Intended for healthcare professionals


UK improves health outcomes but not as fast as similar countries

BMJ 2013; 346 doi: (Published 05 March 2013) Cite this as: BMJ 2013;346:f1478
  1. Nigel Hawkes
  1. 1London

Between 1990 and 2010 the United Kingdom improved its health outcomes but not as fast as 18 other similar developed countries, a new study has found. Relative to the other countries UK performance worsened on most measures of healthy life expectancy over the two decades.

The findings, from the Global Burden of Disease Study and published in the Lancet, found that on years of life lost the UK could in 1990 boast better than average performance in eight of 30 categories: self harm, road injuries, congenital abnormalities, cardiovascular causes other than heart disease or stroke, cirrhosis, diabetes, falls, and kidney disease. By 2010 this was down to four: road injuries, diabetes, liver cancer, and kidney disease.1

In terms of disability adjusted life years lost the UK performed better than average in eight categories in 1990 but in only three in 2010: major depressive disorders, diabetes, and kidney disease. In 1990 it was worse than average in five categories: heart disease, lung cancer, chronic obstructive pulmonary disease, lower respiratory infections, and breast cancer. In 2010 it remained worse in five categories, but they had changed. COPD, lower respiratory infections, and breast cancer remained, but heart disease and lung cancer had been replaced by drug use and preterm birth complications.

The picture painted by the study is of health improving but not fast enough to put the UK higher than mid-table in performance on the chosen measures when compared with the other 14 pre-expansion members of the European Union together with Australia, Canada, Norway, and the United States (collectively termed the EU15+).

The team responsible for the study, led by Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, concluded, “The performance of the UK in terms of premature mortality is persistently and significantly below the mean of the EU15+ and requires additional concerted action. Further progress in premature mortality from several major causes, such as cardiovascular diseases and cancers, will probably require improved public health, prevention, early intervention, and treatment activities.”

The UK ranked particularly poorly in premature mortality among people aged 20 to 54, where its ranking has deteriorated sharply as a result of an increase in numbers of deaths related to drugs and alcohol. These were relatively unimportant causes of death in 1990 but had risen to sixth and 18th places, respectively, by 2010.

Public Health England responded to the findings by saying that although the overall picture was one of improvement, there was considerable cause for concern. Kevin Fenton, its director of health and wellbeing, said, “This report is both a wake-up call and an opportunity for the UK. The results from this study identify where we need to improve and where existing and future resources will need to be realigned to meet the needs of our demographically changing population.

“Ultimately, in order to really make a difference in improving our nation’s health, concerted action will be required with individuals, families, local communities, local councils, the NHS, and government all taking responsibility and working together towards a healthier population.”

John Newton, chief knowledge officer at Public Health England, said that in particular areas of the UK, such as the south east and south west of England, results were as good as in any of the other countries. “But there are also areas, such as the north west, which do as badly as the worst, and this is completely unacceptable. We in the UK need to take a hard look at what can be done to help people enjoy the levels of health already enjoyed by some countries,” he said.


Cite this as: BMJ 2013;346:f1478


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