mental illness rises as you get older, but across all ages up to 65 years, mental illness is nearly as common as physical illness.
  16. 16. Health and behaviour As of 2010, musculo-skeletal problems – such as back pain and arthritis – are the most common conditions to limit people’s daily activities and the largest single cause of years lived with disability. They affect 8.3 million adults and 10,000 children in England. 8.3 million adults and 10,000 children
  17. 17. 2003 2013 Children aged 11–15 years Children aged 11–15 years Ever taken drugs Ever smoked at least once Ever taken drugs Ever smoked at least once Health and behaviour Children’s health behaviours have improved dramatically over time. Reported use of drugs, smoking and alcohol have all roughly halved over the past 10 years. Drank alcohol in the last week Drank alcohol in the last week
  18. 18. £671 million 450,000 STIs Spending and costs In 2014/15 local authorities are committed to spend £671 million (almost a quarter of their overall grant from the Department of Health) on sexual health services. During 2013/14 there were approximately 450,000 diagnoses of sexually transmitted infections in England.
  19. 19. Spending and costs The costs of health and care services are not widely known. Some costs can be avoided or reduced through cost-effective public health interventions. £792 Year of telecare £10,424 Final year of life £235 Ambulance journey to hospital £3,283 Inpatient stay in hospital £31 10 minutes with a GP £114 A&E attendance
  20. 20. +£76 8 +£53 9 Return on investment The costs to society of transport-induced poor air quality, ill-health and road accidents exceed £40 billion per year. Getting one more child to walk or cycle to school could pay back as much as £768 or £539 respectively in health benefits, NHS costs, productivity gains and reductions in air pollution and congestion.
  21. 21. Teenage pregnancy Return on investment Every £1 spent preventing teenage pregnancy saves £11 in health care costs. £11
  22. 22. £15 No smoking Return on investment School-based public health interventions can be good investments. For example, smoking prevention programmes in schools can return as much as £15 for every £1 spent.
  23. 23. £8 Dave woz ere LOL Return on investment Parenting programmes to prevent conduct disorder pay back £8 over six years for every £1 invested.
  24. 24. £23 Gym Return on investment Birmingham’s Be Active programme of free use of leisure centres and other initiatives returned an estimated £23 in quality of life, reduced NHS use and other gains for every £1 spent.
  25. 25. Return on investment Housing interventions to keep people warm, safe and free from cold and damp are an efficient use of resources. Every £1 spent on improving homes saves the NHS £70 over 10 years. £70
  26. 26. £3 Job centre Return on investment Worklessness costs the economy more than £100 billion every year. Business in the Community estimates that its programmes getting disadvantaged groups back into work return £3 in reduced costs of homelessness, crime, benefits and NHS care for every £1 spent.
  27. 27. £3.75 Return on investment Social support plays an important role in increasing resilience to illness, helping recovery and improving wellbeing. Befriending services have been estimated to pay back around £3.75 in reduced mental health service spending and improvements in health for every £1 spent.
  28. 28. £5 Return on investment Every £1 spent on motivational interviewing and developing supportive networks for people with alcohol or drug addiction returns £5 to the public sector in reduced health care, social care and criminal justice costs.
  29. 29. £2.50 Return on investment Every £1 spent on drugs treatment saves society £2.50 in reduced NHS and social care costs and reduced crime.
  30. 30. Making the case for public health interventions We hope you found these slides useful. You are welcome to use them in your office, in documents or presentations but please credit The King’s Fund and Local Government Association wherever you do so. For more information on this topic visit www.kingsfund.org.uk/publichealth or www.local.gov.uk/health.

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