Poorest left behind in fight against unhealthy lifestyles, new report finds

Public health

The proportion of people engaging in multiple unhealthy lifestyle behaviours has fallen significantly according to a new report on the clustering of unhealthy behaviours over time from The King’s Fund. However, almost all the improvement has been among higher socio-economic and better educated groups, exacerbating health inequalities.

The study is the first to examine how patterns of multiple lifestyle behaviours have changed over time in England. It uses data from the Health Survey for England to analyse changes in the clustering of four key lifestyle behaviours – smoking, excessive drinking, poor diet and lack of exercise – between 2003 and 2008.

The report found that the proportion of the population engaging in three or four of these behaviours fell by 8 per cent over the period (from 33 per cent to 25 per cent). This suggests that public health initiatives have been important in improving health among the population as a whole.

However, the report shows that these initiatives failed to have an impact among lower socio-economic groups during this period. The proportion of manual workers and people with no qualifications engaging in all four behaviours remained unchanged. As a result, the gap between higher and lower socio-economic groups has widened – those with no qualifications were five times more likely to engage in all four behaviours than better educated groups, compared to only three times as likely in 2003.

While noting the successes of public health initiatives, the report suggests that they have focused too much on tackling individual behaviours. It recommends public health policy should focus more on tackling multiple behaviours and targeting those in lower socio-economic and educational groups.

David Buck, Senior Fellow at The King’s Fund and the lead author of the report said:

’Our research highlights an unsung public health success – a reduction in multiple unhealthy lifestyle behaviours among the general population. However, the lack of progress among lower socio-economic and educational groups is worrying and has exacerbated health inequalities.

‘If the government is serious about improving the health of the poorest fastest, it must focus on reducing multiple unhealthy risky behaviours among the poorest groups, rather than only relying on focused on single behaviours.’

Read the report: Clustering of unhealthy behaviours over time
Read David Buck's blog: Improving the health of the poorest, fastest: why clusters of lifestyle behaviours matter

Notes to editors

For further information, or to request an interview, please contact the Press and Public Affairs office at The King’s Fund on 020 7307 2585/82 (if you are calling out of hours, please ring 07584 146 035).

The Clustering of unhealthy behaviours over time: implications for policy and practice report analyses the proportion of the population engaging in combinations of the four major unhealthy behaviours: smoking, drinking, poor diet and lack of exercise. It has been estimated that these unhealthy behaviours account for half of the disease burden in the developed world. By reducing the number of unhealthy behaviours, mortality is reduced.

The report analysed the Health Survey for England, comparing 2003 to 2008 data sets.

The public health system in England is currently being reformed. From April 2013, local authorities will be given a ring-fenced budget to spend, a share of over £2 billion to deliver health improvement programmes

Part of the Department of Health’s vision for public health, outlined in the Public Health Outcomes Framework is 'to improve and protect the nation’s health and wellbeing, and improve the health of the poorest fastest'.