Global burden of disease study shows mixed picture for UK health

(Medical Xpress)—Life expectancy in the UK has improved over the last 20 years, but levels of ill health have not and the UK is now below average compared with 18 other countries on many important indicators.

These data are revealed by a special analysis of the high profile Global Burden of Disease Study 2010, published in The Lancet. An analysis of the study, which was funded by the Bill and Melinda Gates Foundation, was co-authored by University of Manchester honorary Professor John Newton, Chief Knowledge Officer of Public Health England, and Professor Kevin Fenton, Director of Health and Wellbeing of PHE, among others.

This new body has been established to protect and improve the nation's health and wellbeing, and to reduce inequalities. PHE will take up its full responsibilities on 1 April, 2013.

The report looked at how the health of the UK compares with 14 other EU countries, Australia, Canada, Norway and the United States. These countries were chosen as comparators with a similar or higher level of health expenditure. Results are presented for 259 diseases and injuries, and 67 risk factors or clusters of risk factors, together with comparable data for years of life lost and disability-adjusted life years between 1990 and 2010.

In the 20 years from 1990 to 2010, life expectancy overall increased by 4.2 years in the UK to 79.9 years. However, improvements in mortality have been very small for some age groups and the UK has performed poorly compared with other countries. Also, some specific causes of death show marked increases, such as Alzheimer's disease, cirrhosis of the liver, and drug use disorders. The best results are for heart disease mortality where the UK has seen the largest fall in mortality of any of the 19 countries over the period.

Although the overall picture is one of improvement, there is considerable cause for concern in these figures. Premature mortality has hardly changed in the UK for both men and women in the 20-54 year old age group. The leading causes of death in this group are heart disease and self-harm, but also liver disease, breast cancer and road injury. The number of years of life lost (a measure of the extent of premature mortality) has actually increased in this age group for liver disease (cirrhosis), drug-use disorders and alcohol, cancelling out the benefit of substantial improvements in most cancers and in road deaths.

Professor John Newton, who is honorary Professor of Public Health and Epidemiology at the University of Manchester, said: "The GBD study only looked at figures for the whole country but within the UK we know we have areas such as the South East and South West that achieve results as good as any of these countries. But there are also areas such as the North West which do as badly as the worst and this is completely unacceptable.

"We should be proud that life expectancy in the UK has increased as much as it has since 1990, but we need to make sure that these extra years are healthy ones. As a society we must look after our vulnerable people better. Poor mental health causes an enormous and increasing burden of disability as does the pain and disability of arthritis, and loss of independence due to poor sight, hearing and incontinence.

"Despite some enviable recent success, for example on smoking, we in the UK need to take a hard look at what can be done to help people in the UK achieve the levels of health already enjoyed by other some countries. Central and Local Government, charities, employers and retail businesses all have a part to play."