Intended for healthcare professionals


Government’s misplaced prevention agenda

BMJ 2018; 363 doi: (Published 05 December 2018) Cite this as: BMJ 2018;363:k5134
  1. Lucinda Hiam, honorary research fellow1,
  2. Danny Dorling, Halford Mackinder professor of geography2
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2University of Oxford, Oxford, UK
  1. Correspondence to: L Hiam Lucinda.Hiam1{at}

Fixing the health crisis is a choice for politicians, not people

“Prevention is better than cure.”1 It’s an old adage, and one the new secretary of state for health and social care, Matt Hancock, chose for his plan to improve healthy life expectancy in the UK, saying: “It’s about people choosing to look after themselves better, staying active and stopping smoking ... Making better choices by limiting alcohol, sugar, salt and fat.”2 Public Health England hailed the announcement as “a seminal moment.”3 Others were underwhelmed.4

“Most of us are now living longer,” states the plan. This is misleading. Decades of increasing life expectancy in the UK have ceased5; infant mortality is now rising6 and life expectancy is declining for many age groups,7 and for the most deprived groups of women.8 Furthermore, a recent study in the Lancet found the life expectancy gap between the most affluent and most deprived deciles increased between 2001 and 2016 for both men (from 9.0 years to 9.7 years) and women (6.1 years to 7.9 years). …

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