Time to move: the major
benefit of physical activity should be embraced, says Chief Medical Officer
Sir Liam
Donaldson, the Chief Medical Officer, today published his 2009
Annual Report, in which he states that the harm caused by
inactivity has been ignored for too long and it is now time for
action. Up to 70% of adults in England do not do the recommended
minimum amount of physical activity and child fitness is falling
by up to 9 per cent every decade.
In his report, On the State of Public Health, England’s
Chief Medical Officer calls for action to help reverse the
nation’s trend towards physical inactivity, including recommending
that the Government undertakes a pilot of fitness assessments for
every secondary school pupil. Sir Liam is calling for a major
change to get the population active, whatever their age.
Sir Liam said:
“Inactivity pervades the country. It affects more people in
England than the combined total of those who smoke, misuse alcohol
or are obese. Being physically active is crucial to good health.
If a medication existed that had a similar effect on preventing
disease, it would be hailed as a miracle cure.
“Studies indicate that approximately 61 per cent of men and 71
per cent of women over the age of 16 years failed to meet the
minimum adult recommendation for physical activity. Inactivity
increases the risk of more than six chronic diseases. This is of
grave concern. Improving physical fitness in children helps build
a lifelong habit of participation in physical activity. We must
get our children moving to improve their future health.”
In addition to a pilot of comprehensive physical fitness testing
in secondary schools, Sir Liam also called for:
New recommendations on the minimum physical activity
requirements to be built into public health programmes.
Recommendations for minimum physical activity requirements to be
consistent across the United Kingdom.Further research to be
undertaken to establish the most effective interventions to
increase physical activity within specific age groups.
Sir Liam’s Annual Report also addressed four other key areas of
public health.
Winter kills
Typically mortality rises 18 per cent during the winter months in
England. Each one degree Celsius decrease in average winter
temperature results in 8,000 additional winter deaths in England.
Many of these deaths are amongst older people, especially women,
and those with underlying health problems. Most are due to
increased cardiac death, strokes and respiratory problems.
Cold weather has a number of predictable health impacts. It
causes blood pressure to rise, weakens the lung’s resistance to
infection and makes blood thicker, increasing the risk of
thrombosis. The annual cost to the NHS of treating winter-related
disease due to cold private housing is over £850 million.
To address the issue of excess winter mortality, Sir Liam calls for:
A national cold weather plan to be developed.Healthcare
providers to identify those who are vulnerable to harm from cold
weather and refer them for appropriate help.Supermarkets and local
shops to consider offering free home deliveries to vulnerable
people during periods of cold weather.Warm clothing technology
appropriate for older people to be developed and promoted.Further
research into the risk factors for winter mortality and how it
might be prevented.
Sir Liam said:
“England’s annual winter death toll averages over 30,000 people.
Though this has gradually fallen over the last half century, it is
still too high. Finland - a colder country than ours – has a 45
per cent lower winter death rate. We have a comprehensive and
effective national heatwave plan that is put into place during
excessively hot weather. If a comparable national cold weather
plan were to be developed, it could save thousands of lives each year.”
Rare is common
A disease is considered rare when it affects fewer than five in
every 10,000 people. There are more than 6,000 rare diseases,
affecting around three million people in England. Rare diseases
are an important cause of illness and death, but do not receive
the attention they need and deserve.
As rare diseases can affect many different body systems,
misdiagnosis is common. In one study, over a third of people with
a rare disease were initially misdiagnosed - some experiencing a
delay of up to 30 years from first symptoms to the correct
diagnosis being made. Whilst there have been significant
improvements in diagnosing and treating children with rare
diseases, the same is not true for adults. People with rare
diseases are now living longer, but the transition from children’s
care to adult services is often difficult.
Sir Liam calls for:
· The appointment of a National Clinical Director for rare
diseases.
The network of reference centres for rare diseases to be
strengthened to enable better coordination of specialist services,
including the transition from paediatric to adult services.
Adequate numbers of specialists to be recruited and trained so
that future service needs can be met.
