A question I often ask, as I talk to meetings and groups, is “which of the following is the commonest cause of premature death in your area?”
- Cardiovascular disease (heart disease and stroke).
- Liver disease
- Lung disease
What do you think? Of course you could dive straight into Longer Lives and find the answer, but without this information, many people would say “cardiovascular disease”.
In fact, cancer deaths in people aged under 75 have outstripped cardiovascular deaths in England since the mid-1990s.
Source: Compendium of population health indicators; https://indicators.ic.nhs.uk/webview
This is not to downplay the importance of any of these causes - cancer and cardiovascular disease account for two thirds of all premature deaths. Of the “top five” they have one thing in common – they are largely preventable.
The Office for National Statistics (ONS) estimates about two thirds of all premature deaths are avoidable – that is, they could potentially be avoided by public health action (preventable), better health care (amenable) or both - and that preventable deaths make up about half of all avoidable deaths. The opportunity is great for PHE and the new public health system to contribute to a reduction in the underlying causes and risks of poor health – smoking, excess alcohol consumption, physical inactivity and rising levels of obesity.
So, how are we going to do it? Working with our local government and NHS partners, we will play our full part in the “Call to Action” to reduce premature mortality. England remains “mid-table” in terms of European premature mortality rankings and we are determined to do better. Putting into action the things we know work and ensuring we do things at scale could save thousands of lives. Work is under way to allow us to better understand the full potential impact of public health interventions.
One important tool which will help us in this endeavour is the Global Burden of Disease study, which was published for the UK in March this year. Work is ongoing to produce this at sub-national levels. It reminds us that there are other conditions such as mental illness and musculoskeletal disease which contribute greatly to the overall burden of disability in the population, as well as the importance of high blood pressure as a major risk factor for cardiovascular disease. There is good evidence that increased levels of physical activity can improve all three.
PHE is committed to basing policy and practice on evidence, and that means making sure that both the public and local decision makers have, and understand, the best available evidence. Although data doesn't change things by itself, clearly presented information can be viewed as an intervention in its own right.
Finally, we need to recognise that the causes of ill health are constantly changing over time. While there is more awareness of the increase in liver disease, we should also recognise that other significant causes of preventable death have grown over the last ten years; namely malignant melanoma and accidental injury. PHE is committed to ensuring we have the right information in the right place at the right time.
How else do you think information could be used - by PHE, local government or others - to contribute to reducing preventable deaths? What sorts of data tools could we create to help us harness that information?