The King's Fund has published research on the clustering of lifestyle behaviours, which explores the inter-linked relationships of smoking, drinking, diet and exercise across the population.
Many adults engage in more than one unhealthy behaviour, which can result in a potential 14 year gap in life expectancy if all 4 unhealthy behaviours are followed. The research found that the overall percentage of individuals engaging in 3 or 4 unhealthy behaviours had fallen from 33% in 2003 to 25% in 2008.
However the fall in numbers seems to be amongst those people from higher socioeconomic and educational groups. People with no qualifications were 5 times more likely to engage in more than 3 unhealthy behaviours in 2008 compared to 3 times more likely in 2003. Yet although lifestyle behaviours impact strongly on mortality risk, the impact on quality of life is not so evident. This may be interpreted as people not fully understanding the impact of adopting multiple unhealthy behaviours until it is too late.
These findings suggest the gap in health inequalities is still widening, with implications for policy and strategy development. How do we best motivate and support people to climb down the "risk ladder"? Should future policies and strategies focus on multiple behaviours rather than single issues? Which single issues should be prioritised?
The King's Fund does recommend that the NHS follows through the Making Every Contact Count agenda, and that there appears to be a need for health trainers and for commmunity champion roles to be further developed.
For alcohol behaviour change, IBA is known to be highly effective and should arguably be prioritised as having the greatest benefit of all lifeltysle brief interventions. However discussion has agreed that IBA must not exclude other lifestyle conversations as alcohol use, smoking and diet can be inextricably linked.
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