· Strengthened research to develop and market medicines for the
‘orphaned’ rare diseases.
· Increased public and professional awareness of this neglected
group of diseases.
Sir Liam said:
“While many excellent services are provided for those with rare
diseases, this is not the norm and services are inconsistent
across the country. Improved coordination and management is needed
to ensure that excellence becomes the standard, no matter where a
patient lives.”
Grandparenting for health
There are currently over 11 million grandparents in England and
this number is rising. Today, grandparents are living longer and,
with family sizes becoming smaller than in previous decades, they
have more time to spend with each of their grandchildren.
Grandparents could be a great asset to a child’s health and
development, but are usually overlooked in discussions about
building healthy childhoods.
Almost 61 per cent of grandparents visit their grandchildren
weekly, and 92 per cent of grandparents find their grandchildren
very rewarding. Grandparents undertake a wide range of activities
with young grandchildren. Many of these help a child’s general
social and educational development, but few activities focus on
health. More health related activities would be beneficial for
both grandchildren and grandparents. Studies show that for many
the relationship remains strong and influential into adolescence.
Adolescents reported better emotional health and were better
adjusted if their closest grandparent was involved in their life.
To capitalise on this relationship, Sir Liam recommends:
The important contribution of grandparents to children’s health
and well-being should be recognised and valued.Evidence-based
tools and advice for grandparents to promote the health of their
grandchildren should be produced.Policy initiatives aimed at
improving children’s health should consider the potential role and
impact of grandparents.Children should be encouraged to maintain
their relationships with their grandparents and support them
throughout life.
Sir Liam says:
“Childhood is a vital time for health. Grandparents are a great
asset in a child’s development. When policy on children’s health
is being developed the role of grandparents should form part of
the thinking. Developing the role of grandparents as educators and
mentors of their grandchildren’s health could add an important new
dimension, as well as benefitting their own health.”
Climate change and health
Climate change and health are inextricably linked. Climate change
damages global health in many ways. For example, drought caused by
climate change harms crop growth, and therefore causes
malnutrition. Drought also threatens the improvements in clean
water supply that are being made in many less developed countries.
Worldwide, 5.5 million years of healthy life are already lost
annually because of climate change.
There are a number of fortuitous opportunities to slow climate
change whilst also improving health. In his report, Sir Liam
recommends that national targets should be set to double travel on
foot and to increase travel by bicycle eight-fold. This will
reduce obesity, diabetes and heart disease significantly, whilst
also slowing climate change. The NHS also has an important role to
play, as it has the greatest carbon footprint of any public sector
organisation in Europe. It must take opportunities to reduce its
carbon emissions whilst also enhancing service and efficiency.
Sir Liam also called for:
The synergies between improving health and slowing climate
change to be championed by the Government and health leaders to
drive bold lifestyle changes. The health impacts of climate change
to feature prominently in undergraduate and postgraduate health
professional education curricula.The NHS in England to make its
facilities readily accessible by public transport, and to make
services increasingly available online, using modern technology,
to reduce travel.The NHS in England should use its buying power
and other means to drive rapid transition to a low-carbon economy;
the aim should be to reduce its carbon footprint by 10 per cent
from its 2007 level by 2015.
Sir Liam said:
“Climate change and health are inextricably linked. A problem
that is everybody’s is too easily treated as a problem that is nobody’s.”
Notes to Editors
1. Professor Sir Liam Donaldson is the Chief Medical Officer for
England. His 2009 Annual Report can be found at www.dh.gov.uk/cmo
2. This is Sir Liam’s ninth Annual Report on the state of the
nation’s health. His previous Annual Reports have called for
action on key public health issues, including smoke-free enclosed
public places (2002 and 2003 report), the obesity ‘time bomb (2002
report), an opt-out system for organ donation (2006 report) and a
minimum unit pricing on alcohol to curb binge drinking (2008
report).
3. For further information or requests for interviews, please
contact the Department of Health newsdesk on 020 7210 5221.
Contacts:
Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk