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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
ACHIEVING A
SUSTAINABLE
ECONOMY
ENSURING A STRONG, HEALTHY
AND JUST SOCIETY
PROMOTING GOOD
GOVERNANCE
USING SOUND
SCIENCE RESPONSIBLY
Preventing chronic disease
 Releases resources for treating
unavoidable illness
 Improves individual health and well
being
 Secures long-term viability of health
services
 Safeguards the future
Preventing
environmental
damage
Sustainable
development
Preventing
chronic
disease
Sustainable
social policy
Sustainable
development
Preventing
environmental
damage
Preventing
chronic
disease
Projected global
distribution of
chronic disease
deaths
WHO, 2005
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.
Chronic disease
Poverty
Poverty
Chronic disease
“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
Healthier
people
and planet
Reduce road
traffic
Combat
global
warming
Promote
active travel
Reduce
risks
of chronic
disease
Healthier
people
and planet
Fresh,
affordable,
local food
Stronger
local
economies
Prevent
damage to
environment
Reduce risks
of chronic
disease
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
Healthier
people
and planet
More
access to
green spaces
Better
physical and
mental
health
Sustain
the natural
environment
Reduce
risks
of chronic
disease
Barriers to change
 ‘Producer capture’
 Less investment in research
 Political short-termism
 Professional training
 Media campaigns
 ‘Downstream’ measures
The evidence
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

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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
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
th
30
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
Prevent
the
preventable
A safer
future
Better
health,
better use of
resources
Towards a
sustainable
social policy
Manage
unavoidable
disease
Sustain
through
prevention
Prevent
through
sustainability
Thank you
www.sd-commission.org.uk