North West Public Health Observatory

5th June 2000 Volume 1, Issue 2


Health and the Environment

At a discourse on state medicine,delivered to the university of Dublin on the 6th April 1872, and reported in the British medical Journal of the 13th of April 1872 pp385, William Stokes (Regius Professor of Physics) foresaw a day when "...no man for his own ends and profit, will be permitted to damage the health ...of his neighbour ... The gifts to man from Heaven - pure air, pure water, bright light, and wholesome food will be more freely shared."

Used by Professor John Ashton in the Milroy Lecture 2000.

When will that day arrive?

How close are we? Are we at least moving in the right direction?

Clean Water [top]

Blue Flag Awards

On the 1st of June the list of beaches that achieved a blue flag award was published. The European Blue Flag Campaign is an initiative of FEEE (Foundation of Environmental Education in Europe) and is administered in the UK by Tidy Britain Group. To be considered, a beach must have attained the ‘guideline’ standard of the European Union Bathing Water Directive before being assessed for twenty-four other criteria. A marina must fulfil a similar range of criteria but does not have to fulfil the Bathing Water Directive standards. This year the UK came in ninth place out of a total of 19 participating European countries, with a record number of 57 beaches received the award. This is up 16 on last year’s total. Of the 57 beaches, 24 are in England, mostly located on the South and East coasts. No beaches in the North West met the stringent ‘guideline’ water quality standard set, and were therefore not evaluated further, so none received an award. The main problems in the North West are reported to be;

  • microbial contamination from human sewage and farm effluent
  • comparatively high levels of rainfall and run off into the sea
  • comparatively low levels of sunshine so less ultra violet radiation that could kill the ‘bugs’ in the water
  • prevailing North Westerly winds that tend to push effluent back onto instead of away from beaches
  • restricted circulation of water in the Irish Sea
  • history of oil, chemical, heavy metal and radioactive waste contamination

Some of these are preventable, and their effects are exacerbated by the other factors that relate more to the geography of the North West. European Blue Flags are also given to marinas that pass 16 checks on environmental management. Britain comes in seventh place in Europe with 29 marinas making the grade this year, including one in the north West at Maryport Marina in Cumbria.

Seaside Awards [top]

The Seaside Award was introduced in 1992 to provide information about a wide range of beaches in the UK. It is given to beaches that comply with European Bathing Water mandatory directive standards and are clean, safe, well managed and provide appropriate information including details about current and previous water quality. (European bathing water ‘mandatory’ standards are lower than the ‘guideline’ standards required for the Blue Flag award.) The Seaside Award is an annual UK award scheme, which encompasses both resort and rural beaches. Its primary functions are to help raise standards of cleanliness, hygiene, safety and environmental management at beaches and to provide a comprehensive and free public information service for beach users.

A Seaside Award resort beach ensures proper safety and first aid provision, access and facilities for disabled visitors, clean and well-maintained facilities, dog control and hygiene and a range of public information. A Seaside Award rural beach, which has more limited facilities, is clean, considered relatively safe for swimming, provides life-saving equipment, and is checked regularly. Both resort and rural beaches are required to display the bathing water quality results for the current season as well as the previous four years.

There has been a constant increase in numbers of beaches achieving the required standard since the scheme started and this year 272 beaches received a Seaside Award including 10 from the North West. All ten are considered ‘rural’ rather than ‘resort’ beaches. They are; Allonby, Allonby Saltpans, Silloth West, Haverigg, Seascale, Silecroft, St Bees, Wallasey, West Kirby and Formby. All achieved ‘mandatory’ levels, but none achieved ‘guideline’ levels for water quality. Further information can be obtained from the ‘Tidy Britain Group’ http://www.tidybritain.org.uk/

Wholesome Food [top]

The most detailed survey ever undertaken of the diet and nutrition in young people in Britain was published on the 1st of June by the Department of Health and the Food Standards Agency. The report, the National Diet and Nutrition Survey of Young People aged 4 to 18 years, looked at food consumption, nutrient intake, physical measurements, nutritional status (measured by blood samples), physical activity, and the socio-demographic characteristics of a sample of over 1700 young people.
The main findings from the study show:

  • One in five 4 – 18 year olds ate no fruit at all during the week of the study.
  • There is no evidence of widespread malnutrition.
  • Most young people aged 7 and over were inactive and girls were even less active than boys.

Other findings show that:

  • There has been a decline in the proportion of energy gained from fat.
  • There is an increase in the amount of energy gained from carbohydrate.
  • Intakes of most vitamins and minerals are above recommended levels.
  • Young people are eating too much salt, often twice the recommended level.

There were some regional differences in diets, but few significant differences in energy and macronutrient intake between regions. Intakes of most vitamins and minerals tended to be lower in Scotland, and to a lesser extent in Northern England, than elsewhere. When differences in energy intake were taken into account, lower intakes persisted in Northern England for zinc among boys and girls, and iron and manganese among girls. Young people in Scotland and the North also tended to have lower biochemical status of vitamins such as vitamin C and folate.

