Intended for healthcare professionals

Rapid response to:


Rise in mortality in England and Wales in first seven weeks of 2018

BMJ 2018; 360 doi: (Published 14 March 2018) Cite this as: BMJ 2018;360:k1090

Rapid Response:

Re: Rise in mortality in England and Wales in first seven weeks of 2018

Hiam and Dorlings [1] editorial and analysis is a welcomed contribution and timely prompt to keep the focus on the worsening health outcomes across England and Wales. Whilst evidence suggest life expectancy is likely to reduce for men and women in the United Kingdom (UK) [2], alongside a rise in infant mortality in the poorest families [3], it is critical attention remains focused on a key potential cause, austerity driven policy measures, especially for those in poverty.
One element of maintaining health outcomes for the population is a substantial Public Health programme to tackle the rise and financial burden of lifestyle related diseases such as obesity. Part of this programme, would be underpinned by the promotion of physical activity and healthy lifestyles. Sport is one possible vehicle for the promotion of physical activity, healthy and active lifestyles [4, 5, 6]. Yet within England, sport and leisure services and in turn opportunities have received unprecedented funding cuts [7].
Budgetary constraints in local authorities between 2008-onwards have subsequently resulted in an expenditure decrease for non-discretionary services including sport development and community recreation. This area of expenditure forms one component of sport-related services and primarily focuses on raising participation in ‘hard-to-reach’ groups. Research by Widdop et al [8] found that policy goals associated with raising and widening participation were not met to any significant degree between 2008 and 2014 as participation levels have changed little for lower income ‘hard-to-reach’ groups. These outcomes are potentially in part due to austerity measures reducing local authority expenditure.
As noted earlier, sport and physical activity can help contribute to reduced lifestyle related diseases and in turn, the associated financial burden of such diseases for the National Health Service. The economic constraint because of austerity driven policy measures by local authorities, not only appears to illustrate an example of a false economy, but also suggests that the cuts hit those in poverty most. Taking stock, as western countries seem to be recovering from the 2008 economic recession [9], austerity policies are still very much in place, and their impact will most likely continue to influence the lives of people, especially those in poverty, long after such policies are relaxed [10]. As such, there is little doubt that this editorial and analysis serves as welcomed encouragement for additional multidisciplinary research into the impact of austerity driven policies, now and into the future, especially for underserved groups such as those in poverty.

References –
1. Hiam L, Dorling D. Rise in mortality in England and Wales in first seven weeks of 219. BMJ 2018; 360 doi: (Published 14 March 2018) Cite this as: BMJ 2018;360:k1090
2. Dorling D., Gietel-Basten S. Life expectancy in Britain has fallen so much that a million years of life could disappear by 2058. Why? The Conversation, 29 Nov 2017.
3. Taylor-Robinson D, Barr B. Death rate now rising in UK’s poorest infants. BMJ2017;357:j2258. doi:10.1136/bmj.j2258
4. Parnell D, Pringle A, Zwolinsky S, McKenna J, Rutherford Z, Richardson D. Reaching older people with physical activity delivered in football clubs: The reach, adoption and implementation characteristics of the Extra Time programme. BMC Public Health 2015; 15: 220.
5. Milanović Z, Pantelić S, Čović N, et al. Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis British Journal of Sports Medicine 2018. doi: 10.1136/bjsports-2017-097885
6. Hunt K, Wyke S, Gray CM, et al. A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. The Lancet 2014;DOI: 10.1016/S0140-6736(13)62420-4
7. Parnell D, Millward P, & Spracklen, K. Sport and austerity in the UK: An insight into Liverpool 2014. Journal of Policy Research in Tourism, Leisure and Events 2015; 7(2), 200–203;DOI: 10.1080/19407963.2014.968309
8. Widdop P, King N, Parnell D, Cutts D, & Millward P. Austerity, policy and sport participation in England. International Journal of Sport Policy and Politics 2017; 10(1) 7-24; DOI:10.1080/19406940.2017.1348964
9. Cantillon B, et al. 2017. Children of austerity: impact of the great recession on child poverty in rich countries. Published by The United Nations Children’s Fund and Oxford University Press.
10. Haudenhuyse H. The impact of austerity on poverty and sport participation: mind the knowledge gap. International Journal of Sport Policy and Politics 2017; 10(1) 203-213; DOI:10.1080/19406940.2017.1406975

Competing interests: No competing interests

31 March 2018
Daniel Parnell
Senior Lecturer in Business Management
Manchester Metropolitan University
Room 4.09, Sport Policy Unit, Department of Economics, Policy & International Business, Manchester Metropolitan University, Oxford Road, Manchester, M15 6BH