Health at Work Health at Work Making a differenceMaking a difference

Health at Work Health at Work Making a differenceMaking a difference

15 October 2007

6600%% ooff aadduullttss iinn EEnnggllaanndd rreeppoorrtt aa cchhrroonniicc hheeaalltthh pprroobblleemm

Out of 59m there is: Diabetes Mellitus affecting 1.3m people with perhaps another million

undiagnosed. COPD affecting 600,000 people Asthma affecting 3.7m adults and 1.5m children Arthritis affecting about 8.5m in UK Epilepsy with 400,000 sufferers England & Wales (1998) Mental Ill Health affecting 1 in 6 of the population, including 1 in 10

children 8.8m people in England have long term illness that severely limits

their day to day ability to cope.

The number of people with chronic conditions The number of people with chronic conditions is rising is rising

(Source; General Household Survey 2002)(Source; General Household Survey 2002)

The number of people with chronic conditions The number of people with chronic conditions is rising is rising

(Source; General Household Survey 2002)(Source; General Household Survey 2002)All people reporting a chronic condition

21

24

2930

31 31

35

33 3332 32

35

20

22

24

26

28

30

32

34

36

1972 1975 1981 1985 1991 1995 1996 1998 1998 2000 2001 2002

Year (note: data from 1998 is weighted)

Pe

rce

nt

And rising at all agesAnd rising at all agesAnd rising at all agesAnd rising at all ages

People reporting a chronic condition (by age)

0

10

20

30

40

50

60

70

80

1972 1975 1981 1985 1991 1995 1996 1998 1998 2000 2001 2002

Year (note: data from1998 is w eighted)

% o

f s

am

ple

0-4y

5-15y

16-44y

45-64y

65-74y

75+

Women are slightly more prone to report chronic Women are slightly more prone to report chronic conditions; social class has a bigger impact though…conditions; social class has a bigger impact though…

((source General Household Survey 2002)source General Household Survey 2002)

Women are slightly more prone to report chronic Women are slightly more prone to report chronic conditions; social class has a bigger impact though…conditions; social class has a bigger impact though…

((source General Household Survey 2002)source General Household Survey 2002)

% people with a longstanding problem

41%

34%

30%

40%

32%30%

20%

25%

30%

35%

40%

45%

Manual worker Intermediateworker

Managerial andprofessional

worker

Women

Men

Alan Johnson said a "cultural and societal shift" was neededThe public health threat posed by obesity in the UK is a "potential crisis on the scale of climate change", the health secretary has warned.

Obesity likened to climate changeObesity likened to climate changeObesity likened to climate changeObesity likened to climate change

And it is likely to continue rising And it is likely to continue rising becausebecause

And it is likely to continue rising And it is likely to continue rising becausebecause

Increased Chronic Disease

And it is likely to continue rising And it is likely to continue rising becausebecause

And it is likely to continue rising And it is likely to continue rising becausebecause

Increased Chronic Disease

Health care systems world wide are Health care systems world wide are faced with the challenge of responding faced with the challenge of responding to the needs of people with chronic to the needs of people with chronic medical conditions such as diabetes, medical conditions such as diabetes, heart failure and mental illness.heart failure and mental illness.

WHO 2000

Leading Risk Factors for Leading Risk Factors for Preventable DeathPreventable Death

Leading Risk Factors for Leading Risk Factors for Preventable DeathPreventable Death

• Maternal and child underweight

• Unsafe sex• High blood pressure• Tobacco• Alcohol

• Unsafe water, poor sanitation and hygiene

• High cholesterol• Indoor smoke from solid

fuels• High body mass index

Leading Risk Factors for Leading Risk Factors for Preventable DeathPreventable Death

Leading Risk Factors for Leading Risk Factors for Preventable DeathPreventable Death

• Maternal and child underweight

• Unsafe sex• High blood pressure• Tobacco• Alcohol

• Unsafe water, poor sanitation and hygiene

• High cholesterol• Indoor smoke from solid

fuels• High body mass index

                                 

                             

                                                         

                                 

                                                         

                                 

InequalitiesInequalitiesInequalitiesInequalities

1980 1985 1990 1995 2000 2005

IV & V

I & II

UK falls further down European health league despite rise in funding

Ian Traynor in BrusselsTuesday October 2, 2007The Guardian

Do you take time off for a cold?

Thousands of people from Guernsey refuse to take time off work when they're ill because they fear for their jobs, according to research.

GPs reconsider advice to patients on sick leaveA new survey of 1500 GPs has found that two-thirds (64%) are unaware of the evidence that work is beneficial for physical and mental health. However, nearly 90% said that if they knew of this evidence it would affect the advice they give to their patients.

05 September 2007 – GPs reconsider advice to patients on sick leaveA new survey of 1500 GPs has found that two-thirds (64%) are unaware of the evidence that work is beneficial for physical and mental health. However, nearly 90% said that if they knew of this evidence it would affect the advice they give to their patients.

Effective Risk CommunicationEffective Risk CommunicationEffective Risk CommunicationEffective Risk Communication

Keeping the audience at the centre is essential, applying a case-by-case approach in selecting strategies that are best suited to:

• Reach people’s hearts and minds

• Secure their involvement in the issue and its solutions

• Support and facilitate the journey to reduce or contain the risk

All public health initiatives have the potential to cause harm as well as good.

Research shows that for teenagers who smoke, this is an act of social conformity, not rebellion.

Risk and Cultural TypesRisk and Cultural TypesRisk and Cultural TypesRisk and Cultural Types

• Individualistic

• Hierarchical

• Egalitarian

• Fatalistic

People are entitled to eat what they want – and if they put on weight it’s nobody else’s business

Fit

Disabled

FeelingWell

FeelingUnwell

Disease or disabilitynot detected & feeling well

Disease or disabilitynot detected but feeling ill

Disease or disabilitypresent but feeling well

Disease present and feeling ill

Dahlgren and Whitehead 1991 from Acheson 1998

HEALTHDISEASE

HOSPITAL

ACUTE

CURE

TREATMENT

PATIENT

INTERVENTION

COMMUNITY

CHRONIC

PREVENTION

MONITORINGCARE

PERSON

BIOMEDICALBIOMEDICAL PSYCHOSOCIALPSYCHOSOCIAL

Health needs assessment is a systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities.

(NICE 2005)

Why measure health?Why measure health?Why measure health?Why measure health?

• To establish priorities

• To assist planning

• To justify resources

• To assist in the development of professionals

Steps of Health Needs AssessmentSteps of Health Needs AssessmentSteps of Health Needs AssessmentSteps of Health Needs AssessmentGettingstarted

IdentifyingHealth

priorities

Assessing a priority for

action

Planning forChange

Moving on/Review