The healthmatters blog; commentary, observation and review
As the clocks go back and people turn their heating up, research shows cancer patients are estimated to spend an additional £15.7m a year on their energy bills
New figures by Macmillan Cancer Support and npower estimate that people diagnosed with cancer in the UK over the last two years spend an additional £15.7 million a year on their energy bills, as a result of using more energy due to their illness and treatment.
People undergoing cancer treatment are often at home and feel the cold more due to side effects such as weight and hair loss and reduced energy levels, so tend to turn their heating up. This can result in their energy consumption going up while their income may be significantly reduced, making energy costs a big concern for cancer patients.
So far this year Macmillan has received over 14,000 enquiries from cancer patients and their loved ones (equating to over 53 interactions a day) about their energy costs, a 15% increase from 2015ii. It’s estimated that this winteriii an additional 6,400iv people will contact the charity asking for support.
Today Macmillan and npower are highlighting the support available for people living with cancer through npower’s Macmillan Fund and Macmillan’s Energy Advice Team. npower’s Macmillan Fund is the only programme in the UK offering bespoke support to npower customers living with cancer by capping energy bills and writing off debt. Macmillan Energy Advisors, who are part-funded by npower, offer support and advice to help people living with cancer regardless of their energy supplier.
In the last 12 months Macmillan’s Energy Advice Team has seen a 33% increase in calls and on average deal with 20 calls a day from people affected by cancer v. This is expected to rise in the coming months as people turn their heating up and need it on for longer.
Worryingly only 6% of people living with cancer who are financially impacted by their diagnosis are aware that they may be entitled to receive support to pay their energy billsvi yet almost 60% of those who are severely financially impacted by their diagnosis are unable to heat their home adequately vii.
Over the last 12 years, npower has given over £8 million to help over 32,000 families by providing them with support such as emergency energy grants or writing off their debt. npower’s Macmillan Fund has helped almost 4,000 cancer patients turn their heating on and up, writing off £4.2 million in debt, an average of £1,655 per household whilst on the scheme.
After npower customer, Sue, aged 59 from Essex, was diagnosed with terminal pelvic cancer in April 2016. Sue was no longer able to work and began claiming benefits. After speaking to Macmillan she was helped by npower’s Macmillan’s Fund:
“Due to my treatment, I’m at home all the time”, says Sue. “As my income has come down, I couldn’t pay my energy bills; it took months to sort my benefits out so I had no income whatsoever. I thought I was going to lose my home. I thought I was going to lose everything. I was paying £220 a month on electricity and I just couldn’t afford it.
“When Macmillan explained they could get my payments down to £28 a month. I was absolutely dumbfounded. npower and Macmillan’s support has helped me take back control. I don’t have to worry any more about using electricity, putting on the washing machine or putting the heating on in winter. They gave me back a bit of dignity.”
Alison Rooks, Energy Advice Team Leader at Macmillan says: “Rising energy needs aren’t something people automatically associate with having cancer. However, cancer patients going through chemotherapy feel the cold. It can be a bone numbing cold that they just can’t shake, regardless of the weather outside. Combine that with spending more time at home as well as reduced income from not being able to work and managing energy bills can soon become difficult for cancer patients.
“Npower’s Macmillan Fund provides vital support to their customers undergoing cancer treatment, allowing them to focus on their health instead of their energy consumption and keep warm without the worry.”
Elizabeth Gardner, Head of Corporate Responsibility & Community at npower said: “Our partnership with Macmillan allows us to offer tailored support when no other help is available for people affected by cancer. Sadly many people are unaware of this support and rarely think to notify their energy supplier of their diagnosis. By working with Macmillan, we help people living with cancer at a time when they need it most – so they can focus on their health”.
