Non Communicable Diseases are the biggest cause of mortality, morbidity, disability, healthy life years lost and a major cause and consequence of health inequalities
The priorities for action should have the biggest impact, the shortest timescale, be most sustainable, most equitable in reducing health inequalities and injustices for the vulnerable and across generations, achieve the maxim co-benefits for the environment and reducing demand on public services and realisation of human rights.
Linked Avoidable Non Communicable Diseases and conditions:
- CHD and Stroke -cardiovascular
- Circulatory diseases
- Cancers
- Respiratory diseases
- Liver disease
- Type 2 Diabetes
- Kidney disease
- Obesity
- Neurovascular and mixed Dementia
- Musco-skeletal etc.
Impact on healthy life expectancy and life expectancy
Non Communicable Diseases are a cause and manifestation of health inequalities in current and future generations. These are diseases that “break the bank “
Impact on economic growth and sustainability of public services
- Estimated at $47 trillion over the next two decades.Approximately 75% of the 2010 global gross domestic product (GDP). Source: World Economic Forum / Harvard School of Public Health. 2011
- Alter demographics
- Stunts country level development
- Two –punch blow to development- national economies and individuals in poverty
- Not a mark of failure of individual will power, but politics at the highest level
What are the real determinants of this spread?
- Transnational corporations are major drivers of NCD epidemics and profit from unhealthy commodities
- Public regulation and market intervention can prevent harm caused by unhealthy commodity industries
Some key potential priorities for consideration:
- Something like the Office for Budget Responsibility for the Public’s Health
- A comprehensive review of the marketing of unhealthy commodities and services to children, young people and the vulnerable
- Levys on the unhealthy commodity industries to provide additional public health funding to cover the societal costs as well as reduce their consumption
- Ensuring new trade agreements protect and promote the publics health
- A new public health bill – the state has powers to monitor in real time the commercial risks to the publics health, to ensure the state has (reserve)powers to tackle unhealthy commodity industries and services, set out duties for public bodies to consider the health of future generations and the planet and address health inequalities and the right to health
An OBR for health?
- Health should be properly considered in all fiscal, economic and market policies (human and planetary ill health and poor wellbeing are anthropogenic)
- Sustainability of Public Services especially the NHS and social care (“the miscalculation of sublime proportions”). NHS is set to cost 1.6 times GDP by 2065
- Health as an asset to prosperity and productivity- Health Creating (not damaging) Economy
- Focus on health life expectancy and health inequalities
- House of Lords review – Sustainability of NHS and Social Care (2017) proposed an Office for Health and Care Sustainability
- Mechanism for health in all policies
- Minimum Unit Price alcohol/Air Pollution etc.
- Lead technical Agency – Public Health England
Processed food marketing and promotions:
Around three-quarters of food advertising to children is for sugary, fatty and salty foods. For every £1 spent by the WHO promoting healthy diets, £500 is spent by the food industry promoting unhealthy foods
We need a comprehensive review of the marketing regulators and codes
- Regulators and codes not fit for purpose
- Regulators essentially accountable to industry – self regulation
- Statutory instruments focus on protecting market and plurality and the protection publics health is a low order objective
- Action is after the event and codes are produced by the industry so are not effective as their production is conflicted
- Self regulation is a failure for children, young people and the vulnerable
- Could be applies to tobacco, alcohol and ultra processed food products and services (gambling etc.)
- Reduce consumption
- Some of these industries pay little tax- needs reviewing
- Pay for the externalities and provide additional funding for public health
- Sugar Drink Industry levy – way forward – Minimum Unit Pricing of alcohol in England
- Tobacco – estimated £500 million- support for tobacco licensing scheme, smoking cessation support, Social marketing, Tso’s regulatory support etc.
We need a new Public Health Act. The last one was in 1936. The legislation addresses the epidemics of yesterday
- Non Communicable Diseases require new forms of health protection
- Duties for Public Bodies – consider health of future generations and the planet and address the causes of health inequalities
- Realisation of human rights (Social rights and the progressive realisation)
- Statutory monitoring and surveillance of unhealthy industries and services
Trade agreements have an effect on health. They could be used to protect our health. We could learn from the experience of other countries.
Some key potential priorities for consideration:
- An OBR for the Public’s Health
- A comprehensive review of the marketing of unhealthy commodities and services to children, young people and the vulnerable
- Levy’s on the unhealthy commodity industries to provide additional public health funding to cover the societal costs as well as reduce their consumption
- Ensuring new trade agreements protect and promote the publics health
- A new public health bill – the state has powers to monitor in real time the commercial risks to the publics health, to ensure the state has (reserve) powers to tackle unhealthy commodity industries and services, set out duties for public bodies to consider the health of future generations and the planet and address health inequalities and the right to health
More details in the proposals for a health-creating economy. 2017. UK Health Forum
This was presented at our conference Public Health Priorities for Labour