This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.
  • The Arthritis and Musculoskeletal Alliance (ARMA) is the umbrella body for the arthritis and musculoskeletal community in the UK, and our mission is to transform the quality of life of people with musculoskeletal conditions. We have 33 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.

Tag: public health

Health Matters is a Public Health England publication containing facts, resources and information on major public health issues for public health professionals, local authorities and CCG commissioners.

The edition released at the end of January 2020 focuses on physical activity for the prevention and management of long-term conditions.

Public Health England has published the Productive Healthy Ageing Profile data update for November 2019.

This tool provides data on a wide range of topics relevant to healthy ageing. Indicators can be examined at local, regional or national level.

The aim of this tool is to support PHE productive healthy ageing policy and inform public health leads and the wider public health system about relevant key issues.

Many indicators are also now available for the latest local authority and clinical commissioning group geographies.  

Readers of this newsletter will all be aware that physical activity is essential for musculoskeletal health. Every month we seem to report new publications on the subject. This month is no exception: two recent publications highlight the challenges and propose some solutions.

Researchers have studied adolescents’ activity levels in 146 countries and found that more than 80% are not meeting the recommended levels of activity. In the UK in 2016, more than 85% of girls were not active enough, and neither were almost 75% of boys. It was great to see that the BBC coverage of the story included stronger bones and muscles as one of the reasons activity is important.

The British Medical Association has published Get a Move on: Steps to increase physical activity levels in the UK. This report makes policy recommendations across four core parts of people’s lives – travel, leisure, school and work – and sets out the steps government and policymakers should take to increase physical activity levels across the UK.

The report also includes reference to the important role of activity to “maintain or improve musculoskeletal strength, supporting healthy ageing and reducing the chance of falls for older people. For example, physical activity can reduce the likelihood of hip fractures by up to 68%.”

 

ARMA joins Public Health England and the Centre for Ageing Better to make England the best place to grow old, because musculoskeletal health is vital to healthy ageing.

ARMA joined over sixty high-profile organisations in the UK’s health, housing, employment, research and voluntary sectors to launch a landmark shared vision on healthy ageing.

There are five key principles: prioritising prevention and public health; creating opportunities for people to contribute to society as they age; fostering accessible and inclusive homes and neighbourhoods so everyone can live where they want; narrowing inequalities in healthy ageing; and challenging ageist language, culture and practices.

This initiative is led by Public Health England (PHE) and the Centre for Ageing Better. We will work together with these and others because musculoskeletal health is vital to a good later life.

Find out more from the Ageing Better website.

In September, Public Health England published a report on their review of the scale, distribution and causes of prescription drug dependence, and what might be done to address it. This included findings on opioid use for non cancer pain. The report made recommendations for action to reduce the problems caused by dependency and stated that effective, personalised care should include shared decision-making with patients and regular reviews of whether treatment is working.

Long-term prescribing of opioids for chronic, non-cancer pain is not effective for most patients. PHE’s analysis shows that, in 2017 to 2018, 5.6 million patients were prescribed opioid pain medicines for non cancer pain and that there are large variations across clinical commissioning groups (CCGs). After a long increasing trend, the annual number of prescriptions for opioid pain medicines has slightly decreased since 2016. Prescribing rates for opioid pain medicines had a strong association with deprivation, being higher in areas of greater deprivation.

See the PHE website for more details of the report and the implications for patients.

Interventions to increase physical activity

We know that keeping active is important for maintaining MSK health. The challenge is always how to encourage people to be more active. This themed review from NIHR provides some evidence about what works (and what doesn’t).

The review outlines evidence from over 50 studies of what is effective in getting people more active. Evaluations range from programmes in schools and communities to changes in transport and the environment, which are designed to promote greater activity. The report summarises the evidence and includes prompts for reflection to help make practical use of the findings.