If you’re living with cancer, are a cancer patients and struggling to pay your energy bills, visit the Macmillan Keepwarm campaign page for more information or call Macmillan Cancer Support on 0808 808 0000 Monday to Friday, 9am to 8pm.
i) Macmillan/YouGov online survey of 1,266 adults aged 18 and over in the UK with a previous cancer diagnosis. Fieldwork conducted between 22nd December 2015 and 5th January. The figures have been weighted and are representative of the living with cancer population. Results in this report are based on the 503 respondents who were diagnosed within the last two years. The average yearly bill increase amongst the 21% of respondents diagnosed in the last two years whose energy bills have increased as a result of their diagnosis and treatment was £177. This figure has been extrapolated onto the number of people diagnosed in the last two years. The numbers of people living with cancer diagnosed within the last two years that are estimated as those people alive in 2010 with a cancer diagnosis in the last two years – source: Macmillan Cancer Support and Public Health England’s National Cancer Intelligence Network Partnership Work-Plan. 2013.
Segmenting the cancer patients survivor population – the data was sourced and presented in collaboration with the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales, Public Health Wales, the Scottish Cancer Registry and the Northern Ireland Cancer Registry.
ii) Calculated by number of calls to Energy Advice Team and number of people helped by Macmillan fuel grants (Jan to Aug 2015 and Jan to Aug 2016): 12,013 in 2015 and 13,857 in 2016
iii) Winter is based on the four months November to February
iv) Calculated by: number of grants queries per month in 2016 Macmillan has received about energy costs – on average 1,372 grants queries per month, meaning that next four months we could predict another 5,488 enquires combined with the average number of calls to the Energy Advice Team so far in 2016 236 new unique calls per month, meaning that over the next four months we could predict another 944 new unique calls. Bringing total to: 6,432 enquiries overall
v) In 2015 EAT received 2074 January to September calls and in 2016 January to September received 2766 calls
vi) Macmillan Cancer Support/Truth online survey of 955 adults in England, Scotland and Wales who have a cancer diagnosis. Fieldwork was undertaken between 3 – 21 September 2015.
vii) Macmillan Cancer Support/Truth online survey of 955 adults in England, Scotland and Wales who have a cancer diagnosis. Fieldwork was undertaken between 3 – 21 September 2015.
SuperCarers, an online care platform, is on a mission to disrupt the UK’s archaic, expensive and inefficient care system with a solution targetted at home care. As technology continues to revolutionise the way we eat, travel and shop; now Supercarers is providing an ageing population with a safe, reliable and affordable solution for home care. The company has launched a £500,000 equity crowdfunding round on Seedrs to drive its growth.
Two million elderly people in the UK alone have a care related need and four million will need daily help by 2029 and yet by 2025 there will be a deficit of 600,000 carers in spite of increasing demand. Local authorities can’t keep up with the increasing costs or scale of care, leaving many without the critical assistance required to live their lives with dignity.
SuperCarers is the brainchild of brothers, Adam and Daniel Pike, who witnessed the inefficiencies of the care system first hand as they were growing up. Reflecting on their Gran’s story in 2014 inspired them to leave their city jobs roles and pursue a viable solution to help other families in the same predicament: affordable, world-class home care.
Their story is one that millions across the UK can relate to. The boys’ mother had become the primary carer for their elderly grandma but struggled to balance this responsibility with her other full-time role as mother of two young boys. Grandma Pam was desperate to stay in her own home but because home-care agency support was inadequate and unaffordable she was forced to go into a residential care home, where her health and happiness deteriorated rapidly.
The Supercarers mission
The mission to improve the quality of life for older people, families and carers finally began with the launch of SuperCarers in December 2015. The fledgling business offers a unique solution to the gaping hole in the care market, enabling families to work and manage family life with the assurance that their elderly parents can continue to live in the comfort and security of their own homes.
Point of difference to home care
The company curates a personal matchmaking service where families can find vetted, reliable and compassionate carers for loved ones. SuperCarers matches carers with families based on personality and interest, as well as care need, location and timing.
