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Health priorities should be set with preventative measures to the fore


Adoption of 25X25 goals is big plus, writes Joshua Bird

‘An ounce of prevention is better than a pound of cure.” This idiom that has its roots right back to the founder of modern medicine, Hippocrates, in ancient Greece, yet it is all the more pertinent in modern-day Scotland.

As the NHS in Scotland and across the UK faces increasing pressures to deliver for the nation, societal changes – such as an ageing population and rapid urbanisation – combined with the globalisation of unhealthy lifestyles seek to deliver the perfect storm that might just break the institution of free health care at the point of entry.

A total of 75 per cent of all premature deaths in Scotland however are caused by diseases that are largely preventable; diseases such as coronary heart disease, cancers, stroke, chronic obstructive pulmonary disease (COPD) and diabetes are all known to have roots in a combination of lifestyle and societal choices. They are chronic medical conditions that are non-transmissible, slow progressing and long lasting and are known as non-communicable diseases (NCDs).

So great is the global burden of these NCDs – the leading cause of death globally with 38 million people dying from one, or a combination, of the diseases above in 2013 – the international community came together to develop the World Health Organisation’s (WHO) 25 per cent by 2025 framework on non-communicable disease.

The framework prescribes seven targets that national governments should seek to achieve by the year 2025 and by doing so would reduce the rate of deaths by NCDs by a quarter globally. The targets, as defined by WHO, seek to address lifestyle choices that would deliver a risk reduction in any of the diseases mentioned above. They include targets on smoking, alcohol consumption, physical activity, salt intake, obesity, diabetes and hypertension.

By reaching these targets in Scotland we could prevent as many as 3,800 premature deaths a year, a cause very much worth pursuing. So where now for prevention in Scotland?

The Scottish Government has of course made efforts in this field for a number of years now with strategies abound on issues such as obesity, alcohol abuse, tobacco use and many more. The government also has focuses on cancer prevention, heart disease prevention and many other areas.

However, it would seem, given the close relationship between risk factors and disease, that the time has come for the Scottish Government to integrate health prevention, much as it has done with health and social care delivery in recent months.

A sporadic and isolated approach to NCD prevention simply leads to sporadic and isolated success. The opportunity is now for Scotland to not only lead the UK but lead the world in adopting the WHO targets as national priorities; to recognise the economic and more importantly human cost of inaction and tackle the biggest causes of premature death in Scotland.

• Joshua Bird is policy & public affairs officer for the British Heart Foundation Scotland

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