PPT 1b – study of disease

1. PPT 1b – study of disease Lesson objective – to learn how disease is researched and defined

2. Task 1 – in groups of two or three • Research and investigate patterns of disease or ill health from the chosen cards Breast Cancer Child hood obesity Heart disease and Angina HIV

4. Facts and figures about stroke An estimated 150,000 people have a stroke in the UK each year. Stroke accounts for around 53,000 deaths each year in the UK. Stroke is the third most common cause of death in England and Wales, after heart disease and cancer. Stroke accounts for 9 per cent of all deaths in men and 13 per cent of deaths in women in the UK.] At least 450,000 people are severely disabled as a result of stroke in England. Stroke costs the economy an estimated £8 billion per year in England alone [6] and it is likely that it costs proportionate amounts in Scotland, Wales and Northern Ireland. Stroke patients occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds. Stroke units save lives: for stroke patients general wards have a 14 per cent to 25 per cent higher mortality rate than stroke units Each year over 130,000 people in England and Wales have a stroke. About 10,000 of these are under retirement age. [ Demographic data and patterns of illness and disease Epidemiological data It is essential for identifying what health problems are occurring in a population and targeting the relevant health promotion activity to address them. Epidemiological information tends to be of two types: Information that gives you a picture of the population’s health at any time (incident data) Information that shows you trends over time (trend data). Ill health data, which deals with illness and death, is routinely collected by health organisations and interpreted by a range of health organisations including public health observatories and Office for National Statistics. http://www.apho.org.uk/addons/_105057/atlas.html?HPT=R&config=

5. If your PCT is red this means that there is more of a chance people suffering a stroke will end up in hospital than if they lived in other areas. Your PCT managers should be taking an interest in this pattern and seeing if anything can be done to improve this situation. Conversely if you PCT is green, this means there is less of a chance people suffering a stroke will end up in hospital than if they lived in other areas. The managers of your PCT should also understand this pattern and where possible share this learning with their colleagues in other organisations. If your PCT is blue this means the number of people being admitted for strokes is similar to our expectations.

6. Root Causes of Health Inequalities

7. Questions – thinking back to AS Unit 1 • What internal environmental factors can affect health? • What external environmental factors can affect health? • Key words - ? • Disposable income • Low income • Pollution • Poor housing • Diet – nutrition • Smoking • Drugs

9. Levels are very high across a swathe of the West Country and the South. Women in Torridge and Teignbridge in Devon, in large areas of Dorset and Somerset are highly vulnerable. Industrial belts of the North East and Cumbria show low rates, and the North West, West Midlands and most of London do better than averabe. In London, breast cancer is most common in Westminster and Richmond upon Thames. Cases of breast cancer

10. Major causes of death in males in the UK

11. The industrial belts of Scotland, the North East, North West and Yorkshire show very high rates compared with national levels. By contrast, rural England and suburban districts show the impact of declining smoking levels in recent years, and the West Midlands shows a lower level than other industrial areas. In London, risk is very high in Wandsworth and south and east boroughs. These indications clearly show that the best population health improvements are achieved by directing resources towards leveling up health status in the worst areas. Major causes of death in males in the UK