SuperCarers bypasses the high overhead costs of agency middlemen, without forfeiting quality of care via a user-friendly online platform. The smart technology empowers families to monitor, manage and pay for care independently. This in turn generates a saving that alleviates the financial burdens of traditional care and simultaneously improves the quality and pay of carers.
SuperCarers workers earn £12.80/hour, versus a typical £7.40, and as a result the platform attracts motivated and compassionate carers. Smart technology creates a simple and effective platform with transparent payment, care scheduling and communication. A personalised matching process tailors care to the requirements of each and every individual.
Alan Rosenbach, Director of Strategy of the Care Quality Commission (CQC), is chair of the SuperCarers Care Advisory Board. To read more about SuperCarers visit their website here.
Raiding the piggy banks
The King’s Fund’s report into the progress of the implementation of the Five Year Forward View has hit some raw nerves. Stephen Dalton, Chief Executive of the NHS Confederation, said:
“This report shows long-term plans for improvement are being put on the back burner because of short-term funding issues arising from a health and care system which is stretched to breaking point. We understand the need to ensure services have enough money today but the tactic adopted is to effectively raid resources which were meant to enable change and ensure we develop a 21st century NHS offer. If we are to have a sustainable NHS and care system, the government needs to urgently invest in social care, halt planned cuts to public health, get serious about preventing ill health and kickstart an honest, open public conversation about what needs to change if the next generation is to carry on benefitting from the high quality health care we have today.” We can only agree.
A Conservative critique
A new report on the NHS from UK 2020 a think tank established by Rt Hon Owen Paterson MP to produce a conservative policy platform for the General Election of 2020. Argues that despite improvements since the early 2000s, the NHS is still lagging behind the health systems of most comparable countries on most health outcome measures for which robust data is available.
The report goes on to say that the NHS has relatively low survival rates for the common types of cancer, although it does better on some of the rarer ones. The same claim is made for measures of ‘amenable mortality’, an indicator which captures unnecessary deaths across the healthcare spectrum. Long waiting times are still a problem, even if this one that the UK shares with a number of other countries. The uptake and diffusion of medical innovation is relatively slow. The NHS does guarantee universal access to healthcare, but so do all healthcare systems in the developed world, with the exception of US system. Healthcare spending is lower than in some of the neighbour countries, but this does not indicate superior efficiency. In more sophisticated estimates of health system efficiency, the NHS is, once again, inferior to most other countries.
A further report is promised on what the NHS can learn from other countries. NfN moles are placing their bets on compulsory health insurance being the offering.
Did somebody say market failure?
On October 19th the Health Services Journal reported that private company Ramsay Health Care UK had pulled out of a project with Cambridge University Hospitals Foundation Trust in which it had been appointed to run a 90 bed private hospital as part of a complex including a hotel, conference centre and a medical education centre. The company took the decision to pull out shortly after the EU referendum on 23 June. This blow to a flagship NHS infrastructure project comes as capital funding for the NHS is in desperately short supply. The Cambridge project has been seen by some as a potential model for new infrastructure development elsewhere.
An anonymous commentator in the HSJ said in response:
“What is it about the Cambridge, rather than Cambridgeshire, system where it has to be the test bed for most new health concepts and then see them fail. The PCT were at the forefront of mergers when it took on Peterborough, the local commissioning group CATCH were the forerunner of the CCG model with the architect as their local MP, the failed Older Peoples tender was the first to attempt outcome based commissioning using capitated budgets and now this. What next?”
Answers in an email to ‘info at HealthMatters dot org dot uk’ please.
A new study has highlighted the scope of computerised cognitive behavioural therapy (CBT) tools available worldwide and outlined their impact on people with mental health needs.
The study from RAND Europe, commissioned by the education and social service company Ingeus, showed that computerised cognitive behavioural therapy tools, which are online platforms or mobile applications to help tackle common mental health illnesses such as depression, anxiety or insomnia, have grown significantly in the past two years. These tools are available in a number of countries, including Australia, China, Denmark, Ireland, Japan, Norway, Spain, Sweden, the Netherlands, the UK, and the U.S.Cognitive behavioural therapy is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel.
