The cost of being unhealthy

Unhealthy graphic Image copyright Thinkstock

We eat too much, drink too much and don't get enough exercise. It's that simple. And if you think that doesn't apply to you, you're probably wrong.

There are seven established factors that raise the risk of ill health. They cover everything from smoking to low fruit and vegetable consumption.

An incredible 93% have at least one risk factor, according to the Health Survey for England. Over a third have three or more.

Of course, there are some encouraging signs. Smoking rates are falling and there's evidence to suggest obesity and problem drinking rates are stabilising. But, nonetheless, the scale of unhealthiness is still proving to be serious burden.

Cost to the individual

Take cancer. Research suggests that nearly half of all cancers are caused by avoidable life choices. Smoking, of course, is a major culprit, but so is diet and weight. Similar findings have been reached for other big killers from heart disease to diabetes.

But that cost is not just born by the individual: it is felt by society too. There are 3,000 alcohol-related admissions to hospital each day. The cost of that tots up. Alcohol Concern estimates dealing with these patients sets the NHS back by nearly £2bn a year.

Once the financial impact of alcohol-related problems on A&E, GPs and hospital outpatients clinics is taken into account, the cost is nearly £3bn.

The burden of dealing with obesity is even worse. Public Health England has put the costs at over £4bn. It's no wonder that NHS England chief executive Simon Stevens calls it "a slow-motion car crash in terms of avoidable illness and rising health care costs".


Unhealthy nation

Image copyright SPL
  • One in five adults smokes
  • A third of adults drink more than the recommended levels of alcohol
  • A third of men and a half of women do not get enough exercise
  • Nearly two-thirds of adults and 28% of under-15s are overweight or obese
  • Only a quarter of adults eat the recommended five portions of fruit and vegetables each day
  • Nearly a third of people have high blood pressure
  • Children consume three times the level of sugar they should, adults more than twice
  • The average person consumes 7.2g of salt - the recommended level is 6g

In fact, it is often overlooked in the continuing debate about the pressures on the NHS that getting people to live healthier lives is critical to the future of the NHS.

In October, NHS chiefs made an unprecedented plea to ministers - they asked for more money. But it wasn't a "something for nothing" request.

They set out a compelling case about how the health service was facing a £30bn shortfall by 2020 - and said if the budget was increased by £8bn in real terms they would do the rest.

Their plan involved changing the way services work, putting more emphasis on community services in an attempt to stem the rising demands on hospitals, which tends to lead to more expensive treatment.

But an equally important element was encouraging people to become more healthy. Prof John Ashton, president of the Faculty of Public Health, says this should not come as a surprise.

"Lifestyle-related illnesses cost the taxpayer millions of pounds we can ill afford. Unless we tackle these issues effectively, the NHS will not be able to survive the increasing pressures."

Radical solutions

So how is that to be done? Public health experts talk about a partnership between the national, local and individual spheres of civic society.

Moves have been made to encourage people to make healthier choices through measures such as food labelling, while councils, which now have responsibility for public health, are pursuing a variety of approaches at the local level from restricting the sales of cheap, high-strength alcohol to offering discounted access to leisure services.

More radical solutions, such as incentivising good behaviour, through steps such as offering vouchers, have also been explored in places.


The cost of our behaviour

Image copyright Thinkstock
  • A 20-a-day smoker will spend nearly £3,000 a year on cigarettes
  • Over half of lifelong smokers die from their habit - usually from cancer, lung disease or heart disease
  • Alcohol-related problems cost the NHS £2.8bn a year
  • The bill for obesity-related illness is more than £4bn a year
  • Inactivity is estimated to cost the NHS £1.8bn
  • Overall sickness absence costs the economy £22bn a year - mental health and musculoskeletal problems are major factors

But there is a desire to get employers engaged too. Sickness absence costs the economy £22bn a year - a scourge which Dame Carol Black, who has been advising the government on workplace health issues in recent years, describes as "bad for families, the community and the economy".

Again, steps are being taken to tackle the problem. This year a new scheme Fit for Work is being rolled out across England, Wales and Scotland to offer employers access to a free occupational health service for staff who are on long-term sick leave - half of the workforce don't currently have access to one.

But companies are also being asked to play their part by being encouraged to sign up to the Public Health England-endorsed Workplace Wellbeing Charter, which asks them to take steps such as encouraging physical activity in the workplace and offering healthy foods and snacks.

However, it's not just about preventing sickness absence - healthy employees are three times more productive than unhealthy ones, research has found. Health is truly everybody's business.

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