Our unhealthy nationCOVID-19 has unveiled some uncomfortable truths for the UK. The Global Burden of Diseases, Injuries, and Risk Factors Study found that Britain had the worst healthy life expectancy in Europe. 1 This finding was driven by obesity, hypertension, chronic respiratory conditions, excess alcohol use, and inactivity, compounded in some areas by poor physical, economic, and social environments.Our national health is worse than we thought: the analysis by Outcomes-Based Healthcare using objective National Health Service (NHS) clinical data found that on average, women in England get their first major health condition when they are aged only 55 years, and in the poorest areas when they are aged only 47 years. 2 Moreover, people in low-income areas live with ill-health for nearly 20 years longer than those in the highest-income areas. We have known this fact for many years but have not done enough to change it. Now is the time to do so.This state of poor health has meant that Britain was inadequately prepared for a virus that is most severe for the least healthy in our society. More people have died in Britain from COVID-19 pro rata than most other countries. 3 This is in part the result of our poor national health. We have the highest obesity rates in Europe and people who are obese (body-mass index ≥30 kg/m²) have a 40% greater risk of dying from COVID-19. 4 People with chronic respiratory problems, diabetes, or coronary heart disease are also all at greater risk. 3•9 million people in Britain have diabetes, 5 and an estimated 4•0 million people have untreated hypertension. 6 These risks and chronic conditions are more prevalent in people on low incomes and in poor communities, so more poor people die from COVID-19 than people on high incomes from wealthy areas.COVID-19 has exposed the lack of action on prevention and population health improvement over many years. It would be a mistake to think that the solution to future infections lies only in better vaccines and more hospitals. We need to prevent illnesses, both contagious and chronic ones.The British Prime Minister Boris Johnson in the Conservative government manifesto declared that his government would work "for everyone to have five extra years of healthy independent life by 2035 and
For more on CIPHA see www.cipha.nhs.uk
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