Health Matters: Prevention – A Life Course Approach

Health Matters: Prevention - A Life Course Approach

The latest edition of Health Matters, PHE’s professional resource, focuses on taking a life course approach to the prevention of ill health and explores the evidence base for this approach. The resource signposts to evidence-based interventions and tools, as well as to evaluation and monitoring techniques.

This blog provides a summary of the full edition’s content.

What is a life course approach?

A person’s physical and mental health and wellbeing are influenced throughout life by the wider determinants of health, which are a diverse range of social, economic and environmental factors, alongside behavioural risk factors which often cluster in the population, reflecting real lives.

These factors can be categorised as protective factors or risk factors.

Positive and negative influences across the life course. Protective factors: having a healthy and balanced diet; an environment that enables physical activity; good educational attainment; being in stable employment with a good income; living in good quality housing; having networks of support including friends and family. Risk factors: smoking; adverse childhood experiences; crime and violence; drug and alcohol misuse; poor educational attainment; poor mental health.

Addressing the wider determinants of health will help improve overall health by optimising the conditions into which people are born, live and work. Rather than focusing on a single condition at a single life stage, a life course approach considers the critical stages, transitions and settings where large differences can be made in promoting or restoring health and wellbeing.

Adopting the life course approach means identifying key opportunities for minimising risk factors and enhancing protective factors through evidence-based interventions at key life stages, from preconception to early years and adolescence, working age, and into older age.

Health inequalities across the life course

Systematic variation in the protective and risk factors of health are social inequalities. These are strong and persistent drivers of health inequalities, leading to differing trajectories and outcomes over the course of a person’s life. This can influence life expectancy and healthy life expectancy.

Some people are impacted more by the negative influences of health, leading to shorter life expectancy and more years living with disability.

By altering policies, environments and societal norms, inequalities affecting the life course trajectory can be reduced, which could benefit the whole population across the lifespan, as well as future generations.

Health inequalities across the life course. Comparison between the most and least deprived deciles in England.

PHE has produced a series of evidence papers on local action on health inequalities across the life course, and together with partners have a health inequality collection comprising comprehensive evidence, resources and guidance to support reduction of health inequalities in national, regional and local areas.

The life course approach and local action

To achieve the desired outcomes of the life course approach, national policies should be translated into local actions. With local government services facing increasing demand and a challenging financial situation, it is important to note that the life course approach does not demand new or extra actions that would incur additional costs. Rather, it is based on the current responsibilities and working practices of local authorities, as well as public health responsibilities.

Local authorities are already taking practical action on prevention across the life span, and some local authority-led integrated health and wellbeing services are addressing multiple risk factors in a more comprehensive way and are targeting more deprived communities where these factors are more prevalent.

Alongside local government, the NHS also plays a vital role in the life course approach, particularly through service provision and their role in prevention.

Interventions across the life course

This edition of Health Matters sets out recommended interventions across the life course selected by PHE for local government, the NHS and commissioners. These are interventions that address a range of public health challenges, from vaccination to supporting mental health and emotional wellbeing, under the following stages of the life course:

  • preconception and becoming a parent
  • infancy and early years (0-5)
  • childhood and adolescence (5-19)
  • working age (16-64)
  • ageing well

Call to action

Now is the time to prioritise prevention of ill health. Taking action early, appropriately and together we can ensure that our children have the best start in life and are ready to start school, that our young people are supported so they enter adulthood physically and mentally resilient, ready to start work, that adults are able to secure and maintain a good job and a home, and that older adults have fulfilling, productive and connected lives.

This edition outlines several calls to action for using the life course approach to health and wellbeing, as well as tools that PHE has produced to help monitor and evaluate this.

In terms of tackling health inequalities across the life course, there are multiple actions that can be taken, for which PHE have relevant resources. These include:

  1. Building healthy and resilient communities
  2. Adopting a place-based approach to health
  3. Tackling housing and fuel poverty
  4. Taking action on poverty and health
  5. Taking action on health and justice

Actions to promote health equity and tackle health inequalities across the life course. 1) Build healthy and resilient communities, 2) Adopt a place-based approach to health, 3) Tackle housing and fuel poverty, 4) Take action on poverty and health, 5) Take action on health and justice

Visit the Health Matters area of GOV.UK or sign up to receive the latest updates through our e-bulletin. If you found this blog helpful, you can read other Health Matters blogs.

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Author: Elaine Rashbrook