Exercising awareness of better choices

Writing in agendaNi, Chief Medical Officer Michael McBride, outlines the importance of empowering people to make better choices and improve lifestyles for individual wellbeing and for the health service as a whole.

In my latest annual report, I focussed on how the choices that we make and the lifestyles that we lead impact on our health for good or bad. In this respect, I see my role, and the role of the Department of Health, as one of supporting and empowering people to make the choices that help them achieve and maintain good health and wellbeing. This can be through the provision of information on levels of physical activity and through the provision of services such as smoking cessation and immunisation programmes. It’s also about working with other partners, in business or in the community, to make the healthy choice an easy choice, irrespective of socioeconomic status or where you live.

And there are many positive signs that we are making progress: people are living longer, healthier lives; dental health among five-year-olds and 12-year-olds is improving; and our children and young people are less likely to become smokers. However, there remain areas of concern such as the ongoing high levels of self-harm and suicide, and the damage caused by the use of new psychoactive substances.

Furthermore, our communities experience improvements in health differently, with those living in the most deprived areas having the poorest outcomes – in fact male life expectancy in the most deprived areas currently stands at 73.6 years, which was the average life expectancy of males across Northern Ireland 17 years ago. This is something we must take seriously and continue to address and I am pleased that inequalities are a key measure in the current draft Programme for Government.

In looking at some areas of progress to date, I would like to highlight what we have achieved recently in promoting physical activity; establishing important new immunisation programmes; introducing further measures to restrict smoking; helping prevent accidents in the home, and addressing the increase in use of new psychoactive substances.

Physical inactivity has been shown to be the fourth leading risk factor for global death, after high blood pressure, smoking and high blood glucose.

Being physically active is really simple; guidelines produced by myself and the other Chief Medical Officers highlight that adults need to be active 150 minutes a week. To show people how to build physical activity into their daily lives we have now launched a range of infographics that are presented in a comprehensive, visual and easily understood way. I believe that by providing this information, and by giving people opportunities to be active, we can greatly reduce the impact of physical inactivity on the health and wellbeing of the population and on the health service.

Advances in immunisation programmes

Vaccination is about preventing illness: stopping a disease occurring in the first place rather than treating symptoms or after-effects. I am pleased that in 2015 we were able to introduce two new vaccination programmes to provide protection against different strains of meningococcal infection that can cause meningitis, a potentially fatal illness.

Babies are now offered the Men B vaccine with other routine vaccinations at two months, four months and 12 to 13 months of age. Vaccinating babies at these times helps protect them when they are most at risk of developing Men B disease. Infants under one year of age are most at risk of Men B, and the number of cases peaks at around five or six months of age.

A new vaccination programme for teenagers was introduced in response to a rapid increase in cases of a highly aggressive strain of meningococcal disease: group W. A Men ACWY vaccine is now offered to all 14 to 18-year-olds, and will replace the Men C vaccine which was already offered to all adolescents in school year 11. The programme is being delivered over a two-year period with the initial priority being given to those who were 18 years old in 2015, and anyone aged up to 25 years of age starting university for the first time.

Smoking

The choices that adults make often impact on the health of children. The link couldn’t be more obvious than with the single most damaging health behaviour, smoking, particularly smoking in shared spaces. I believe that in such situations it is necessary to introduce legislation to support healthy lifestyles and choices. This is what we have done by introducing legislation to allow the Department to ban smoking in private vehicles where children are present. We are working on the regulations for bringing the ban into force and intend to consult on these in the autumn. I look forward to the introduction of the ban which will protect children from exposure to tobacco smoke and which will further de-normalise smoking.

Home accident prevention

Two people die here every week as a result of an accident in the home. Falls account for almost half of all injuries and deaths. Most of these accidents arise from things that look harmless such as ill-fitting footwear, unsecured blind cords, or inappropriate lighting. They can be prevented if we are aware of the dangers and hazards that are present in the home and if we act to minimise the risks. The Home Accident Prevention Strategy aims to minimise injuries and deaths caused by home accidents, and provides a focus for the many organisations that are working to achieve this.

There is a particular focus on those who are most at risk: babies and children under five, people over 65, and people living with greater social, economic and health disadvantage. The strategy focuses on the types of accidents that are most prevalent but we are also mindful of emerging dangers, such as recent increases in children being poisoned through ingestion of liquitab detergents and of liquid contained in e-cigarette refills.

One type of home accident that is particularly shocking is blind cord strangulation. I have met bereaved families who have lost very young children through this kind of tragedy. Working collaboratively, we have introduced a scheme whereby information about blind cord safety is given out by Registrars at the registration of all new births. This can help new parents to take practical steps from the outset, for example when planning the layout of a baby’s bedroom or nursery. Environmental Health Officers based in local councils offer general advice and free home safety checks, and we also try to raise awareness during health visitor checks. Further information is available at http://makeitsafe.org.uk/ and https://www.nidirect.gov.uk/articles/blind-cord-safety

New psychoactive substances

These drugs, often incorrectly referred to as “legal highs”, have emerged as a major threat to the health of the population over the past few years. Given how new and completely untested these substances are, they have the potential to be as dangerous as traditional drugs of misuse like cannabis, ecstasy and cocaine.

I am determined to tackle this issue, setting up a Drug and Alcohol Monitoring and Information System (DAMIS) to quickly share information and alerts on substances causing harm. Continued calls for more robust legislation to address this issue led to new legislation, enforced from May 2016, which bans the manufacture, selling, supply and import/export of these substances. I believe that this legislation, while it is not a silver bullet, sends out a clear message that these substances are not safe.

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