The review covers studies of:

  • Early years
  • Children of primary school age
  • Young people of secondary school age
  • Adults
  • Workplace changes
  • Older adults
  • Changes to the built and natural environments

It shows which interventions are effective and some which looked promising but showed no long term increase in activity. Perhaps unsurprisingly the review shows that there are no single solutions. What may drive us to keep and stay active depends on who we are, where we live, and wider system issues. Moving Matters will be a useful resource for anyone looking at what might help increase activity levels and so increase MSK health.

Public Health England has published two documents related to MSK prevention. The first is a whole-system strategic framework for prevention of musculoskeletal conditions across the life-course. The purpose is to provide stakeholders and system collaborators with a clear statement of PHE, NHS England and Versus Arthritis’ commitments to promote MSK health and to prevent MSK conditions. Each collaborating organisation, including ARMA, has identified what they will be contributing, and in some cases, leading on.

The document contains information about a range of MSK prevention activities and links to resources and tools to help prevention activity.

Alongside this is an MSK prevention logic model which provides an overview of the programme vision: help maintain and improve the musculoskeletal health of the population in England (across the life-course), supporting people to live with good lifelong MSK health and freedom from pain and disability which will be delivered by system partners and collaborators within 5 years.

Guest blog by Dr Jeanelle de Gruchy, President of the Association of Directors of Public Health

To its great credit, New Zealand has become the first country in the world to produce a “wellbeing budget” – a commitment to prioritise population wellbeing as the main mission of the government. A similar philosophy was adopted in Wales in 2015, with the Well-being of Future Generations Act requiring public bodies to think about the long-term impact of their policies on both people and places.

This is a bold and exciting approach for anyone living with a musculoskeletal condition or campaigning for change on their behalf – and for the wider public health community. It puts the highest value on quality of life when it comes to national policy and investment decisions. The Association of Directors of Public Health has long championed taking a whole system and long-term view of how we create and support the health and wellbeing of everyone in society.

What does that mean in practice?

The ADPH recently published updated versions of our life course policy position statements capturing the collective views of Directors of Public Health in local government. There are four documents covering: Best Start in Life, Living and Working Well, Healthy Ageing and Health Inequalities.

Our statement on Living and Working Well focuses on the ‘working age’ population – the approximately 63% of people between the ages of 16-64 – and how to promote healthy, happy and productive lives. We know that the biggest causes of poor health (‘morbidity’) in England are low back and neck pain.

Delivering change means putting a greater emphasis on improving the social determinants of health – such as housing, air quality, education, income and food – factors which overwhelming shape our health and driving down inequalities in how long we live in good health (‘healthy life expectancy’).

It means promoting good mental health by intervening early to prevent the adverse childhood experiences that can have a lifelong impact. We know that along with mental health, poor musculoskeletal health (like back and neck pain) accounts for the majority of sickness absence in the UK, making this an issue of concern beyond the health sector. As ARMA highlights in its policy paper Musculoskeletal and Mental Health, we need to understand the inter-relationship between MSK conditions and mental health rather than treating them in isolation.

It means enabling people into good work and creating healthy workplaces which prevent many musculoskeletal conditions arising, as well as supporting those with musculoskeletal conditions to thrive in work.

These are all areas that need to be addressed in the upcoming green paper on prevention.

Finally, more funding for public health is now critical. A spending review is expected at some point this year and there is a growing consensus that public health investment – in its widest sense – must be a priority. In February, ARMA – and many of its members – signed up to a public letter in the Times, coordinated by ADPH and supported by 54 organisations, setting out the case.

The government has the welcome ambition to improve healthy life expectancy so that, by 2035, we are enjoying at least five extra years of healthy, independent life, whilst closing the gap between the richest and poorest. If the public health funding gap continues to grow, this ambition will not be met, with the costs being borne by the NHS, the economy and individuals.

We look forward to working with ARMA in the months ahead to raise the voice of public health and echo the call recently made by the APPG on Wellbeing Economics for a spending review which walks the walk on wellbeing.