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Life expectancy trends. Portugal. Scotland. SMOKADIABESITY. ‘ Smokadiabesity ’ reaches epidemic proportions. But low fitness still kills more Americans than smoking, diabetes and obesity combined!. Blair. 2009. BJSM, (43) pp1-2. Mortality in sedentary and exercising subjects.
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Life expectancy trends Portugal Scotland
‘Smokadiabesity’ reaches epidemic proportions. But low fitness still kills more Americans than smoking, diabetes and obesity combined! Blair. 2009. BJSM, (43) pp1-2
Investments that work • Whole of school programmes • Transport policies • Urban design that provides safe access for recreational physical activity • Physical activity and NCD prevention integrated into primary health care systems • Public education to raise awareness • Community engagement and resources • Programs that promote ‘sport for all’
Life expectancy trends Portugal Scotland
What people think about Scotland’s health • The Scots are unhealthy • It’s because they’re fat and lazy • It’s because they smoke a lot • They eat the wrong kind of food • They drink too much • If only they adopted healthy habits, they would be healthy • Only ONE of these statements is true!
All cause mortality,men 65-69 3951 1665
Slope index of inequality X Mean = 2694 X 2763 X X X All cause, M65-69 2763/2694 = 1.025
Slope index of inequality breakdown by cause of death SII= 2763 SII= 792 SII= 1971 All cause IHD Other causes
Male inequalities, all ages, by cause All other causes IHD
Relative inequalities in mortality by causeMen, Scotland 2000-02
Chronic liver disease, including cirrhosis Source: Whyte B., Ajetunmobi T. Still “the sick man of Europe”? GCPH, 2012
Adverse childhood events study • Physical/sexual/emotional abuse • Neglect (physical/emotional) • Domestic substance abuse • Domestic violence • Parental mental illness • Parental criminality
Adverse childhood events risk of alcoholism Hillis et al 2011
Adverse childhood eventsrisk of perpetrating violenceBoys experiencing physical abuse Duke et al 2010
Corey Keyes and Flourishing “They are happy and satisfied; they tend to see their lives as having a purpose; they feel some degree of mastery and accept all parts of themselves; they have a sense of personal growth in the sense that they are always growing, evolving, and changing; finally, they have a sense of autonomy and an internal locus of control, they chose their fate in life instead of being victims of fate.”
....the social and physical environment must be: Comprehensible Manageable Meaningful ......or the individual will experience chronic stress Antonovsky and salutogenesis Aaron Antonovsky 1923-1994
Can we change these effects? • “However, research (Hill, Bromell, Tyson, & Flint, 2007) suggests that although the first five years of a child's life are very important, there is tremendous opportunity during the school years for significant transformation. Low-SES children's behavior is an adaptive response to a chronic condition of poverty, but a brain that is susceptible to adverse environmental effects is equally susceptible to positive, enriching effects”
Fr Greg Boyle • “Here is what we seek: a compassion that can stand in awe at what the poor have to carry rather than stand in judgment at how they carry it.” ― Gregory Boyle
Health or Wellness? • We all have an interest in a world free from avoidable illness • a world free of alienation is a world free of crime and conflict • in which young people achieve their potential • in which older people live independent and fulfilling lives