England’s average life expectancy rises, though many are living with long-term health conditions

People in England are reportedly living on average, eight years longer than before, though one of the main challenges faced by the UK is due to people living with long-term health conditions.

The new study on The Global Burden of Disease (GBD) data published in 2013, featured in The Lancet identified the main challenges faced by developed countries, such as the UK, include the increasing number of people living with disabilities such as long-term musculoskeletal (MSK) disorders.

The study, produced by the Arthritis and Musculoskeletal Alliance (ARMA) highlighted how musculoskeletal disorders are under-prioritised compared to the growing problem.

Professor Anthony Woolf, chair of the ARMA and co-author of the study, said: “The new Global Burden of Disease evidence published in The Lancet paints a familiar and compelling picture which requires us to take stock of where resources need to be invested in order to successfully meet the challenges not just of tomorrow, but of today. This means a better understanding of the risk factors behind the growing burden of disability in this country, and a greater emphasis on tackling some of the major causes of this through a more joined-up and preventive approach.

“MSK disorders in particular must not be an afterthought but must constitute a central focus for national and local strategies aimed at improving health and well-being across the board.”

The latest evidence supports a present trend in people living longer, though more needs to be done to support people with MSK disorders, through integrated care models and a preventative approach to care.

Co-author and Wellcome Trust Research Training Fellow at the University of Oxford, Dr Adam Briggs, said: “Life expectancy is increasing across the country but large inequalities still remain. Life expectancy in 2013 for those living in the most deprived areas was still lower than those in less deprived areas enjoyed in 1990. How deprived you are is the key driver of these differences rather than where you live and therefore deprivation and its causes need to be tackled wherever they occur."

MSK disorders affect almost ten million people throughout the UK and account for the fourth largest NHS programme budget, worth £5 billion in England alone.

The treatment of MSK disorders accounts for the largest workload of the health service, whilst 40 per cent of those are as a result of potentially preventable risk factors.

Lower back pain and neck pain are identified as being at the top of the list of conditions with the highest Disability Adjusted Life Year (DALY) such as: Years of Life Lost (YLL) compared to Years Lived with Disability (YLD), before life threatening conditions such as COPD in fourth place, lung cancer in fifth and diabetes in eleventh.

Chief executive of ARMA, Federico Moscogiuri, added: “This data offers the latest and strongest evidence yet that effectively addressing the growing burden of MSK disorders is where some of the biggest wins lie for healthcare, social care and public health alike.

“We fully support the study authors’ call for ‘new, more integrated more integrated models of care spanning health and social services that respond to the specific needs and circumstances of individual patients’, and we call on Government and on all commissioners of care in England to prioritise MSK disorders and to take a more preventive approach in addressing them, in line with ARMA’s Key Messages for Commissioners in England.”

The study reveals that in England and other similar developed, high-income countries, a large number of DALYs are accounted for as YLDs instead of YLLs. MSK disorders have been identified as a ‘dominance cause of YLDs’ and account for a significant amount of health resources and as they are commonly age-related, it is expected that they will become more prevalent as the population grows and ages.

Dr Liam O’Toole, chief executive of Arthritis Research UK, said: “The study provides conclusive evidence that for too long, the needs of the millions of people in the UK living with neck, back pain and osteoarthritis have been ignored. This is an issue that will not go away. But there is hope; evidence shows that losing weight and keeping active can reduce the risk of getting arthritis and help to manage the pain caused by arthritis.

“Ahead of the Spending Review, we urge the Chancellor to commit to maintaining public health spending at current levels and invest more to help people maintain and improve their health."

The Bone and Joint Decade - the Global Alliance for MSK Health, works to improve and change priorities associated with the effects MSK conditions have on people and society, on a national and international scale.

The Alliance is calling for the World Health Organisation (WHO), the United Nations and national Governments to provide plans in response to the Global Burden of Disease study and the significance that MSK disorders have on the world.

Director of health and wellbeing, for Public Health England, Professor Kevin Fenton, said: “People are living longer, but they are living longer with disability, which will require more integrated models of care spanning health and social services. The other important implication for health services is that it is likely that up to 40% of its workload is due to potentially preventable risk factors. This reaffirms the importance of people taking positive steps today, liking eating well and stopping smoking, to improve their health in the long term.”