Chronic diseases and public health failures fuelling Covid-19 deaths – study

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Press Association
A combination of rising chronic diseases and public health failures over the past three decades has created a “perfect storm” that is “fuelling” Covid-19 deaths both in the UK and around the world, scientists have said.

Their research is based on the latest findings from the Global Burden of Disease (GBD) study published in The Lancet, which analysed new health data from 204 countries and territories.

The findings show that in the UK, non-communicable diseases (NCDs) – chronic diseases that are not passed from person to person – are now responsible for 88% of the overall disease burden.

The five leading causes of death in the UK from NCDs in 2019 were heart disease (93,400 deaths), stroke (50,600), chronic obstructive pulmonary disease (43,900), lung cancer (42,800) and Alzheimer’s disease and other dementias (32,400).

The researchers said urgent action is required to address chronic diseases as well as social inequalities and the Covid-19 pandemic to regenerate health systems and protect against future threats.

Dr Richard Horton, editor-in-chief of The Lancet, said: “One lesson of this pandemic is that it is not a simple pandemic.

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“In fact, it’s a synthesis of at least two epidemics – a coronavirus, and an epidemic of non-communicable diseases on a background of poverty and inequality.”

He added: “Non-communicable diseases have played a critical role in driving the more than one million deaths caused by Covid-19 to date, and will continue to shape health in every country after the pandemic subsides.

“As we address how to regenerate our health systems in the wake of Covid-19, this Global Burden of Disease Study offers a means of targeting where the need is greatest, and how it differs between countries.”

It’s a synthesis of at least two epidemics – a coronavirus, and an epidemic of non-communicable diseases on a background of poverty and inequality

The GBD study – which provides a comprehensive analysis of 286 different causes of death, 369 diseases and injuries, and 87 risk factors in 204 countries and territories – revealed the UK has the lowest healthy life expectancy in western Europe at 68.9 years, on a par with Monaco.

Although life expectancy at birth increased from 75.8 years to 81.1 years between 1990 and 2019, the researchers said the gap between the most and the least deprived regions is wide – ranging from 84.5 years in Richmond upon Thames in 2019 to 76.4 years in Blackpool.

Meanwhile, data from Public Health England also shows a correlation between cumulative rates of Covid-19 cases per 100,000 residents and average life expectancy figures from the GBD study.

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For example, the rate of coronavirus cases in Richmond upon Thames is 644 per 100,000 people while in Blackpool it is 1,410 per 100,000 residents.

Dr Horton said: “I don’t think it’s a coincidence that we are seeing some of the most serious effects of Covid-19 in some of the areas of the United Kingdom where there are the lowest life expectancies.

“If you take life expectancy as a marker for overall health suffers, then what you’re seeing is that in parts of the United Kingdom, some of the most challenging health profiles are (among) the populations that are most vulnerable to Covid-19.

“So this is where I want to really emphasise this point – we are not dealing with a pandemic.

Most of these risk factors are preventable and treatable, and tackling them will bring huge social and economic benefits

“We are dealing with a syndemic – it is the interaction with the virus with people living with other diseases.”

The data also showed that tobacco use (125,000 deaths), high blood pressure (87,800), dietary risks (78,500), high blood sugar (75,500), and high BMI (56,200) were among the five leading risk factors causing health loss in the UK in 2019.

Several of these risk factors and NCDs – such as obesity, diabetes, and cardiovascular disease – are associated with increased risk of serious illness and death from Covid-19 and highlight the critical need for stronger public health efforts, the researchers said.

Professor Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, US, who led the study, added: “Most of these risk factors are preventable and treatable, and tackling them will bring huge social and economic benefits.

“We are failing to change unhealthy behaviours, particularly those related to diet quality, caloric intake, and physical activity, in part due to inadequate policy attention and funding for public health and behavioural research.”

Professor John Newton, who is director of Health Improvement at Public Health England and a member of the Global Burden of Disease Scientific Council, said the report “calls for governments to do more to tackle the impact of unhealthy behaviours”.

He added: “Covid has shown that health is an absolutely critical component of economic growth and equality and cannot be ignored.”

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