Not really news

... especially not good news...The National Audit Office's report, Tackling inequalities in life expectancy in areas with the worst health and deprivation, takes a long, hard look at DH's achievements as regards inequalities. And the verdict? A good effort, but not exactly value for money.
"The Department of Health has made a concerted effort to tackle a very difficult and long-standing problem. However, it was slow to take action and health inequalities were not a top priority for the NHS until 2006. We recognize that this is a very complicated issue and that it took time to develop an evidence base. However, the best, cost-effective interventions have been identified and now must be employed on a larger scale in order to have a greater impact and improve value for money.
"The Department should target its efforts on the most deprived areas of the country and develop costed proposals to maintain or increase investment in preventative interventions to tackle the conditions which lead to health inequalities."
Amyas Morse, head of the National Audit Office, 2 July 2010.

Health Policy Insight casts a wise look back to Julian Tudor Hart's inverse care law.

Unfair distribution

The recently revised NICE guidelines on COPD provide some grim reading. Currently, NICE says that COPD affects between 2% and 4% of the population, but the burden of the disease falls heavily on areas of deprivation: "men aged 20-64 employed in unskilled manual occupations being 14 times more likely to die from chronic obstructive pulmonary disease than those in professional occupations ." At the moment, COPD is the UK's 5th leading cause of death but this is expected to rise, with the condition becoming the 3rd leading cause of mortality worldwide. And it doesn't stop there: NICE's review suggests that this is a substantially under-diagnosed condition, under-represented in death certificates and in primary care prevalence assessments.

More about health budgets

Two recent articles in the BMJ argue that it’s not just about ringfencing health budgets: social welfare and the health of the nation are far more entwined than that. Joan Benach and others look at the international situation, while David Stuckler and colleagues examine the UK perspective in more detail.
Age UK (the name for the merger between Age Concern and Help the Aged) argues that the Autumn spending review should include ringfencing of social care budgets, too. The King’s Fund’s John Appleby also notes ominously that the real extent of cuts will only be made clear in the Autumn spending review and looks at the ripple effect for health of cuts and the Office for Budget Responsibility’s prediction of slower economic growth.

Education

NICE is currently consulting on draft guidance for personal, social and health education (PSHE), especially focusing on relationships, sex and alcohol. The consultation period ends on 15 July.

Breastfeeding

Figures released by DH last month suggest that there has been no significant rise in breastfeeding when measured at 6-8 weeks, although there has been a slight rise in breastfeeding intiation. The Breastfeeding Network believes it's (in part) the marketing that's to blame: the slogan "breast is best" is offputting and misleading, implying that breastfeeding is the exception, not the physiological norm. DH has also published a summary of consumer insight research on breastfeeding and introducing solid foods, which considers current marketing strategies as well as qualitative research with mothers.

Healthy eating

NICE has nailed its colours to the mast on the matter of reducing trans-fats in foods, in new guidance on prevention of cardiovascular disease. The guidelines also push for a more rigorous approach to food labelling, using the traffic light system, a policy recently rejected by the European Parliament. An article in the Journal of Public Health surveys attitudes to and use of food labelling systems in Europe. Looking at inequalities in cardiovascular disease mortality, a team from Australia has published some work on the association between CVD mortality and educational achievement and considering how far this can be explained by known risk factors, such as smoking and being overweight.

Budget response

The Chancellor's announcement that Child Tax Credit would be increased was greeted with rather more than faint praise by the Joseph Rowntree Foundation. However, the blog does go on to outline how the new budget will affect people in poverty, focusing on changes to inflation measures, the VAT hike and cuts in public sector budgets. Health professionals have already criticised the earlier decision to cut plans for the further extension of free school meals elligibility.