England could have the lowest disease burden in the world – that is years of life lost to death and lived with disability – a new Public Health England study has revealed.
The study, published in The Lancet, ranks the diseases and risk factors that cause death and disability in England compared with other high-income countries.
It found that between 1990 and 2013, life expectancy in England increased by 5.4 years, from 75.9 years in 1990 to 81.3 years in 2013. This was one of the biggest increases compared with the other EU15+ countries. Improvements have been made in a number of areas, including reductions in the death rates of cardiovascular disease, stroke, chronic obstructive pulmonary disease and some cancers. However, there has been increased death rates from liver disease.
South East England has the lowest disease burden when compared to high-income countries, and England as a whole performs better than the EU15+ average.
Preventable risk factors accounted for 40% of ill health, with the two biggest risk factors identified as poor diet (10.8%) and tobacco (10.7%).
Additionally, while life expectancy has shown improvements, more people are living longer with long-term health conditions. For example, with diabetes, the years of life lost to the disease have decreased by 56% but years living with disability have increased by over 75%.
Professor John Newton, Chief Knowledge Officer, Public Health England, said: “The findings show the huge opportunity for preventive public health. If levels of health in the worst performing regions in England matched the best performing ones, England would have one of the lowest burdens of disease of any developed country.
“And even though there have been big falls in premature mortality, the top causes of early deaths in England and in each English region are still heart disease, stroke, lung cancer and chronic obstructive pulmonary disease, which to a greater or lesser extent are attributable to preventable risk factors.”
Dr Adam Briggs, co-author of the study and Wellcome Trust Research Training Fellow, University of Oxford, said: “Life expectancy is increasing across the country but large inequalities still remain. Life expectancy in 2013 for those living in the most deprived areas was still lower than those in less deprived areas enjoyed in 1990. How deprived you are is the key driver of these differences rather than where you live and therefore deprivation and its causes need to be tackled wherever they occur.”
Professor Kevin Fenton, Director of Health and Wellbeing, Public Health England, added: “People are living longer, but they are living longer with disability, which will require more integrated models of care spanning health and social services. The other important implication for health services is that it is likely that up to 40% of its workload is due to potentially preventable risk factors. This reaffirms the importance of people taking positive steps today, liking eating well and stopping smoking, to improve their health in the long-term.”