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Health Challenge England - next steps for Choosing Health: Introduction

  • Last modified date:
    8 February 2007
Lifestyles in the 21st century present new challenges for health that will affect our whole life. Health challenges stem from choices we make in the way we travel, the food we buy, the way we use our leisure, and in the way we interact with others - in particular as we grow and develop through life. Health Challenge England is about recognising the shared responsibility we all have to make the changes that will help improve our health.

Our responsibility as a government is to understand how we can help people to live the healthy lives they want and create the conditions to enable them to make healthy decisions.

In November 2004, the White Paper Choosing Health: Making healthy choices easier set out an ambitious agenda of new thinking and practical action to tackle inequalities in health and engage people in looking after their own health. Understanding our nation's health is central to stepping up action to improve it. Choosing Health promised to bring together for the first time key indicators that provide a picture of the health of people in England to ensure that we continue to face up to this challenge.

The Health Profile of England published in 2006 brings together data on key indicators that provide a picture of the health status of people in England in 2004. It describes and benchmarks the health challenge faced when Choosing Health was first published. It demonstrates both the scale of the problem we confront as a nation today in tackling preventable ill health, and the unacceptable geographical variation in health and the inequalities this brings.

As is so often the case with health information at population level, the time taken to gather, validate and analyse data from many different sources means that Health Profile of England does not fully reflect recent progress - much of it achieved through innovative partnerships between public services and with business and voluntary sector organisations. That does not diminish its value as a reference resource for strategic planning. One of the goals of our public health information strategy, Informing Healthier Choices is to develop real time public health data.

We are making progress, but for the present, the analysis set out in this report provides a more complete and useful picture than we have previously had.

We have already made significant progress in meeting the commitments we made in Choosing Health . This paper, Health Challenge England - next steps for Choosing Health sets out how we have developed this new approach to public health; a new approach that aims to enable everybody to make a contribution to the nation's health. It also describes how this will be taken forward in the next two years.

What have we learnt?

Over the past two years, we have learnt more about people's expectations around health and how we can build effectively on the successes, learning from the experience of the new approaches that have developed. This document will highlight some of these and give examples of how we are approaching health improvement in new, more targeted ways. These priorities are set in the context of public sector reform such as in health, education and local government - for example, in Every Child Matters: change for children reforms of services for children and Youth Matters for young people and families - and new commitments for improved health and social care services in Our Health, Our Care, Our Say.

The choices people make in how they live their lives impact on their health and wellbeing. Other factors play a part, but success in improving population health will depend on making it easier for more individuals to make healthier choices, as well as ensuring strong incentives and easier access to support - rather than inhibit - healthy choices.

We know there are some areas where government needs to take the lead in protecting people's health, but central government is only one player. Action by individuals and by government must sit alongside action led by communities, third sector organisations and business. This is the only way we can succeed in making healthier choices part of people's everyday lives.

This programme for change has been underpinned by significant new investment. We are committed to achieving sustained progress in improving the health of the whole population with a specific focus on health inequalities, smoking, obesity, alcohol and substance misuse, sexual health including teenage pregnancy, and mental wellbeing.

Good health is dependent on what we eat, how we travel, how we live

What happens next?

The foundations for the next steps are already in place. Many of the specific commitments outlined in Choosing Health have been met, a key one being legislation to make enclosed public places and work places completely smoke-free from summer 2007. (At-a-glance detail on progress across 13 key areas is in fact sheets published alongside this paper.)

We recognise through feedback that people want to have more control over their own health and wellbeing. People want, and expect, more convenience and choice in the advice and support available on what they can do to prevent ill health. They also want early intervention when problems arise, and opportunities to extend self-care. We are emphasising prevention, choice and personalising service responses to individuals. We are examining the root causes of behaviour, and seeking new ways to engage with every part of society to create an environment where healthier choices are easier for all. Opportunities exist across life to improve health. But by connecting with parents and children, we can help develop healthy habits from the outset.

Our reform programme focuses on developing services designed to meet the needs of the people who use them and offering patients more choice as well as a real voice in the services they get. These reforms apply equally to the range of responses the NHS and its partners offer, from supporting people in managing and preventing health problems, to providing care and treatment when they are ill.

The new emphasis on commissioning for health and wellbeing is underpinned by better local information about what services patients want, and their expectations. With greater diversity of providers including the third sector come new opportunities to redesign NHS and its partners responses - not only to address the growing demand for prevention and health improvement services, but to tackle health inequalities.

Despite considerable challenges we face we can improve the nation's health: we have successfully reduced deaths from cardiovascular disease (coronary heart disease (CHD) and stroke and related diseases) - these fell by nearly 36% between 2003-05 over the 1995-97 baseline. Meanwhile, cancer mortality in people under 75 fell by 14% between 1996 and 2003. This equates to around 43,000 lives saved over this period.

Much of this progress has been the result of effective prevention. But we also recognise that success depends on using the evidence of what works to influence responses that impact on the way people live their whole lives. Understanding and acting on the different challenges different people face is key to delivering effective interventions.

One-size solutions usually do not work for all. Health Challenge England is not only shared by individuals and government, but also by communities, third sector organisations and business. Success depends on the choices of millions of individuals and organisations.

Our task in government is to empower them all and create the conditions in which everyone can make healthier choices. We also need to guard against giving 'advice from on high', being nagging or selfrighteous.

Our job is to ensure good health is something every citizen has the right to and can enjoy. We have to shift the way we think about becoming healthier, away from negative views to something that can be easy for everyone and a popular thing to do.

People want more convenience and choice in the advice and support available on what they can do to prevent ill health

Additional links

Ambitions for Health

Ambitions for Health sets out our formal response to the recommendations contained in It's Our Health.

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