Computerised cognitive behavioural therapy tools aim to address a variety of mental health conditions, with the study finding that these largely had a positive impact on users. It also found that condition-specific tools could reduce the symptoms of other conditions. For example, a tool to help those with insomnia could simultaneously reduce symptoms of depression. Despite the overall positive impact, the study revealed that some groups with mental health needs are less likely to participate in treatment (or trials) of computerised cognitive behavioural therapy tools than others. For example, the average user was a woman in her late 30s with a university degree and in full-time employment. However, computerised cognitive behavioural therapy tools specifically focused on people with depression had a more equal proportion of male and female participants, while those specifically for people with anxiety disorders had somewhat younger and less-well-educated participants. News from Nowhere asks: if these are the characteristics of the users, exactly what is the problem being solved?
To view the report visit Rand Europe.
Sellers’ market in general practice
The problems of accessibility and understaffing in general practice are not unique to Britain. The New Zealand Dominion Post reported on November 2 that up to 25% of people surveyed across the country had been unable to get a routine appointment with their usual medical centre (not their usual doctor, please note) within 24 hours. General practices in New Zealand are struggling to recruit new doctors and half of current GPs seem likely to retire in the next ten years. There is also the same tendency to work part-time as there is in Britain.
During the junior doctors strikes there was talk by some doctors in training of emigration to avoid the overbearing manner of the NHS and to take advantage of the better salaries and easier working conditions of health services in New Zealand and Australia. The New Zealand doctor shortage may well attract some disaffected British doctors, who might also be attracted to the different lifestyle. In a sellers’ market they could set their own terms.
But it is not that simple. The doctor shortages in New Zealand are least in trendy Auckland, the cultural centre of the country, and greatest in rural communities. In the countryside, notes the Dominion Post, doctors face geographical isolation, less peer support, longer working hours (including out of hours work) and encounter a wider range of clinical problems than their urban peers. If British doctors only want the easier jobs they compete with themselves in New Zealand, and the labour market could turn towards the buyer.
Celebrity chef and health campaigner Jamie Oliver has been recognised by the Royal Society for Public Health (RSPH) for his contribution to advancing the cause of public health in the UK. The award for Outstanding Contribution to Championing the Public’s Health was announced at the RSPH Awards 2016, the UK’s premier national health and wellbeing awards event, held at the Royal College of Surgeons in London on 27th October.
Jamie Oliver received the award in recognition of both his high profile campaigning on childhood obesity and the on-the-ground community work of his Food Foundation. Jamie’s campaigning has been widely credited as having been key in pushing the government to introduce the sugar levy on soft drinks, a key pillar of action to tackle childhood obesity recommended by many public health organisations, including RSPH. Meanwhile, the Food Foundation’s Ministry of Food Centres have seen great success in getting people in communities across the UK passionate about healthy food.
Jamie Oliver is also featured talking about his work on childhood obesity in RSPH’s new film, Championing the Public’s Health, which was premiered at the award ceremony. The film is a collaboration with ITN Productions which takes a topical look at current public health challenges and initiatives. See the film here.
Nurses are three times more likely to have experienced domestic abuse in the last year than the average person (14% compared with 4.4% nationally) according to new research, published in a report by Cavell Nurses’ Trust.
Skint, shaken yet still caring. But who is caring for our nurses?’ includes findings from a survey of more than 2,200 nurses, midwives and health care assistants (HCAs) and reveals that those in the profession are also twice as likely to be unable to afford basic necessities as the average person and more than two in five nurses have a physical or mental health condition expected to last longer than a year. The charity, which gives money and support to nurses, midwives and HCAs facing a crisis, commissioned the survey to gauge the quality of life of nursing professionals.
