Preventing depression in low-income mothers

It is well-established that women in low-income households have an increased risk of developing mental health problems, in particular depression | The Mental Elf

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Studies have found that these women are around twice as likely to develop the disorder compared with those from higher-income households (Hobfoll et al, 1995). Low-income women are also less likely to seek and receive appropriate treatment, in part because of the associated costs (Lennon et al, 2001).

For women who are mothers, this is especially consequential: parental depression has been linked with developmental, emotional and mental health problems in children (McDaniel et al., 2013). In the United States this has been highlighted as a public health concern, and it is increasingly being recognised that community-based services offer valuable opportunities to reach those for whom help is less accessible.

Head Start is a US government-funded service aimed at families at or below the federal poverty level with young children under five. They use a case-management structure to establish a healthy family environment in order to look after the child’s development and wellbeing. Depression affects almost half of the mothers at Head Start. A recent study by Silverstein et al. (2017) examines the efficacy of embedding a depression prevention strategy in the Head Start program.

How Early do Social Determinants of Health Begin to Operate?

From a life course perspective, important insights about how social determinants of health operate can be gained by analyzing the various forms that social climate can take in different life periods | Journal of Pediatric Nursing

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Highlights:

  • Perceptions of power imbalance and exclusion affect children’s self-rated health as early as elementary school.
  • Social exclusion in school is associated with lower odds of “excellent or very good” or “good” self-rated health.
  • Rejection from peers is a more important determinant of children’s self-rated health than is physical aggression.

Full reference: Zhang, A. et al. (2017) How Early do Social Determinants of Health Begin to Operate? Results From the Fragile Families and Child Wellbeing Study. Journal of Pediatric Nursing. Published online: 10th July 2017

Cutting smoking rates could save NHS £67m a year

Study highlights the burden that smoking places on UK society, particularly on the poorest and least advantaged groups | OnMedica | Tobacco control

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If smoking rates dropped to 5% in the UK by 2035, the NHS could save £67 million in just one year. This is according to research published this week in Tobacco Control.

Researchers at the UK Health Forum, commissioned by Cancer Research UK, examined the health and economic impact of the UK becoming ‘tobacco-free’ – where less than 5% of the population smoke. The study predicts that achieving this target would avoid nearly 100,000 new cases of smoking-related disease, including 35,900 cancers over 20 years.

The impact of this health improvement amounts to a saving of £67 million in direct NHS and social care costs and an incredible £548 million in additional costs to the economy in 2035 alone.

If today’s trends continue, around 15% of people from the most deprived groups are predicted to smoke in 2035, compared to just 2.5% from the wealthiest.

Read more via OnMedica

Full reference: Hunt D, Knuchel-Takano A, Jaccard A, et al. Modelling the implications of reducing smoking prevalence: the public health and economic benefits of achieving a ‘tobacco-free’ UK

Health care costs in the English NHS

The Centre for Health Economics in York has published ‘Health care costs in the English NHS: reference tables for average annual NHS spend by age, sex and deprivation group’.

This paper describes how to calculate average health care costs broken down by age, sex and neighbourhood deprivation quintile group using the distribution of health care spending by the English NHS in the financial year 2011/12.

The results can be used by cost-effectiveness analysts to populate their extrapolation models when estimating future health care costs. The results will also be of interest to the broader community of health researchers as they illustrate how NHS spending is distributed across different subgroups within the population.

The analysis presented in this report indicates that health care costs at any given age are higher for those living in more deprived neighbourhoods than those living in more affluent neighbourhoods. Research looking at the social distribution of health has found that quality of life is also lower at any given age for those living in more deprived neighbourhoods than for those living in more affluent neighbourhoods.

Read the full report here

What does improving population health really mean?

The King’s Fund has published ‘What does improving population health really mean?’

Put simply, population health means the health outcomes of a defined group of people, as well as the distribution of health outcomes within the group.

The health of a population is influenced by a wide range of factors and the interactions between them. They include the local environment – such as the conditions in which people live and work; social and economic factors – like education, income and employment; lifestyles – including what people eat and drink, whether they smoke, and how much physical activity they do; and access to health care and other public and private services. Age, sex and genes make a difference to health too, as well as social networks and the wider society in which people live.

The NHS has an important role to play in improving population health and must work with local government and other partners to develop more co-ordinated approaches to improving population health. At a local level, this should involve developing common aims for improving health, defining how these goals will be measured, and sharing resources to achieve them. It may also involve developing more systematic ways for NHS staff to identify people’s non-medical needs and work with others in the community to address them. STPs offer an important opportunity for the NHS and its partners to work together to achieve this.

But NHS and local government leaders can only do so much. A major factor outside their control is the political decisions made by government – for example, on welfare spending or housing policy –which have a major impact on people’s health. Short-sighted cuts to local government and public health budgets at a national level will make ambitions to improve population health harder to achieve.

Read the full text here

Budget needs to be serious about a society for everyone

The Joseph Rowntree Foundation has published ‘ Budget needs to be serious about a society for everyone’.

Two Budgets this year give the Government two opportunities to put in place the building blocks for a country that works for everybody.  The Brexit vote highlighted the urgency of this and the Prime Minister responded with a welcome commitment to make it her domestic priority. But if the commitment is to ring true with people on low incomes, two significant threats to their living standards must be addressed.

First, some households face declining living standards even when working full time. Second, poverty is projected to increase and to hit families particularly hard – with child poverty likely to rise by over a million by 2021/22. The Budget this week is a chance for the Chancellor to prevent families falling over a precipice.

Read more here

Just about managing: Four million more people living on inadequate incomes in modern Britain

The Joseph Rowntree Foundation has published ‘Just about managing: Four million more people living on inadequate incomes in modern Britain’.

This report sheds light on how different kinds of household are faring, against the Minimum Income Standard (MIS). MIS is a benchmark of income adequacy, as defined by what the public think is needed for a decent living standard. It is calculated by the Centre for Research in Social Policy (CRSP) at Loughborough University.

The report warns that millions of just managing families are on the tipping point of falling into poverty as prices rise in the shops, with forecasts showing the cost of living could be 10 per cent higher by 2020.

Between 2008/9 – 2014/5, based on the latest available data from official statistics:

The number of individuals below MIS rose by four million, from 15 million to 19 million (from 25 to 30 per cent of the population).

There are 11 million people living far short of MIS, up from 9.1 million, who have incomes below 75% of the standard and are at high risk of being in poverty.

The remaining eight million fall short of the minimum, by a smaller amount, and despite having a more modest risk of poverty, are just about managing at best.

Read the report here

In response to this report, the head of analysis at the independent Joseph Rowntree Foundation (JRF), Helen Barnard, said:

“Record employment in the economy is welcome and work has to be the best route out of poverty. But we know employment alone will not always help people reach a decent standard of living.

“Our analysis shows four million more people over the last six years have fallen below a decent leaving standard, meaning they are struggling to make ends meet.

“Tackling the high cost of living is crucial to helping just managing families, particularly with a challenging outlook: inflation is likely to average 2.6% this year, in sharp contrast to the very low inflation of recent times.

“Government focus on modest incomes is welcome, but there is a fine margin between just managing today and poverty tomorrow.”

Read the comments here