12. More people are dying in Britain due to being overweight or obese than anywhere else in Europe, a study revealed yesterday. Around one in every 11 deaths in the UK is now linked to carrying excess fat - 50 per cent more than the rate in France. Experts also warned that the number of fatalities due to obesity may soon, for the first time, exceed those caused by smoking. Being overweight or obese leaves people at high risk of heart disease, diabetes, high blood pressure and osteoarthritis. It also makes them much more likely to develop several types of cancer. The growing health disaster is being blamed on the rise of aggressively marketed, fatladen fast food and couchpotato lifestyles. Around half of British adults are overweight, and 17 per cent of men and 21 per cent of women are obese. The difference between being overweight and obese lies in a person's Body Mass Index, which is calculated from weight and height. An adult with a BMI of more than 25 is classed as overweight and one with a BMI of more than 30 is obese. Britain is the 'fat capital' of Europe, according to researchers from the University of Madrid's School of Medicine whose study is published in the European Journal of Clinical Nutrition. The lowest death rate from being obese and overweight was in France, but the researchers said it was clear that Europe as a whole has a problem. The study found that up to 400,000 deaths each year in the EU are directly linked to excess weight. Of all the deaths in the UK that were linked to excess weight, about 66 per cent were down to obesity, and 33 per cent to being overweight. In around 70 per cent of overweight-linked cases, the final cause of death was heart disease and in 20 per cent, it was cancer. Overall, around 12 per cent of heart disease deaths in Britain were due to being overweight, and 5.7 per cent of total deaths from cancer were also directly caused by being overweight or obese. Dr Jose Banegas, who led the research, said excess weight is a major public health problem. 'One in two in the EU is obese or overweight,' he added. 'Excess weight may well come to replace smoking as the major killer of adults in the near future. 'Most countries have not yet made any systematic effort to raise public awareness as to the dangers of obesity.' As well as being worst for fat-related deaths, the UK tops the smoking mortality league, with 21 per cent of all deaths linked to tobacco. Obesity costs £2.6billion a year in NHS bills and indirect losses to the economy. Other studies have shown that the percentage of overweight children in Britain has virtually doubled in the last decade. Dr Andrew Hill, of Leeds University, said the rate of adult obesity in Britain is rising by one per cent of the population a year. Doctors say that being obese when you are 40 knocks up to seven years off your life. Obese people who smoke will die more than 13 years before their time. Doctors are unsure why France should come out with the lowest rate of deaths due to excess weight. The French do not eat less saturated fat than the British and have similar cholesterol levels. It has been suggested that they are protected from heart attacks by drinking alcohol, particularly red wine. Fat families are to be prescribed a visit to their local Sainsbury's by GPs, where they will be taken by the hand and shown healthy foods. The supermarket has struck a deal with family doctors and the drug firm Roche under which overweight patients will be offered tours of selected stores with advice from nutrition experts.

14. Morbidity rates • Morbidity rates refer to the number of people within a certain unit of the general population who have a certain disease or condition. The unit of population is generally 100,000, although this may vary depending on location and the condition in question. Morbidity rates are used to help determine the overall prevalence of a specific illness, as well as where the most instances of the condition occur when compared to the population as a whole. • Researchers use morbidity rates as general statistical data in determining how common a particular condition is, as well as in determining which members of the population are more likely to become afflicted. For example, some illnesses are gender- or race-specific. • Scientists can determine these things by looking at morbidity rates among men and women of the population to find out who has been affected. • This data can be used to provide better care for patients, as well as to develop preventative tactics to help healthy citizens avoid any risks associated with contracting the condition.

15. Mortality rates in the UK • Death rates in England and Wales are at their lowest-ever recorded levels, official figures show. • Circulatory conditions like heart disease remain the most common cause of death, contributing to a third of the deaths registered. But over the decade, mortality from these diseases fell by 40% for both men and women. • Cancer accounted for over a quarter of deaths in 2009, but death rates from the disease have also fallen since 1999, by 15% for men and 12% for women. • Baby boon Infant mortality has also fallen to its lowest-ever rate, with a rate of under 5 per 1,000 births. This compares with more than 150 per 1,000 a century ago. The fact fewer people are dying and more of us are living with heart disease and heart failure, means it's crucial we stay focused and make sure people get the treatment and care they deserve” • Peter Hollins British Heart Foundation • Separate research released last year predicted that babies born today in the UK and other wealthy nations could expect to live to 100.

16. UK 'has higher early death rate than many other rich nations' • People in the UK have a higher risk of early death than those in many other wealthy countries, a study shows. • While deaths before the age of 60 in the UK have nearly halved in the past 40 years, the rate for women remains similar to Slovenia's and Albania's. • Experts said the large inequality gap was to blame for the findings, which were reported in the Lancet journal. • Globally, men in Iceland and women in Cyprus had the lowest risk, the Washington University-led team found. Smoking and drinking In the UK, 58 deaths per 1,000 among women were before the age of 60, while for men the figure stood at 93. In western Europe only Danish and Belgian women had a higher risk than those in the UK. British men fare a little better as the early death rate is mid-ranking for western Europe. Mortality rate is the number of deaths in a group of people, usually expressed as deaths per thousand. Thus it refers to the frequency of death or the expected occurrence among a defined group of people. Hence it is also known as the death rate. It may be restricted to deaths in specific age, race, sex, or geographic groups or adjusted to suit a standard population. Therefore there are a number of different types of mortality rates depending upon the population and illness being considered.

17. Both morbidity and mortality rates are useful to health experts why ?