According to the National Centre for the Study and Prevention of Violence and Abuse (NCSPVA) one of the many, complex reasons nurses are experiencing higher levels of domestic abuse is because of the values they uphold in their daily roles, such as care, compassion and courage. The report also revealed that one in every seven (14%) nurses has experienced domestic abuse in the past year and that one in 50 (2.2%) nurses has been injured as a result of domestic violence in the last year.
Claire Richards, Institute of Health and Society, NCSPVA, said: “The values that nurses adhere to in their career – including the six Cs of nursing: care, compassion, competence, communication, courage, commitment – may increase the likelihood of them staying with an abusive partner for reasons of altruism or a possible belief their partner needs them. Nurses may see their partner’s behaviour as part of a wider problem, such as depression, unemployment or a drink problem that they seek to treat or heal.”
For further information go to www.cavellnursestrust.org/research
New research shows that half (49%) of teenage boys (aged 16-18) in the UK would not feel comfortable talking to their fathers about their mental health (including stress, anxiety and depression). When asked why, more than a third said it was because their father doesn’t talk about his feelings and 31% said they wouldn’t want to burden them.
The survey revealed that over half of young men (54%) who are experiencing mental health problems ‘put a brave face on’ or ‘keep it to themselves.’ The poll of 16-18 year old men was published by Time to Change, the campaign run by Mind and Rethink Mental Illness to change public attitudes towards mental wellness. The research, which found that a quarter (27%) of teenage boys experience mental health problems at least once a week, aims to uncover the extent to which teenage boys’ attitudes and behaviour towards mental health are influenced by their fathers.
While many teenage boys considered talking about mental health with their fathers to be off limits, Time to Change highlights the positive impact of role modelling behaviour from fathers to sons. 70% of sons felt completely comfortable talking about their mental health when this had been encouraged by their father. The research also showed that virtually all teenage boys who were comfortable opening up to their father about their mental condition (98%) said that they would want to have a similarly open relationship with their sons in the future.
Time to Change is now urging all fathers to talk more openly, so that if and when their sons develop mental health problems in the future, they can be on hand with support. The newly released research also offers a helpful insight into how teenage boys would like their dads to reach out. The majority of young people wanted their fathers to talk to them (57%) with others stating a preference for a less direct approach such as going out somewhere together (26%).
Over the next five years, Time to Change will introduce a targeted campaign to encourage men to think and act differently about mental health problems and be more open and supportive of friends, family and colleagues.
For advice and tips visit: http://www.time-to-change.org.uk/
It’s official – dog owners in the UK are fitter and healthier than people without dogs, according to a new study.
Research indicates that people who own a dog are likely to exercise at least three times more a week than the rest of the nation, as they walk or run for an average of 74 minutes every day, in addition to their normal exercise.
In the process, dog owners will cover an average distance of 1092 miles a year on foot, compared to the 364 miles walked by those who don’t have a one.
The research found that not only did owning a dog affect the amount of walking a person does, but also that dog walkers were more active overall.
As well as walking around the neighbourhood daily, it emerged dog owners are more likely to walk than drive anywhere, more likely to take the stairs than the lift, and are generally always on their feet.
In contrast, people who don’t own a dog only keep fit twice a week, and walk for just 18 minutes a day.
A resounding 73 per cent of owners say they love the fact they manage to get so much exercise now they own a dog, with the majority feeling fitter, healthier and more energetic since owning a dog, and not just in body, but in spirit too.
One in three dog owners said walking their dogs allowed them to de-stress after work, and a quarter felt it helped them to escape their busy schedules.
A spokeswoman for Butcher’s Pet Care, which commissioned the research into 2,000 dog owners, said: “It’s fantastic that owners and their dogs involved in our research are so fit and healthy with the majority going for walks at least twice a day, and this is having a positive impact on their owner’s health which is great to see.
“We know dog owners will walk far more than the average adult, as exercising their dog becomes part of their daily routine. Rather than relaxing in the garden dog owners are likely to be running around playing, and instead of nipping down the corner shop in the car, they’ll put the dog on the lead and walk.
