ASH Daily News for 21 January 2020


  • Study: Poorest working age adults in worse health now than a century ago
  • Jeremy Hunt: I will be ‘honest’ about my mistakes
  • Tobacco control pledge signed to tackle Wakefield’s £95 million health problem


  • No smoking 4 weeks before surgery cuts risks, says WHO



Study: Poorest working age adults in worse health now than a century ago

The poorest third of the UK’s working-age adults (age 30-59) today have worse health than people born a century ago had at the same age, according to research that also shows the health gap between rich and poor is growing. The study found that the poorest people are experiencing ill health earlier in life – a situation that means, given the size of postwar cohorts, that public health services will face rising demands. “The pressure on the NHS, for example, is going to be even greater than expected given the ageing population,” said Dr Stephen Jivraj, author of the study.

The study involved an analysis of data collected from the annual British General Household Survey between 1979 and 2011, and focused on adults aged between 30 and 59. Jivraj found that among men and women in the lowest third for household income, those born in the late 1960s reported higher levels of limiting long-term illness than those born in the early 1920s. No such trend was seen for women among the middle or richest third of the population. Among men in the wealthier two-thirds of the population there was a drop in limiting long-term illness among younger age cohorts.

Overall, 32% of the poorest third of women born in 1968-1970 reported a limiting long-term illness when aged between 30 and 59, compared with 12% of the richest third. In those born in 1920-22, the prevalence was 23% among the poorest and 13% among the richest. In other words, the younger generation had a far larger health gap than the older one. In men the gap was 24 percentage points in the younger generation and 9 percentage points in the older one. A widening gap across generations was also seen when it came to reports of general health, although the overall trend was less stark.

The study has limitations, including that it is based on self-reporting, and that data from 29,058 individuals was used for the 1947-49 birth cohort and only 2,457 individuals for the 1920-22 cohort. While the study does not unpick what may be driving the widening health gap, Jivraj noted that the trends were similar to those seen in household income where the gap has widened over the years. He said it may also be linked to factors such as smoking or lack of secure housing.

Ben Franklin, the head of research at the Centre for Progressive Policy, said the study added to a growing body of literature showing a widening gap in the health of people with higher and lower socioeconomic status. “We have got the NHS, which is a great thing for the UK, and it helps to level up the UK in terms of ensuring equality of access to world-class healthcare, but that alone is not going to solve persistent and growing health inequalities…if we are going to deal with our health inequalities in society, we need much greater upstream prevention.”

Source: The Guardian, 21 January 2019

Journal of Epidemiology and Community Health: Are self-reported health inequalities widening by income? An analysis of British pseudo birth cohorts born, 1920–1970

See also:
The Herald – Health of poorest adults in Britain today ‘worse than it was for those born in 1920’
The Times – Health divide between rich and poor has widened since 1950s

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Jeremy Hunt: I will be ‘honest’ about my mistakes

Jeremy Hunt has told the Health Service Journal he will be “completely honest” about the mistakes he made as health secretary if successful in his bid to become the next House of Commons Health Select Committee chair.

Asked whether his chairmanship would be undermined by his involvement in many of the decisions and policies the committee would examine, Mr Hunt — who was secretary of state from 2012 to 2018 — said it would not for two reasons. He said: “Where I made mistakes [affecting the issues being examined] I will be completely honest about them.” He added, for example, that he now acknowledged he had made mistakes in handling the junior doctors dispute. Mr Hunt also claimed the nature of the health debate was now distinctly different from his period in the office, during which “most of the time, we didn’t have enough money”. Last year’s spending settlement had changed the focus of the debate, he said. “Now it’s about how we use that money.”

During his time as health secretary, Mr Hunt was vocal about patient safety. Asked whether he was worried the issue had slid down the government agenda and if he wanted to become the committee chair to remedy this, he said: “I do want more focus on the quality and, particularly, the patient safety agendas.” The South West Surrey MP said his two other priorities would be mental health and social care. He said the NHS should be a “world leader” in mental health but had yet to seize the opportunity. He described social care reform as “unfinished business” from his time as health secretary, revealing he had wanted to produce a 10-year long-term plan for social care to match the one produced for the NHS. However, Mr Hunt said this was “blocked” by the then chancellor, Phillip Hammond.

The Commons health committee chair must be a Conservative MP, under current Parliamentary arrangements, although they are selected by a vote of all sitting MPs. The election will take place on 29 January. Two other candidates are standing — former health minister and MP for Central Suffolk and North Ipswich Dan Poulter, who is a medical consultant, and MP for Newton Abbott, Anne Marie Morris.

Source: Health Service Journal, 17 January 2020

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Tobacco control pledge signed to tackle Wakefield’s £95 million health problem

NHS and other health organisations in Wakefield have signed a new tobacco control declaration following a meeting of Wakefield’s Health and Wellbeing Board. Signatories have agreed to: create environments that support quitting through implementing smokefree policies, support a local tobacco control plan to address the causes and impacts of tobacco, and protect tobacco control work from the commercial interests of the tobacco industry.

In Wakefield, smoking is responsible for around a third of deaths while 4,700 annual hospital admissions are attributable to smoking. The ASH Ready Reckoner tool estimates that smoking costs society in Wakefield around £95.1 million a year.

Adam Sheppard, clinical chair of Wakefield CCG said: “Smoking is the single biggest cause of premature death and disease in our communities and tackling it is the single most important way we can reduce health inequalities in Wakefield. Working together, across all our partners in the district, with a single vision for a smokefree Wakefield is the best way of doing this and this is why we are delighted to be committed to this declaration.”

Councillor Faith Heptinstall, chair of the Health and Wellbeing Board and Cabinet Member for Adults and Health, added: “We all know the damage that smoking can do, not only to individuals but to society, and that’s why we have committed to this declaration. We want people across our district to live long and healthy lives and we will do everything we can to support people to quit smoking and prevent them from taking up the habit in the first place.”

Source: Pontefract and Castleford Express, 20 January 2020

See also: ASH – Ready Reckoner

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Study: No smoking 4 weeks before surgery cuts risks

Patients who stop smoking at least four weeks before an operation significantly reduce the risk of having post-surgical complications, according to a new study by The World Health Organisation (WHO) the University of Newcastle in Australia and the World Federation of Societies of Anaesthesiologists (WFSA).

The study said that minor or non-essential operations on regular smokers could be delayed to give them time to quit and thereby improve outcomes such as wound healing and heart function. The study found that every additional tobacco-free week beyond the four weeks improved health outcomes by 19% due to improved blood flow throughout the body to essential organs.

“The report provides evidence that there are advantages to postponing minor or non-emergency surgery to give patients the opportunity to quit smoking, resulting in a better health outcome,” Dr Vinayak Prasad, head of the No Tobacco unit at WHO, said in a statement. WHO said that all countries should build cessation programmes and educational campaigns into their health systems to spread awareness and help people to quit smoking.

Source: Free Malaysia Today, 20 January 2020

See also: The World Health Organization – Smoking greatly increases risk of complications after surgery

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