Healthy eating round-up

You are what your friends eat, a systematic review of social network analyses of adolescent eating habits and bodyweight, underlines the importance of school friendships in shaping young people's eating behaviours. It also suggests that social network-based health promotion interventions may play well amongst this group. Well, you don't say ...
Another systematic review considers children's attitudes to obesity, body size, shape and weight, finding that children tend to focus on size, rather than health and also that researchers had rarely engaged effectively with their subjects.
Meanwhile DH has published some new material allied with the eatwell plate, a resource designed to show what a healthy, balanced diet should look like.

Going local

Many avowed solutions to health inequalities lie outside of the sphere of influence of public health professionals. So how can local health departments attempt to address inequalities, asks an article in Health and Social Care in the Community? Its authors suggest that the role of social capital is critical. A team from the Netherlands have also published a study about social capital, looking at its relationship with self-reported health and finding that its positive association with health is especially so for people in urban environments

Smoking Cessation

While smoking has declined amongst the UK population, prevalence amongst ethnic minority groups has not reduced at the same rate, a briefing from the Race Equality Foundation observes. As well as setting out the demographics and providing some examples of cessation interventions, the briefing also gives a helpful overview of smokeless tobacco products used by ethnic minority groups in the UK.

Measuring up

Evaluating the impact of health improvement interventions can be challenging and there’s always a new how-to guide in the offing: here’s one from Local Government Improvement and Development. It stems from the Healthy Communities Programme and includes a selection of project evaluation examples from primary care and a variety of information sources for evaluation and data collection and analysis.

An uphill struggle

Something of a cri de coeur from Clare Bambra and others is contained in a comparison of the Black, Acheson and Marmot reports. Looking at the content as well as the political context in which the reports were commissioned and published, the article find similarities in theoretical underpinning and in effects, not to mention the uncanny likeness of circumstances for Black and Marmot. And there's a rather melancholy conclusion: "Looking to the future, researchers may improve the likelihood of their research having a wider policy impact by focusing less on describing the problem and more on ways to solve it." An analysis of the UK approach between 1997 and 2010 from a Dutch academic is similarly bleak.

Counting the cost

Poor diet is the largest contributor to NHS costs amongst the usual group of suspects, an assertion not missed by the press. The British Heart Foundation Health Promotion Research Group has reappraised the economic impact on the NHS of poor diet, physical inactivity, smoking, alcohol and obesity. Looking at data from 2006-7, researchers found that while smoking and alcohol each accounted for £3.3 billion, poor diet cost the NHS £5.8 billion. A team from the Netherlands, meanwhile, has examined the EU-wide economic cost of health inequalities.

Child Protection

Few surprises from the final paper from the Munro Review, with further critical analysis of the “one size fits all” approach and the quantity of red tape in the current child protection system. Acknowledging the importance of early intervention, the report also (in keeping with a theme in health and social care reform at the moment) stresses the need for more local solutions. And there’s an emphasis on accountability, with the recommendation that Local Safeguarding Children Boards should submit annual reports directly to the Chief Executive and Leader of the Council, as well as to the local Police and Crime Commissioner and the chair of the health and wellbeing board. A further indication that the Munro review wants increased visibility for child protection is the recommendation that councils appoint a dedicated children’s services director. Finally, there’s a lot said in support of social workers, both in terms of removing the bureaucratic barriers and encouraging clearer connections between front-line practitioners and local authority managers. However, as the RCPCH and other have observed, the report has been launched into the maelstrom of NHS reforms and local authority budget cuts, which will inevitably impact child protection provision.

In the country

How will the health service reforms affect rural economies, asks the Primary Care Trust Network (part of NHS Confederation)? Differently, it seems, is the answer. In its briefing, the PCT Network warns commissioners and others to pay attention to the particular demographic and geographic challenges in rural locations, especially the older-than-average population and the hard to reach pockets of deprivation. The report also consider the outlook for the health market, suggesting that rural areas have a propensity for market failure in some sectors: any plans for implementation need to be "rural proofed."

Child abuse deaths: not what you'd expect

An interesting and counterintuitive piece of number-crunching from a team at the university of Warwick shows that child deaths from violence fell considerably over recent years. Looking at ONS mortality data and Home Office homicide statistics between 1974 and 2008, researchers found that deaths from assault fell in infants (below 1 year old) and children (between 1 and 14 years old). For adolescents (15-19 year olds), the picture is different: amongst girls, levels have remained static, but there was a substantial jump in deaths caused by violent assault amongst teenaged boys. And depending on which news report you read, this can either mean that the child protection system works (Independent) or that it fails teenage boys (Children and Young People Now). CYPN also notes that figures released by Cardiff University's Violence and Society Research Group showed a rise in numbers of children under 11 being treated in emergency departments and minor injury units in 2008-9.

Working out what works workbook

DH has published another output from its Health Inequalities National Support Team programme: A Generic Diagnostic Framework for Addressing Inequalities in Outcome at Population Level from Evidence-based Interventions which is designed to help commissioners and others assess how services work as regards inequalities and how to deal with the gaps. The workbook, is distilled from the work of each of the specialist NSTs, can be used in a workshop context and could be useful for Joint Strategic Needs Assessment or Health and Wellbeing Strategy development.

Childcare support

More on how to offer families benefits more effectively. Last month's OECD report on child poverty suggested that the general approach taken by Nordic countries to offer benefits in kind (particularly childcare) rather than in cash tends to work better. The Department for Education has just published reports on its childcare costs affordability pilots, an attempt by DfE and HMRC (under the previous government) to assess how far childcare costs are a barrier to parents getting back to work. Two of the pilot projects, which were conducted in London, were brought to an early close as part of the Government's spending cuts. There are reports on the three strands: the 100% costs pilot, the actual costs pilot and the disabled children's pilot. The Daycare Trust responds positively to the reports' findings and calls on the government to reconsider its recent cut in levels of childcare costs covered in the tax credit system (down from 80% to 70%).