How to raise the bar on the nation’s health and healthcare systems

Posted in: Culture and policy, Evidence and policymaking, Health, Science and research policy

Dr Geoff Bates is a Research Associate at the University of Bath Institute for Policy Research (IPR).

In January, the UK government announced the intention to develop a new Major Conditions Strategy to tackle six major groups of health conditions: cancer, cardiovascular diseases, chronic respiratory diseases, dementia, mental ill-health and musculoskeletal disorders.

The case for new approaches to these conditions is clear. Not only will reducing cases improve health and wellbeing, reduce inequalities and reduce the pressure on our struggling health and care systems, but improving public health will help to deliver other policy agendas. For example, in the recent Health Foundation report 'Health is wealth?' the former Chief Economist at the Bank of England Andy Haldane underlined how a healthier population will benefit productivity and the economy, noting that “the nation’s health and health care systems are central to society’s strength and growth” and “health-induced trends in inactivity have worsened materially the cost-of-living crisis being experienced in the UK”.

Our submission to the major conditions strategy call for evidence focuses on the prevention of disease. This is critical as to reduce ill health, government strategies need to include primary prevention approaches that tackle the underlying causes of poor health. These causes are commonly referred to as wider determinants of health: a diverse range of non-medical factors that influence health outcomes, including social, economic, commercial and environmental factors.

However, the government have long appeared reluctant to act on these wider determinants. Instead, health policy tends to focus far more towards treating poor health than preventing it, and prevention strategies typically try to change individual choices and behaviours rather than the context that these choices are made in. In our submission we therefore argue that the major conditions strategy should explore approaches to tackle the wider determinants of health, as well as focusing on individual behaviours, and provide evidence on how this can be achieved.

Specifically, we draw on evidence from the ‘Tackling the Root causes Upstream of Unhealthy Urban Development’ (TRUUD) project to demonstrate how changing the quality of the urban environment - for example, action to improve housing conditions, increase social connectivity, and reduce congestion and air pollution - can prevent disease. The World Health Organization’s Urban Health Research Agenda and United Nation’s New Urban Agenda highlight how improving the quality of urban environments is an important area for improving public and planetary health.  Our response includes evidence on:

  • How tackling the underlying causes of the major conditions requires approaches to incentivise stakeholders who are outside of the health sector to take action and to integrate health into their decision-making,
  • The use of economic valuation tools that provide data on the costs of ill health and where these costs land across different policy areas to persuade and incentivise different stakeholder groups to think more about health outcomes,
  • Approaches for the more effective communication of health evidence to decision-makers and integration of local health data into urban development processes.

More information about TRUUD is available on the project website including the team’s full response to the call for evidence.

All articles posted on this blog give the views of the author(s), and not the position of the IPR, nor of the University of Bath.

Posted in: Culture and policy, Evidence and policymaking, Health, Science and research policy


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