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Showing posts from May, 2022

The (false) trade off between the economy and health

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A few months ago I had the privilege of delivering the  @ScHARRSheffield 2021 Pemberton lecture    During the q&a at the end someone asked me to explain my statement that the trade off between saving health and protecting the economy was a false choice I gave a pretty poor answer Here I'll try set it out more clearly  In "normal times" (remember them) I've been here quite a few times, most recently here    The onset of illness in working age is very common Multi morbidity (more than one thing wrong with you) more common in poorer populations & earlier onset, see Barnett 2012  also more common numerically speaking in those of working age than those beyond retirement age.   for England (chart below from the Health Foundation)  In Sheffield broadly the same holds true Those with lowest income spend more of their lives, often within working age, in less than good health. When considering Healthy Life Expectancy, in Sheffield, the healthiest are

Personal responsibility and public health

Personal responsibility and public health   1             industry loves this narrative. You have got to wonder why Of note the harmful product industries are strongly in favour of personal responsibility. You can draw your own conclusions why this might be. Read 1) the history of tobacco control esp the write up of California and New York from Stanton Glantz in Tobacco Wars   2             It is a policy framing problem for public health that crosses political divides   This has been one of the deep running rifts in what different camps think about what would be most effective in public policy for many generations It is fair to say that the response to Wanless and Marmot 2010 (for eg Govt response to Wanless in 2004 (John Reid), The NHS Long Term Plan and Five year view, and many others) continued to focus on lifestyle, and within that individual lifestyle choice.   3             two examples – infection and obesity In infectious disease contexts , the pandemic has

Why does thinking about the commercial determinants of health matter within local government

  Why does thinking about the commercial determinants of health matter within local government   1             Why does Non Communicable Disease matters to local government. Why should local government care Non Communicable Disease, or NCD (for example cancer, diabetes, heart disease and stroke, muscle and joint problems) is, by far, the biggest contributor to overall ill health. Of course that matters to NHS demand. Often these illnesses occur concurrently (this is called multi morbidity) and this is more common in working age than old age in sheer numbers. This also matters to social care (a huge amount of social care demand is secondary to and the downstream consequence of illness. It also matters to economic productivity. The health / wealth / economic productivity line is under appreciated. People who develop cancer aged 55 most likely wont go back to work. This this becomes impact on family income, benefit system demand, availability of workforce. See the recent Bank of