“There are also some great social aspects to owning a dog, such as chatting with other owners when out walking – almost one in ten surveyed said they had met one of their closest friends walking their dog.
“Overall it’s safe to say that dog owners are generally more active and spend more time up and about than those people who don’t have a dog to look after – it’s a really great lifestyle choice!”
The poll reveals the average owner spends 58 minutes a day walking with the dog – which equates to approximately 3 miles a day and 21 miles over the course of one week.
This means dog lovers are walking an incredible 351 hours a year, covering a distance of 1092 miles.
In addition to miles walked, owners are chasing their dog around the garden for 16 minutes every day, that’s 97 hours every year.
And the average dog owner also goes for a jog with their dog between two and three times a week for good measure.
Researchers discovered the bigger the breed of the dog, the fitter dog owners were too, with Golden Retrievers, Bulldogs and Boxers needing the most number of walks per day.
A fifth of dog owners like the fact they get to meet and bump into other people when out and about, while a third make the most of the only fresh air they’ll get during the day.
Interestingly, one in 10 people will happily use walking the dog as an excuse to avoid a nagging partner, while one in 20 use the time to catch-up on the phone with their mum or dad.
A quarter of people polled like dog walking as they can escape a hectic schedule and 14 per cent say it is good to get technology-free time.
Some lucky dogs don’t just benefit from walks with their owner – the study indicated one in 10 dogs attend group walking classes, while six per cent go to agility classes.
Four per cent of dogs go to doga – the practise of yoga for dogs.
The Butcher’s Pet Care Spokeswoman continues: “Decades ago, owners very rarely needed to walk their dog as they were often just let out into the garden or roamed the local area freely, but times have changed! It is now up to the owners to keep their dogs fit and due to this their fitness levels have increased too.
“We carried out the research to highlight the many benefits of owning a dog and we hope that it will encourage more dog owners to focus on the health of their pets which includes taking them on regular walks, but also feeding them a natural, meat based and wholesome diet, as the two go hand in hand.”
Butcher’s is a British, family owned company whose heritage in farming and as butchers stretches three generations. In 1987 Graham Baker, Butcher’s Pet Care founder launched their first canned dog food, Butcher’s Tripe Mix, which has come to symbolize the brand’s values of natural meaty goodness without the use of wheat and soya fillers and their proud meat heritage. For nearly 30 years Butcher’s have used their unique skills and meat expertise to specialise in making great tasting meaty meals that dogs love and thrive on.
This year will see Butcher’s celebrate its roots by rebranding its packaging to bring back the iconic butcher of the 1980s.
BREAKDOWN OF STATISTICS
58 minutes walking with the dog
16 minutes running around the garden with the dog
Dog owners – walk / run for total of 74 minutes each day excluding normal exercise, averaging 3 miles
3 miles x 7 days = 21 miles a week
21 miles x 52 weeks = 1092 miles a year
Non dog owners – walk / run for total of 18 minutes each day excluding normal exercise, averaging 1 mile
1 mile x 7 days = 7 miles a week
7 miles x 52 weeks = 364 miles a year
A third of the UK population spent at least one year in relative income poverty between 2011 and 2014.
Traditionally policymakers and anti-poverty organisations such as the Joseph Rowntree Foundation (JRF) have focused on boosting people’s economic capital (e.g., income) and human capital (e.g., educational attainment) to reduce poverty. While investments in these areas have led to important gains in opportunity for many Britons, emerging research from behavioural science shows that other less tangible resources, which derive from psychological, social and cultural processes, significantly influence people’s ability to overcome disadvantage.
The Behavioural Insights team (BIT) was commissioned by JRF to examine the role of individual decisions in shaping people’s experiences of poverty in the UK and to identify the drivers of these decisions. This reflects JRF’s interest in looking beyond traditional, structural drivers of poverty. Our findings, based on a review of the published literature, are presented in a new report, launched today.
