Health in England refers to the overall health of the population of England. Despite overall increases in life expectancy in England, the most deprived areas continue to see no change or a decrease in life expectancy. [1] The Blair Government instituted a comprehensive programme to reduce health inequalities in England between 1997 and 2010 focused on reducing geographical inequalities in life expectancy. It was targeted at the Spearhead areas - the 20% of local authorities with the worst health and deprivation indicators. This led to more NHS resources being directed to the most deprived areas. The strategy was associated with a decline in geographical inequalities in life expectancy, reversing a trend which had increased over a long period. [2] However, health inequalities still remain. In 2014 to 2016, the difference in life expectancy between the most and least deprived areas of England was 9.3 years for males and 7.3 years for females. [3]
A North-South divide in life expectancy continues to be apparent. In 2016 to 2018, this geographical divide can be seen across regions of England. The life expectancy at birth of males and females in the regions of London, the South East, South West and East of England were all significantly higher than the national average. Whereas, life expectancy was lowest in the North East, North West and Yorkshire and the Humber.
On average, there have been reductions in the number of years lived in poorer states of health for both men and women at age 65 in England. As of 2018, Richmond-upon-Thames had the highest male healthy life expectancy at birth in the UK of 71.9 years, 18.6 years longer than males in Blackpool where it was only 53.3 years. For females, the lowest healthy life expectancy at birth was found in Nottingham at 54.2 years, and the highest was in Wokingham at 72.2 years, a gap of 18 years. [4]
Male | Female | |
---|---|---|
England | 79.6 | 83.2 |
North East | 77.9 | 81.7 |
North West | 78.3 | 81.9 |
Yorkshire and the Humber | 78.7 | 82.4 |
East Midlands | 79.4 | 82.9 |
West Midlands | 78.9 | 82.7 |
East | 80.3 | 83.7 |
London | 80.7 | 84.5 |
South East | 80.7 | 84.1 |
South West | 80.2 | 83.8 |
The ten leading causes of death for men in England are heart disease, dementia and Alzheimer's disease, lung cancer, chronic lower respiratory diseases, stroke, influenza and pneumonia, prostate cancer, colorectal cancer, leukemia and diseases of the liver, respectively. In females, the leading cause of death is dementia and Alzheimer's disease followed by heart disease, stroke, chronic lower respiratory diseases, influenza and pneumonia, lung cancer, breast cancer, colorectal cancer, leukemia and kidney disease. Higher mortality rates for heart disease, lung cancer, and chronic lower respiratory diseases in the most deprived areas contribute the most to the life expectancy gap. Smoking and obesity are the main risk factors for these diseases. [6]
People in the most deprived areas are more than twice as likely to die prematurely from cancer, and there has been no significant change in this level of inequality since 2010 to 2012. Similarly, people in the most deprived areas are almost four times as likely to die prematurely from cardiovascular disease compared with those in the least deprived areas, and this inequality has also significantly widened since 2010 to 2012. [7]
The prevalence of many risk factors, including smoking, drug use, high blood pressure and high cholesterol have declined. The prevalence of smoking has declined from 19.9% to 14.9% in the last 7 years and if this trend continues, it will reduce to between 8.5% and 11.7% by 2023. However, there has been an increase in the prevalence of obesity. In England, in 2016, 26.2% of adults were obese and it is forecast that levels of obesity will increase by 2023.
A study by Public Health England in 2017 found that 41% of the 15.3 million English adults aged 40 to 60 do not walk for as much as 10 minutes continuously each month at a brisk pace. A quarter of the English population was found to be “inactive” – doing less than 30 minutes of activity per week. [8]
The heaviest-drinking 20% of the population drink almost two thirds of all alcohol consumed. [9]
Lifestyle diseases can be defined as the diseases linked to the manner in which a person lives their life. These diseases are non-communicable, and can be caused by lack of physical activity, unhealthy eating, alcohol, substance use disorders and smoking tobacco, which can lead to heart disease, stroke, obesity, type II diabetes and lung cancer. The diseases that appear to increase in frequency as countries become more industrialized and people live longer include Alzheimer's disease, arthritis, atherosclerosis, asthma, cancer, chronic liver disease or cirrhosis, chronic obstructive pulmonary disease, colitis, irritable bowel syndrome, type 2 diabetes, heart disease, hypertension, metabolic syndrome, chronic kidney failure, osteoporosis, PCOD, stroke, depression, obesity and vascular dementia.
Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes that begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.
Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.
Tobacco products, especially when smoked or used orally, have serious negative effects on human health. Smoking and smokeless tobacco use are the single greatest causes of preventable death globally. Half of tobacco users die from complications related to such use. Current smokers are estimated to die an average of 10 years earlier than non-smokers. The World Health Organization estimates that, in total, about 8 million people die from tobacco-related causes, including 1.3 million non-smokers due to secondhand smoke. It is further estimated to have caused 100 million deaths in the 20th century.
Occupational lung diseases comprise a broad group of diseases, including occupational asthma, industrial bronchitis, chronic obstructive pulmonary disease (COPD), bronchiolitis obliterans, inhalation injury, interstitial lung diseases, infections, lung cancer and mesothelioma. These can be caused directly or due to immunological response to an exposure to a variety of dusts, chemicals, proteins or organisms. Occupational cases of interstitial lung disease may be misdiagnosed as COPD, idiopathic pulmonary fibrosis, or a myriad of other diseases; leading to a delay in identification of the causative agent.
Health in the United Kingdom refers to the overall health of the population of the United Kingdom. This includes overall trends such as life expectancy and mortality rates, mental health of the population and the suicide rate, smoking rates, alcohol consumption, prevalence of diseases within the population and obesity in the United Kingdom. Three of these – smoking rates, alcohol consumption and obesity – were above the OECD average in 2015.
