In the UK, the National Health Service’s waiting list has reached record levels. Last winter, the emergency medical system collapsed. NHS doctors and nurses are on strike. We not only have problems recruiting people, but we also have problems retaining them. To save the NHS, we need to reduce demand and help people live healthier lives. To name just one example, it was reported in April that more than 5 million people in the UK have diabetes. In 2018 the government released a report that diabetes was one of the biggest burdens on the NHS, accounting for 9% of total spending. One in six people in hospitals has diabetes. Two-thirds of her UK adults are overweight, an important risk factor for diabetes.
Before the pandemic, the King’s Fund reported that Britain’s public health spending was about £3 billion ($3.82 billion), down 15% from six years ago. We absolutely need to increase investment in public health again, but more than that, we need to consider health in every policy area.
Think about poverty. About 1 in 5 people in the UK live in poverty. Poverty has a severe impact on physical and mental health. Poverty is associated with increased infant mortality, reduced adult life expectancy, poor mental health, asthma, diabetes, cardiovascular disease and obesity. It’s estimated that it costs him three times more to get his daily calories from healthy foods than he gets from the same calories from lower-quality foods.
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Housing is also a big issue. According to the Health Foundation, 1 in 3 people report problems with housing affordability, safety or quality. Problems such as mold and moisture can cause respiratory problems and headaches. In January, a coroner ruled that the infant died of respiratory disease after being exposed to mold in his home, and called for housing improvements. Overcrowding, among other things, increases exposure to infectious diseases. During the pandemic, this was one of the factors causing contagion among disadvantaged communities.
Green space is also a big problem. There is now plenty of evidence proving that exercise is like a silver bullet. There is also plenty of evidence that providing people with more open and free green spaces ultimately leads to higher levels of physical activity and improved mental health. In 2020, the government itself calculated that access to green space for all would save the NHS billions of pounds a year. This is especially important in helping children develop lifelong exercise habits. But young people in economically disadvantaged areas have a one in nine chance of accessing such a space.
Governments could prioritize quality housing, green space and socioeconomic support. It also has the potential to address job shortages, precarious employment, indoor and outdoor pollution, and crime, all of which have a huge impact on health. We need to recognize that nearly every government policy impacts public health and think more holistically about long-term health priorities. A healthier population is also a more economically productive and happier population. This is another reason why all government policies should include health impact analysis. Solving some of these problems now will pay off in the decades to come. Not next year, not during the election period, but definitely in 10 or 15 years. Demand for the NHS is already outstripping supply and we cannot afford to wait.
This article appeared in the July/August 2023 issue of WIRED UK magazine.
