A prevention-first approach to health

prevention-first health

The National Health Service turns 75 this week. It faces huge short-term and long-term challenges – from ongoing strikes and lengthening waiting lists to worsening health outcomes – and there has been muck talk about the need for fundamental reform. The former health secretary Sajid Javid, for example, called in the Times newspaper on 4 July – just ahead of the anniversary of the creation of the NHS in 1948 – for the setting-up of a royal commission. It comes just days after a prediction that the number of diabetes cases around the world will double by 2050. Most calls for healthcare reform emphasise the need to shift to a more prevention-first approach, helping people to live healthier lifestyles before their health declines. Education has a massive role to play in achieving that goal.

There has been no shortage of advice recently about the sort of reforms that are needed to rescue a visibly ailing NHS.

One area is the use of robotics and technology more generally, supporting with everything from diagnostics to operations. Artificial intelligence (AI) is more accurate at reading scans than humans. ‘Virtual wards’ would enable many patients to receive hospital-level care at home, freeing up much-needed beds in hospitals. Another is reform of GP care, with technology helping here too, for example by automatically transcribing clinical notes.

A third area is around adopting a more prevention-first approach – tricky ground politically because it inevitably involves the state in encouraging, nudging and/or compelling people to change their behaviour.

James Bethell, a Tory peer who was a health minister during the Covid pandemic, talks about the need for a “new contract” between the government and the people “that is not just a one-way promise for free access but is more of a partnership around healthy living”. The NHS Long-Term Plan (published in 2019) already talks about “supporting people to live longer, healthier lives through helping them to make healthier lifestyle choices and treating avoidable illness early on”.

Stuart Bloom is a senior consultant. He recently set out in the Guardian a six-step strategy for transforming the NHS. Step four talks about improving preventative health. Step five calls for an effective obesity strategy – starting in schools.

Tackling obesity is the key to reducing cardiovascular or cancer mortality. We should set up a programme of diet education in schools with a new (compulsory) GCSE on personal health. Within a few years the public health benefits would be enormous.

A report in the Lancet journal on 24 June said that more than 1.31 billion people worldwide could be living with diabetes by 2050. It was 529 million in 2021. The authors of the report into diabetes – which the Lancet calls “a defining disease of the 21st century” – wrote that type 2 diabetes, which makes up the bulk of diabetes cases, “is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors.”

Life-Based Learning

Life-Based Learning is predicated on the idea that we cannot simply carry on as we are – not least in relation to health and wellbeing. Unless we do more to ensure that individuals – including children and young people – adopt healthy lifestyle choices, we will continue to sleepwalk towards disaster.

Encouraging children and young people – and adults – to take part in regular physical activity is not, on its own, going to magically solve all our health problems. There is a clear link, for example, between health outcomes and economic circumstances. However, regular physical activity does have lots of benefits, especially for children. For example:

  • it improves bone health, muscle strength and heart health
  • it helps reduce anxiety and increases confidence
  • it supports self-esteem and happiness

Schools have a massive role to play. Life-Based Learning is an approach to education and development for children and young people in which the life challenges that we all face become the focus of a fully rounded, life-based approach to learning. Tackling obesity – and promoting children’s physical health and wellbeing more generally – is one such challenge.

LBL priorities children’s physical and mental wellbeing. This includes opportunities for regular sport and physical activity – including the Daily Mile or something similar – and an emphasis on food education and healthy eating.

We need to junk our junk-food culture. Food education and healthy eating – knowledge, knowhow and practice – must be at the heart of any long-term strategy for improving health outcomes. It needs to be proactive and not reactive.

Click on Physical Health in the Categories list on the right-hand side of this page to read much more about improving health and wellbeing and the value of a life-based approach to children and young people’s education.

Image at the head of this article by Anil sharma from Pixabay.

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