Rates of premature mortality in England, compared to most affluent

In addition, the study reveals the greatest burden of disability and long-term conditions such as low back pain, depression and depression, highlighting the need for health services to adapt to managing these conditions.

While overall rates of death have been improved since 1990, unhealthy diet, alcohol and drug use, obesity and high blood pressure, targeting prevention, especially in areas outside the control of the health service.

The study, from the Global Burden of Disease Initiative, provides data on premature mortality, disability and risk factors from 1990 to 2016 for 150 Upper-tier Local Authority (UTLAs) in England, Scotland, Northern Ireland and Wales, with the local, regional and national level.

Years lived with disability years of life lost

Ischaemic heart disease was the leading cause of premature death in the UK in 2016, and was higher in men than in women. Self-harm was the third leading cause of premature death for men.

In England, Wales and Northern Ireland (but not Scotland), the years lived with disability over the years of life lost. Low back and neck pain, skin and subcutaneous diseases, migraine, depressive disorders, sensory and other disorders.

"As death rates decrease, people continue to live with long-term, often multiple conditions," says Professor Nicholas Steel, lead author, University of East Anglia, UK. "Our findings show a significant shift in mortality to morbidity, yet we are still in the process of suffering from serious killers.

Health and deprivation

UTLAs in England (Blackpool), compared to the most tributary (Windsor, Wokingham, Windsor and Maidenhead, and West Berkshire). Rates of premature mortality were most frequently reported for the most part of the United Kingdom, compared with those of the United Kingdom, and the association with depression and chronic obstructive pulmonary disease.

In England, some UTLAs performed better than expected for their level of deprivation. For instance, Birmingham and some London boroughs (eg, Tower Hamlets and Hackney) performed better than UTLAs with similar levels of deprivation in Liverpool and Manchester, strengthening the need for specific action to respond to the distinct problems that may exist in northern cities.

The authors also suggest that the relatively better health seen in London may be because of lower levels of risk; better access to health care; higher educational performance; London, London, London, London.

Professor John Newton, author and director of health improvement at Public Health England, UK, said: "This comprehensive assessment of health in the country highlights the stark division between rich and poor areas. Health and well-being, such as poverty, education and other resources needed for good health. "

"As we work to develop the NHS long term plan, actions tackling the social and structural drivers of ill health are needed if we are to improve the stubborn health gap between rich and poor areas of the country."

Northern Ireland had particularly high rates of anxiety, which had been attributed to the social and economic legacy of civil conflict. In cancer, with cancer and cirrhosis. The authors note that the long-standing differences between the countries of the UK are likely to be due to variations in risk factors and socioeconomic deprivation, rather than differences in health service organization and spending.

Health improvements have slowed since 2010

Between 1990 and 2016, life expectancy has improved in all four countries of the UK, but the rate of improvement has slowed since 2010. Nine out of 150 UTLAs had worse rates of premature death in 2016, compared to 2010.

Rates of premature death varies by cause, and the national slow-down in 2010 has been driven by the gradual disappearance of improvements in ischaemic heart disease, cerebrovascular disease, and to extent colorectal cancer, lung cancer, and breast cancer. The slow-down in improvements in cardiovascular deaths, but this was most apparent in those aged over 85 years.

"The risk of mortality in some cancers is a concern, especially given that some of the common cancers in the UK are," explains Professor Steel.

More tributaries UTLAs saw the greatest improvements in mortality before 2000, but this changed after 2010 when the national slowdown in UTLAs. However, the reasons for this are unclear and more research is needed on the links between deprivation and mortality since 2010.

The need for action outside the health service

In all four countries, unhealthy diet, obesity, alcohol and drug use, low physical activity, and environmental factors, such as air pollution.

"In many cases, the causes of ill health and the behavior that causes it to be more important than the control of health services. The health and well-being of people who want to stop smoking, and that encourages a healthy drinking culture. "says Professor Steel." It's a disease, a disease, a drug and alcohol abuse. "

The ten leading risk factors in the UK, with higher rates of tobacco use in Scotland, and of alcohol and drug use in Scotland and Northern Ireland.

"All countries in the UK could further reduce the burden of disease through effective prevention." to realize that prevention is a core activity, "he says.

Since 2010, the annual rate of mortality has been relatively unchanged since 2000. The continuing dominance of cardiovascular disease as the leading cause of mortality argues for renewed efforts to deliver systematic high fasting glucose, high blood pressure and high cholesterol programs.

Finally, the authors note that the data is needed to estimate morbidity trends across the UK. The UTLA-level data on morbidity (or disability) is subject to greater uncertainty than mortality.

Dr. Christopher Murray, Institute for Health Metrics and Evaluation at the University of Washington, USA, says: "The estimation of disease burden at the local level is in the twenty-first year of the Global Burden of Disease. These local findings demonstrate to other countries the value of empowering policymakers to make more effective decisions that address specific needs of very specific communities.

Writing in a linked Comment, Ellen Nolte, London School of Hygiene & Tropical Medicine, UK, highlights previous research (Rutter et al.) Showing that a series of single, unlinked, interventions that require the individual to act (for example, making healthy The effects of these conditions are not likely to be effective. Instead, she says: "There is a need for a policy that is mindful of the potential tensions and unintended consequences of policies that are not consistent, recognizing the influence of powerful corporate actors in undermining public health policies that seek to promote health, and creates a policy environment that provides the means to address the need for change and the ability to do so. "

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More information:
The Lancet, www.thelancet.com/journals/lan … (18) 32207-4 / fulltext