Public health interventions may offer society a return on investment of £14 for each £1 spent

Each £1 invested in public health interventions could offer an average return on investment to the wider health and social care economy of £14 | NIHR Signal

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This systematic review looked at 52 studies where the return on each £1 ranged from -£21.3 to £221. Legislative interventions such as sugar taxes, and health protection interventions such as vaccination programmes, gave the highest returns on investment. Interventions such as anti-stigma campaigns, blood pressure monitoring and early education programmes, provided smaller (but still favourable) returns. National campaigns offered greater returns than local campaigns. Falls prevention provided the quickest return, within 18 months.

These findings apply to high-income countries. There are some limitations to the data, as a variety of calculation techniques were used and the quality of the included studies varied. However, these are unlikely to alter the direction or approximate size of these effects. The study shows how cost-effective public health interventions can be and should inspire future research into how to better implement what is already known.

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Dementia in older age: barriers to primary prevention and factors

Evidence review showing that changing some behaviours in midlife can reduce the chances of getting dementia in older age | PHE

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These documents help commissioners and researchers make decisions about prioritisation of primary prevention measures relevant to dementia.

This review, by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (2016), shows that there is evidence that the risk of dementia is increased by:

  • physical inactivity
  • current smoking
  • diabetes
  • hypertension in mid-life
  • obesity in mid-life and depression

It also shows that mental activity can reduce the risk of dementia.

To promote primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Read the full overview here

Big rise in male hospital admissions due to eating disorders

An analysis of NHS Digital data by The Guardian shows the number of men being hospitalised with an eating disorder has risen by 70% since 2011 | OnMedica

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It reveals that the number of hospital diagnoses in male over-19s rose from 480 in 2010-2011 to 818 between April 2015 and March 2016.

The rate of increase was slightly higher among older men, at 70% for the 41-60 age group, compared with 67% in the 26-40 category and 63% among 19- to 25-year-olds. In the same period, there was a 61% increase among women aged 19 to 25 and a 76% rise among middle-aged women.

Dr William Rhys Jones, from the Royal College of Psychiatrists’ eating disorders faculty, told the newspaper that pressure for body perfection is on the rise for men of all ages, which is a risk factor for developing an eating disorder. “Images of unhealthy male body ideals in the media place unnecessary pressure on vulnerable people who strive for acceptance through the way they look.”

Read the full commentary here

Using healthcare models to inform obesity interventions.

One in four adults are now obese and the Government has introduced several initiatives to combat this problem and its growing cost on NHS services | Evidence-Based Nursing blog

Examples of Government schemes include:

But this alone is not enough to prevent cardiovascular disease. The Health Belief Model, when applied to nutrition and hydration, indicates that people are more likely to follow a healthy diet and make changes to their lifestyle if they feel that failure to change would increase their risk of developing a serious disease; the benefits of the change outweigh the barriers faced due to the change; they place enough value in their life to make the change and they are prompted to make the changes.

The theory of planned behaviour addresses three aspects: the attitude, the subjective norm and the perceived behavioural control. The attitude is the values and judgement we hold about a healthy diet. The subjective norm refers to what is important to the patients’ family and friends. Perceived behavioural control is how much control the person believes they have over their ability to keep to a healthy diet i.e. whether or not they have the skills or resources to succeed.

Read the full blog post here

The Role of Science in Addressing the Opioid Crisis

Opioid misuse and addiction is an ongoing and rapidly evolving public health crisis, requiring innovative scientific solutions | New England Journal of Medicine

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Image source: Marina Caruso – Wellcome Images // CC BY-NC-ND 4.0

In response, and because no existing medication is ideal for every patient, the National Institutes of Health (NIH) is joining with private partners to launch an initiative in three scientific areas: developing better overdose-reversal and prevention interventions to reduce mortality, saving lives for future treatment and recovery; finding new, innovative medications and technologies to treat opioid addiction; and finding safe, effective, nonaddictive interventions to manage chronic pain. Each of these areas requires a range of short-, intermediate-, and long-term research strategies

Full reference: Volkow, N.D. & and Collins, F.S. (2017) The Role of Science in Addressing the Opioid Crisis.  New England Journal of Medicine. Issue 377: pp.391-394

Sexual health at risk of becoming ‘Cinderella’ service, say GPs

Sexual and reproductive health is at risk of becoming a ‘Cinderella’ service thanks to red tape, and financial and training hurdles facing GPs and their practice teams, the Royal College of GPs (RCGP) has warned.

These issues risk undoing years of improvement in the quality of sexual and reproductive healthcare being delivered to patients – including a halving of teenage pregnancy rates over the past decade and steadily increasing uptake of long-acting reversible contraceptives (LARCs), it says.

The findings of a College consultation, published in a report, Time to Act, show that GPs fear rates of teenage pregnancy and transmission of sexually transmitted diseases will rise – reversing current trends – as vulnerable patients are being excluded from accessing the most appropriate forms of contraception, and widening  health inequalities as a result.

Full report: Sexual and Reproductive Health: Time to Act

Story via OnMedica

Rising popularity of e-cigarettes linked to higher quit rate

Findings from US observational study suggest E-cigarettes appear to have helped to increase smoking cessation at the population level.| OnMedica |BMJ

Researchers have looked at whether the increase in the use of e-cigarettes in the US was associated with a change in overall smoking cessation rate.

They drew on responses to five population surveys from 2001 to 2015. E-cigarette users were identified from the most recent survey (2014-15) and smoking cessation rates were obtained from those who said they had smoked cigarettes in the preceding 12 months. Rates from this most recent survey were then compared to those of four earlier surveys.

Of 161,054 respondents to the 2014-15 survey, 22,548 were current smokers and 2,136 recent quitters. More than a third (38%) of current smokers and nearly half (49%) of recent quitters said they had tried e-cigarettes.

E-cigarette users were more likely than non-users to make a quit attempt (65% vs 40%) and more likely to succeed in quitting for at least three months (8.2% vs 4.8%).

The overall population quit rate for 2014-15 was significantly higher (5.6%) than that for 2010-11 (4.5%), and higher than those for all other survey years.

The 1.1 percentage point difference might appear small, but it represents approximately 350,000 additional US smokers who quit in 2014-15, emphasise the researchers.

Full story at OnMedica

Full reference: Shu-Hong Zhu et al.  E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys  BMJ 2017; 358 (Published 26 July 2017)

Related BMJ editorial: Rise in e-cigarette use linked to increase in smoking cessation rates