In the UK – as in almost all regions of the world – most deaths are caused by chronic, non-communicable diseases (NCDs). Cancer, cardiovascular disease, diabetes and chronic lung disease take a heavy toll on individuals, families and economies, and the terrible tragedy behind the numbers is that many of these deaths – in the UK, 250,000 over a decade – could be prevented or delayed by tackling physical inactivity, poor diet, smoking and alcohol use. The World Health Organization has developed a series of voluntary targets in all these areas, aiming to reduce early deaths from NCDs by 25 per cent by 2025.
The Richmond Group of Charities has set out to find out what ‘25 by 25’ would mean in practice. Living Longer, Living Well: How We Can Achieve the World Health Organization’s ’25 by 25’ goals in the UK extrapolates from existing (downward) trends in NCD deaths in this country. Assuming that progress continues to be made over the next 10 years at the current rate (which, given the ongoing cuts to public-health budgets, is far from guaranteed), we would (just) reach the 25% target for women by 2025 but fail to reach it for men.
However, the report also models four interventions that could shift the curve beyond the 25% target: reformulating food, increasing tobacco tax, restricting alcohol marketing and fostering physical activity through support from GPs. Going beyond simply looking at the number of deaths, it also looks at the impact of these interventions on mental health (particularly depression) and on years lived without disability (staying healthy longer). Among its conclusions are that 26,000 deaths could be avoided if food was reformulated and that almost 100,000 years of disability would be avoided if GPs delivered physical-activity support.
Peter Scarborough, his research team and the Richmond Group are to be congratulated for producing such a thought-provoking report, the first to model national NCD trends to 2025 in this way. It clearly demonstrates that, with concerted action across society, the UK has the opportunity not only to ‘achieve’ 25 by 25, but also to ‘surpass’ it – at the same time, reducing the number of years lived with physical and mental ill-health.
And the impact of the report can go beyond an interesting demonstration of modelling: England also has the opportunity to lead the world in demonstrating the impact that the interventions modelled in this report could have on health and longevity, were they to be actioned. As Lord Nigel Crisp has put it: ‘The UK was one of the pioneers in introducing a universal healthcare system to the whole population. It could lead again in the development of a health-creating society.’