Lifestyle and its influences

Abstract

Lifestyle is never far from public health thoughts, but spring is a good time to examine how we are faring on challenges like obesity, inappropriate diet, smoking and the increasing influence of the Internet. Behaviour change includes altering a selfselected unhealthy lifestyle, yet the selection may be deeply ingrained from infancy and then continued in adult life. Campaigns to reduce smoking may not engage sufficient young parents, given that the highest prevalence of smoking is in those aged between 20 and 34 years, cited by Denman et al., 1 who also present an interesting argument for an integrated policy on smoking and environmental radon levels. Volunteer workers, for example health champions, may help to engage parents and other individuals on needed change: but the motivation and expectations of volunteers need to be appreciated if they are to be effective. Warren and Garthwaite, 2 in their survey of volunteers in north east England, identified more specific training and fostering positive relationships with paid staff as important, along with an emphasis on transferable skills for paid work elsewhere. In theory, all lifestyle choices are modifiable, but in addition to the profound influence of early parenting and environment, our era is one of unprecedented rapid social change around the globe. Change presents new choices, such as the impact of modernisation described by Witter et al. 3 in a review of health data in Fiji. Non-communicable disease is rising in Fijians, with cardiovascular disease the leading cause of death, linked to increasing alcohol intake, poor dietary choices, smoking and less physical exercise. Obesity levels have doubled over the past decade: there is no vernacular term for obesity in the Fijian language, with being larger traditionally associated with good health. But Witter et al. point to westernisation of the diet as the main culprit. The study included assessing the changing lifestyles in rural, urban and ethnically distinct communities, with the action needed on government and local policy to increase health awareness. Apart from the cultural preferences, there are conflicts to be tackled, for example, alcohol revenues versus advice to drink less: it is not only Fiji that has a struggle with that. Fast food replacing traditional, healthier food is also a common lifestyle change, but Hye-Jin Sun 4 reports that in Korea, the love of salty food has led to a sodium intake at twice the World Health Organization recommended level. Concern about high levels of hypertension and other disorders prompted an impressive variety of campaigns, including a 'no-soup day' on the third Wednesday of every month. Meanwhile, there is progress, for example with a survey reporting that the salt content measured in bowls of soup has lowered by over one-third. Moving across to India, Rai and Singh 5 describe the programmes to reduce maternal and child mortality, currently the highest in the world. Cash transfer schemes have encouraged low-income women to access health facilities, but the most recentl...