Two independent watchdogs have called for a renewed drive to improve public health services after analysing the success of policies over the past decade. A new report by the Healthcare Commission and Audit Commission assesses the impact government policy has had on: narrowing health inequalities; improving sexual and mental health; and reducing smoking, alcohol misuse and obesity.
The report, Are we choosing health? The impact of policy on the delivery of health improvement programmes and services, finds the government’s ambitious public health programme has helped significantly improve overall life expectancy and reduce mortality from the big killers. There have also been advances in tackling smoking and improving sexual health, two areas where health inequalities are significant. While smoking remains England’s single greatest cause of preventable illness and early death, the number of people who smoke has fallen considerably in recent years. Teenage conceptions are at their lowest level in over 20 years and there is better access to genitourinary medicine services and chlamydia screening, although progress in relation to contraceptive services has proved challenging. But these rates of improvement have not been matched in the areas of alcohol misuse and obesity.
In England, which has the fastest rising rate of childhood obesity in Western Europe, a third of school age children are overweight or obese. Deaths associated with alcohol consumption have risen. In men, the death rate doubled from 9.1 deaths per 100,000 in 1991 to 18.3 in 2006. For women, the rate increased from 5.0 to 8.8 deaths per 100,000 over the same period, a rise of around 80 percent. If the trends continue, alcohol and obesity will have an increasingly profound effect on public health and service delivery, the report says.
On alochol, the report comments that the 2004 alcohol strategy for England (AHRSE) was not accompanied by clear measurable objectives or a systematic programme to drive change through the system. As a result, improvement at a local level has been inconsistent.
Anna Walker, the Healthcare Commission’s Chief Executive, said:
The government has begun to tackle the big killers but more needs to be done on some of the main issues affecting our health such as obesity, alcohol and smoking. The government should also apply lessons learned from its most effective programmes to ensure that the problems of obesity and alcohol misuse do not derail health improvement in the future. We do not want to see any reversal of the health gains that have been made. Health inequalities also remain a challenge.
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