New report: Poorest “left behind” in fight against unhealthy lifestyles

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% over the period (from 33% to 25%). 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 socioeconomic 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 approaches focused on single behaviours.”

Buck, D; Frosini, F; 2012: Clustering of unhealthy behaviours over time - implications for policy and practice available for download at: http://www.kingsfund.org.uk/publications/unhealthy_behaviours.html