Indicators of socio-economic status such as receipt of benefits, household income and social class showed that young people, particularly boys in households of low socio-economic status had lower intakes of energy, fat, some other macronutrients and most vitamins and minerals.

Further information can be found on either the website of the Food Standards Agency; http://www.foodstandards.gov.uk/ or the Department of Health; http://www.pipe.ccta.gov.uk

Yvette Cooper, Minister for Public Health related the survey findings to the increased risk of illness. She said that “The study shows that we are right to be concerned about health inequalities in preventing heart disease and cancer, and that those inequalities start in childhood. It reveals low levels of fruit and vegetable consumption among British children, which contributes to high levels of deaths from cancer (particularly colorectal cancer) and heart disease later in life.”

There is very little further information available about the nutrition status of people on a regional basis. Local surveys have been done, such as the Health Related Behaviour Questionnaire developed by the Schools Health Education Unit at Exeter University and carried out in 1994 – 95 in Liverpool by Alex Scott – Samuel and the Liverpool Observatory. Although this survey examined self-reported behaviour only, the results concurred with the national survey results.

Indicators that are known to be affected by lifestyle factors such as coronary heart disease and cancers are worse in the North West than any other Region or nationally, but the risk of these diseases is compounded by other factors such as smoking as well as diet and activity level.

The good news is that in the North West, the average percentage of food energy derived from saturated fatty acids has decreased from 17.1% in the three year period from 1988 – 90 to 15.3% in the three year period from 1995 – 97. This is in line with national changes. (Public Health Compendium of Clinical and Health Indicators.)

Adequate intake of dark green leafy vegetables, fruits and other nutrients are known to be protective against colorectal cancers. For colorectal cancers in the North West, standardised registration for males was 105 (102 108) and females was 98 (96 – 101) But standardised mortality ratios were 113 (109 – 117) and 108 (105 – 112.) click to view charts. Mortality ratios are higher in the North West than any other Region and significantly higher than mortality in England and Wales overall.(Public Health Compendium of Clinical and Health Indicators.) The standardised registration rate for colorectal cancer in females is lower than national average, but the mortality is higher. This might indicate underreporting of incidence among females in the North West, but this seems unlikely. If among females, incidence is truly lower, but mortality is higher in the North West than in England and Wales, it might indicate that females are less likely to be diagnosed early in the course of the disease. This may in turn be caused by failure of women to report symptoms to General Practitioners (GPs) or failure or delay by GPs to refer to specialists.

Can anyone offer a better explanation? Do we need more research into this, so that we know where to target public health activities?

Heart Health in the North West [top]

British Heart Week is the 10th – 18th June. Levels of inactivity in children are reaching crisis point according to a new report launched today by the British Heart Foundation (BHF). The report ‘Couch Kids – the growing epidemic’ has been produced in response to the increasing concern that fewer active children will result in more premature deaths from coronary heart disease in later life. The report is part of a new ‘Get Kids on the Go’ campaign launched today the 5th June by the BHF for British Heart Week 2000. The report is a compilation of research into children’s activity levels and includes a series of BHF recommendations for parents, teachers and young people aimed at getting children more active.

The report highlights the decline in physical education in schools and the need for an integrated approach between national government, local authorities and schools to halt it. The collated figures illustrate a rapid decline in children’s activity levels in England and Wales over the last ten years.
The report reveals:

  • School PE lessons are the only physical activity in which 30% of 11-16 year olds participate
  • Secondary schools in England and Wales allocate less time to PE than anywhere else in Europe
  • Primary schools in England and Wales have more than halved the amount of amount of time allocated to PE lessons over the past five years
  • Car journeys to school have doubled in the last 20 years with almost 30% of pupils now being ferried from door to door

The report makes a series of recommendations including:

  • The Department of Health should implement a national health programme to promote the BHF’s recommendation of an hour’s exercise a day.
  • Schools and local authorities should work together to maximise opportunities for physical activity, including extra-curricular programmes and give greater community access to school leisure facilities.
  • The Department of Culture, Media and Sport Sports Strategy should promote a wide range of sporting and non-sporting activities to all young people.
  • The Department of the Environment, Transport and the Regions should extend its programme of offering advice to schools on developing travel plans, prioritising cycling and walking over car use.
  • Playgrounds should be redesigned to promote play and a range of physical activities.

British Heart Week [top]

Activities organised for this week in the region include;

  • Morecambe Bay Walk – Saturday 10 June
  • Ellesmere Port Flag Day 10 June
  • Flag Days Neston 16 , Bebington/Bromborough 17 June
  • Sponsored Swim, Newcastle Under Lyne 17 June
  • Balloon launch from Blackpool prom – Sunday 18 June

Contact person is Mrs Lynn Brown – (+44) 151 236 6988

Further information about the British Heart Foundation can be found on their website at; http://www.bhf.org.uk/

 
Page last updated Monday, January 19, 2004