Preventing chronic disease and promoting sustainable social policy Anna Coote Commissioner for Health, UKSDC December 2007

Sustainable development Why prevention matters Sustainable prevention Identifying barriers Towards a sustainable social policy

Sustainable development LIVING WITHIN ENVIRONMENTAL LIMITS ENSURING A STRONG, HEALTHY AND JUST SOCIETY ACHIEVING A SUSTAINABLE ECONOMY PROMOTING GOOD GOVERNANCE USING SOUND SCIENCE RESPONSIBLY

Preventing chronic disease RReleases resources for treating unavoidable illness RImproves individual health and well being RSecures long-term viability of health services RSafeguards the future

WHO, 2005 Projected global distribution of chronic disease deaths

Obesity One in four people affected Nearly 1 in 3 children under 11 overweight or obese by 2010 Strong links with diabetes, heart disease and other illness Counting the cost £49 million on health and social care services £3.65 billion in associated costs £3.7 billion in England each year.

Depression By 2020, the second greatest contributor to the burden of disease for all ages and both sexes (WHO, 2007) Does more damage to health than four major chronic conditions: angina, arthritis, asthma and diabetes. (Lancet, 2007)

Mental health problems 1 in 6 people affected Anxiety and depression most common Often leads to physical illness Counting the cost £12 billion on health and social care services £23 billion in lost economic output from people unable to work £41 billion from reduced quality of life and premature death £76 billion in England each year.

“The major causes of chronic diseases are known, and if these risk factors were eliminated, at least 80% of all heart disease, stroke and type 2 diabetes would be prevented; over 40% of cancer would be prevented.” WHO, Preventing Chronic Disease: a vital investment

“Common, modifiable risk factors explain the vast majority of chronic disease deaths at all ages, in men and women, in all parts of the world. They include  physical inactivity  tobacco use  unhealthy diet” WHO, Preventing Chronic Disease: a vital investment

Obesity system map with thematic clusters Foresight 2007 fig 8.1

 Exercise  Diet  Contact with natural environments

Getting out more

Protecting natural environments “We are strongly persuaded that access to good quality green space provides an effective, population-wide strategy for the promotion of good health, well-being and quality of life… we are convinced that the evidence is sufficiently strong to warrant amending planning guidance to recognise the health benefits of green space and to build green space into new and existing developments” Royal Commission on Environmental Pollution, 2007

?

 ‘Producer capture’  Less investment in research  Political short-termism  Professional training  Media campaigns  ‘Downstream’ measures Barriers to change

 Most chronic disease is preventable  People want to stay well  Sustainable development helps prevents disease  Unsustainable development is a major risk to health  Health professionals must take responsibility for tackling climate change  High costs of failing to prevent will overwhelm health systems, wasting resources better spent elsewhere The evidence

Securing our Future Health, HM Treasury, 2002

Climate Change and Health Council declaration, 2007 “We as health professionals and health managers, concerned about the effects of climate change on global health and the environment … Call on individual health professionals to measure and reduce their own carbon footprint and to push for health-related institutions to adopt sustainable practices…”

Connections between household energy efficiency and health The Lancet, September 2007

The NHS spends £90 billion a year

If it were a country its economy would rank 30 th in the world

Good Corporate Citizenship How NHS organisations contribute to sustainable development through their corporate activities -  Procurement  Employment  Travel plans  Managing energy, waste and water  Buildings and landscaping  Community engagement.

“Identifying ways to reduce the causal factors of climate change – mitigation – and effectively help populations and systems deal with risks and threats posed by climate change – adaptation – especially for vulnerable populations, can lead to a greater sense of security and control and result in improved population health. The health sector can and should be at the heart of this.” WHO Europe, 2005

“This is a new dimension for public health which reverses the traditional thinking: from describing what has already occurred and identifying and reducing specific risk factors, to taking action on the basis of prediction and early warning to prevent health consequences in large populations.” WHO Europe, 2005

Towards a sustainable social policy

Thank you