Clustering of lifestyle risk behaviours among residents of forty deprived neighbourhoods in London: Lessons for targeting public health interventions

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Clustering of lifestyle risk behaviours is critical to health. A longitudinal study in Norfolk, UK, which followed 20,244 men and women for an average of 11 years found that those who had all four lifestyle risk behaviours (smoking and non-adherence to government guidelines on alcohol consumption, diet and physical activity, respectively) were four times more likely to have died at follow-up compared with those who had none of the lifestyle risk behaviours. Similar patterns of mortality risk for clustered behaviours have been reported in a study of 11 European countries and in US cohorts. We therefore need to urgently know the extent of clustering in the English population and think hard about whether policies focussed on behaviour change in isolation from one another, either national or local, are really going to work.