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Encouraging healthy lifestyle changes

Encouraging healthy lifestyle changes

By Carolyn Wickware
13 August 2017

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Health in England has improved in the past 30 years, with rising life expectancy and falling death rates from heart disease. Yet while people are living longer, they are spending more years in poor health.

The challenge now for public health is this – how can we help people to live healthier lives for longer? How do we increase healthy life expectancy?

Health in England has improved in the past 30 years, with rising life expectancy and falling death rates from heart disease. Yet while people are living longer, they are spending more years in poor health.

The challenge now for public health is this – how can we help people to live healthier lives for longer? How do we increase healthy life expectancy?

Declines in mortality have not been matched by similar declines in morbidity, and the diseases that are affecting people in England and other high-income countries are on the whole long-term, chronic and disabling disorders like lung disease, type 2 diabetes, musculoskeletal disorders and mental health illness.

Modifiable risk factors and unhealthy lifestyles are largely behind this. Addressing these behaviours is essential if we are to reverse the tide of long-term conditions that threatens not only the health of individuals as they get older but also the future sustainability of our health and social care services and the wider economy.

The NHS spends more than £10bn a year on treating illnesses caused by the effects of poor diet, inactivity, smoking and drinking alcohol. Obesity alone is estimated to cost the NHS more than £6bn a year, while the cost to the wider economy rises to £27bn.

Recognising and tackling variation between different regions and socio-economic groups is also vital – the high prevalence of risk factors across certain social groups brings the issue of health inequalities into sharp focus. For example, smoking prevalence is markedly higher among people who earn less than £10,000 a year or are not in employment.

Most, if not all, behavioural and environmental risks are strongly related to the wider determinants of health, such as the natural and built environment, employment and social relationships, which also need to be addressed in any credible public health strategy.

National and local government, the NHS and the voluntary sector all have a role to play in shifting the focus from treating avoidable disease to preventing it in the first place. But individuals also need to take more control over their own health and wellbeing and must be supported to make healthier choices as part of their everyday lifestyles.

Yet we know that modern life can make it difficult for people to prioritise their health. Busy working lives mean many of us eat a bit too much of the wrong food, while finding the time to exercise can feel impossible. As a result, the stress of daily life gets worse. The social environment we live in has a significant influence on our health – an environment dominated by the car, the desk job and the computer screen, and one that enables a high-risk combination of inactivity and stress.

Helping people take control

However, with a little help and determination, healthier choices can become the norm. In March 2016 Public Health England (PHE) launched the One You campaign to help people recognise the changes they can make to take back control of their own health, from eating healthily, to quitting smoking, getting more exercise and getting personalised health advice and support. 

One You is created for all adults, but particularly those from lower socio-economic backgrounds in mid-life (40-60 years).

The latest data paint a worrying picture of the health of middle-aged adults in England. Some 83% are either overweight or obese, drinking more than the recommended amount of alcohol or not getting enough exercise.

Type 2 diabetes rates have doubled among 40-60-year-olds over the past 20 years, and more than 15 million adults are living with a long-term health condition. Most of this is attributable to unhealthy lifestyle behaviours and choices.

However, there are still lots of small lifestyle changes a person can make in this period that can have a positive impact on health and quality of life, now and in the future. One You showcases that it is never too late to take action. 

One You aims to inform, energise and engage millions of adults, especially those in the 40-60 age group, to make changes to improve their own health by eating well, moving more, drinking less and quitting smoking.

It also provides information on how people can reduce their stress levels and sleep better.

The campaign’s free online health quiz ‘How Are You’ has been taken by over 1.1 million people since it was launched. It indicates which areas people should look to change and recommends free tools and support.

Local action

Much of One You’s advice and support is online as the majority of people in the country have relatively easy and affordable access to the internet. However, we also work with a huge number of commercial, public and charity partners, including local authorities, to take the campaign into everyone’s community and everyday environment.

Local authorities and NHS organisations are an integral part of One You, and we have worked to build a flexible brand that can be used locally to inspire change and engagement with community-led services, helping residents to tackle unhealthy behaviours.

It has been great to see local areas promoting One You, from businesses motivating employees to become more active, to the complete rebranding of services. There are a number of case studies from around the country available to read online to provide ideas and inspiration for local campaigns.

Wellness services

For example, when contracts for individual lifestyle services were coming to an end in Hounslow, west London, the local public health team tendered for an integrated health and wellbeing service based on a holistic approach and focusing on wellness services that address multiple needs, rather than commissioning a plethora of single-issue services.

In late 2015, the local NHS trust, Hounslow and Richmond Community Healthcare, won the contract, and with limited resources to develop a brand for the new service, One You provided a perfect fit. It meant that the new ‘One You Hounslow’ service could focus on supporting those that needed the most help.

We are always keen to find new and innovative ways of reaching target groups – and a great example of this is a recent pilot initiative with Halfords Autocentre in Crawley, West Sussex, where on 10 March, customers could take a free health MOT, including blood pressure checks, while they waited for their cars to have an MOT test.

Health professionals from Public Health England (PHE) were also on hand to support and offer advice on a range of lifestyle issues, with the aim of highlighting the importance of regular check-ups and encouraging people to think more about their own health.

What does success look like for One You?

One You is just one part of PHE’s strategy to address the nation’s health issues. We are continuing to help shape systems and environments to encourage healthier behaviours at the population level, from our work with industry to make sure there is less sugar in the food we eat, to explaining the evidence on e-cigarettes.

We also know how important it is to engage with people and support them to take control of their own health, and that while many people want to adopt healthier behaviours, there is often a mismatch between having a good intention and acting on it.

For example, two-thirds of smokers in England tell us that they want to quit but 18% of the adult population still smoke. One You is there to empower people to actually make a change, with clear links to support and advice to address each of the unhealthy behaviours covered by the campaign:

• Quit smoking: free support includes the NHS Smokefree app, email or text messages, local stop-smoking services and the free Smokefree National Helpline.

• Drinking less: free apps include the Drinks Tracker app and the new Days Off app, and support is also available through services such as UK Smart Recovery.

• Eating a healthy diet: our Be Food Smart app tells you how much sugar, salt and saturated fat is in everyday foods, while the Change4Life website provides lots of simple, healthy recipes.

• Moving more: the free Couch to 5K app has been designed to get people off the couch and running in just nine weeks, while the NHS Choices website offers
a range of tips to get fit for free and use every opportunity to be active.

• Getting better sleep: NHS Choices provides a short sleep assessment, a sleep score and practical tips and advice on what to do next – moving more and taking control of stress can also help with sleep.

• Dealing with stress: free online stress-busting tools are available, or recommending that patients talk to someone such as their GP can help.

One You is not about strict regimes or unachievable goals. A little goes a long way. While our ambition is to see every adult meeting the recommended 150 minutes of physical activity every week, we know that just being active for 10 minutes every day can make a difference too. Older adults who participate in any amount of physical activity at all gain some health benefits, and so some physical activity is better than none. And the potential gains are great – activity reduces the risk of many preventable diseases, from cancer to diabetes, and increases your chances of staying independent in later life.

Finally, our partnerships with commercial organisations such as Halfords, Slimming World, the Asda supermarket chain, and the pharmacy retailer Boots, as well as local authorities and pharmacies across the country, are key to the success of One You. There is a wide range of free resources online for partners to use. We hope everyone will join us in supporting more people to make healthier choices.

Kevin Fenton is director of health and wellbeing at PHE

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