Life expectancy has been rising rapidly and South Korea ranked 3rd in the world for life expectancy. South Korea has among the lowest HIV/AIDS adult prevalence rate in the world, with just 0.1% of the population being infected, significantly lower than the U.S. at 0.6%, France's 0.4%, and the UK's 0.3% prevalence rate. South Korea has a good influenza vaccination rate, with a total of 43.5% of the population being vaccinated in 2019. A new measure of expected human capital calculated for 195 countries from 1920 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by The Lancet in September 2018. South Korea had the sixth highest level of expected human capital with 26 health, education, and learning-adjusted expected years lived between age 20 and 64 years.
Health in Israel is generally considered good.
Social epidemiology focuses on the patterns in morbidity and mortality rates that emerge as a result of social characteristics. While an individual's lifestyle choices or family history may place him or her at an increased risk for developing certain illnesses, there are social inequalities in health that cannot be explained by individual factors. Variations in health outcomes in the United States are attributed to several social characteristics, such as gender, race, socioeconomic status, the environment, and educational attainment. Inequalities in any or all of these social categories can contribute to health disparities, with some groups placed at an increased risk for acquiring chronic diseases than others.
Chronic, non-communicable diseases account for an estimated 80% of total deaths and 70% of disability-adjusted life years (DALYs) lost in China. Cardiovascular diseases, chronic respiratory disease, and cancer are the leading causes of both death and of the burden of disease, and exposure to risk factors is high: more than 300 million men smoke cigarettes and 160 million adults are hypertensive, most of whom are not being treated. An obesity epidemic is imminent, with more than 20% of children aged 7–17 years in big cities now overweight or obese. Rates of death from chronic disease in middle-aged people are higher in China than in some high-income countries.
The major causes of deaths in Finland are cardiovascular diseases, malignant tumors, dementia and Alzheimer's disease, respiratory diseases, alcohol related diseases and accidental poisoning by alcohol. In 2010, the leading causes of death among men aged 15 to 64 were alcohol-related deaths, ischaemic heart disease, accident, suicides, lung cancer and cerebrovascular diseases. Among women the leading causes were breast cancer, alcohol-related deaths, accidents, suicides, ischemic heart disease and lung cancer.
Health in Wales refers to the overall health of the population of Wales.
The objective of cancer screening is to detect cancer before symptoms appear, involving various methods such as blood tests, urine tests, DNA tests, and medical imaging. The purpose of screening is early cancer detection, to make the cancer easier to treat and extending life expectancy. In 2019, cancer was the second leading cause of death globally; more recent data is pending due to the COVID-19 pandemic.
Health in Malta has seen improvements in recent years, with one of the highest life expectancies in Europe. Malta has a good overall quality of health and has seen rapid growth and improvement in key health indicators. Malta has seen significant development in the practice of mental health which has been supported by new infrastructure and increased government health spending. The introduction of health-focused government initiatives, particularly around nutrition, alcohol, smoking, and health will likely contribute to the further improvement of overall health nationwide.
Lebanon is a small middle-income country on the Eastern Mediterranean shore with a population of around 4 million Lebanese citizens, 1.2 million Syrian refugees, and half a million Palestinian refugees. It is at the third stage of its demographic transition characterized by a decline in both fertility and mortality rates. Moreover, Lebanon, like many countries in the Middle East is experiencing an epidemiological transition with an increasingly ageing population suffering from chronic and non-communicable diseases. Mortality related to non-communicable diseases is 404.4 deaths per 100,000 individuals, with an estimate of 45% due to cardiovascular diseases, making them the leading cause of death in Lebanon. Lebanon has health indices that are close to those of more developed countries, with a reported life expectancy at birth of 80.1 years and an under-five mortality rate of 9.5 per 1,000 live births in 2016. Since the end of the 15-year Lebanese Civil War in 1990, Lebanon’s health indicators have significantly improved.
The Glasgow effect is a contested term which refers to the lower life expectancy of residents of Glasgow compared to the rest of the United Kingdom and Europe. The phenomenon is defined as an "[e]xcess mortality in the West of Scotland (Glasgow) after controlling for deprivation." Although lower income levels are generally associated with poor health and a shorter lifespan, epidemiologists have argued that poverty alone does not appear to account for the disparity found in Glasgow. Equally deprived areas of the UK such as Liverpool and Manchester have higher life expectancies, and the wealthiest ten per cent of the Glasgow population have a lower life expectancy than the same group in other cities. One in four men in Glasgow will die before his sixty-fifth birthday.
Health in Norway, with its early history of poverty and infectious diseases along with famines and epidemics, was poor for most of the population at least into the 1800s. The country eventually changed from a peasant society to an industrial one and established a public health system in 1860. Due to the high life expectancy at birth, the low under five mortality rate and the fertility rate in Norway, it is fair to say that the overall health status in the country is generally good.
Males make up just under half of the total Australian population of 23 million. On average Australian males live to around 78 years of age, with the life expectancy of an Indigenous Australian male in 2009 being around 67 years of age and non indigenous men in remote areas living to around 70. On average female mortality rates are lower than males across the entire age spectrum.
Montenegro is a country with an area of 13,812 square kilometres and a population of 620,029, according to the 2011 census. The country is bordered by Croatia, the Adriatic Sea, Bosnia, Herzegovina, Serbia, Kosovo and Albania. The most common health issues faced are non-communicable diseases accounting for 95% of all deaths. This is followed by 4% of mortality due to injury, and 1% due to communicable, maternal, perinatal and nutritional conditions. Other health areas of interest are alcohol consumption, which is the most prevalent disease of addiction within Montenegro and smoking. Montenegro has one of the highest tobacco usage rates across Europe. Life expectancy for men is 74 years, and life expectancy for women is 79.