Building on the concepts of economic and human capital, our report proposes a more expansive capital-based model of poverty and decision-making, encompassing environmental, social, character and cognitive capital (Figure 1). For example, an individual may use their social capital (e.g., trusted social connections) to identify labour market opportunities; but being low in environmental capital (e.g., overcrowded housing) may reduce opportunities for parents to talk with their child in ways that build their human capital (e.g., speech development).
Figure 1. Types of capital resources (including examples)
We applied our capital model to six key decision areas that influence poverty in the UK:
- choosing low-cost credit;
- accumulating savings;
- moving into work from unemployment;
- accessing government entitlements;
- responsive parenting; and
- applying to post-secondary education.
Under each of these six headings, we explain both how a lack of the different types of capital influence individual decisions, and we showcase potential interventions to overcome the negative effects.
The good news is that, while interventions to boost economic and human capital often take a long time to produce results, investing in a person’s psychological resources can often have very fast and wide-ranging benefits. For example, one study we reviewed found that people in poverty performed better on tests (equivalent to a 10 point increase in IQ), and were more likely to consider making use of programmes that would benefit them, if they had recently been asked to recall a proud moment or past achievement (Hall, Zhao, & Shafir, 2014). By comparison, another study we reviewed found that when low-income students were asked to answer demographic questions about their parents’ income and occupations before a test, they performed worse than the low-income students who were not asked these questions (Spencer & Castano, 2007). This psychological perspective of inequality in the UK highlights that processes which build in small empowering interactions between users and service providers, at key moments, can potentially boost a person’s psychological resources which can, in turn, increase their ability to overcome disadvantage.
To give you a flavour of the report, below we explain some of the ways that cognitive, character and social capital influence social mobility, via decision-making.
Cognitive capital: Timely prompts and the take-up of entitlements
Despite the obvious financial benefits, many people on low incomes do not take up the welfare payments they are entitled to. Research shows that money worries can absorb cognitive bandwidth, leaving less cognitive resources to make optimal decisions (Mullainathan & Shafir, 2014). A UK study which examined the impact of GPs offering advice to older people about their welfare entitlements found no real improvement in health outcomes but 58 per cent of participants gained a welfare benefit (Mackintosh et al., 2006). Some benefits were non-financial, such as a disability parking permit, but the median financial award was £58 per household per week. This highlights that there may be many timely opportunities for trusted service providers to encourage people to take-up entitlements that could benefit them, for example at the Post Office.
Character capital: Self-efficacy and responsive parenting
A parent’s belief in their own capabilities can have a significant effect on how they parent, and has been shown to affect their child’s educational attainment. Parenting self-efficacy is bolstered by parental education and social support (Seefeldt, Denton, Galper, & Younoszai, 1999; Young, 2011). Conversely, stressors linked with living in poverty, such as financial strain, have been shown to undermine a parent’s self-efficacy, diminishing their belief in their abilities and perceived control (Carroll, 2013; Machida, Taylor, & Kim, 2002).
A number of parenting interventions involving home visits by health workers have had positive effects in preventing intergenerational poverty. The most successful interventions help parents build on existing parenting practices, rather than introduce lots of new information, which increases parental self-efficacy and reinforces positive habits. A trial in Jamaica found that 20 years after home visits to new parents, adults who had been in the treatment group as children were earning 25 per cent more than those who had been in the control group (Gertler et al., 2014).
Social capital: Social networks and applying to post-secondary education
Qualitative research from the UK shows that when young people from less well-off backgrounds make career decisions, they value and rely on informal information (from their social networks) more than formal information (such as careers services) (Greenbank & Hepworth, 2008).
Similarly, a quantitative US study found that high school graduates were more likely to enrol in college if their friends planned to attend college and if their parents were involved in the school they attended (e.g., contacting the school to volunteer time in the classroom or discuss academic matters). Regardless of a student’s own friends and parents, there was an additional positive effect on college enrolment from social capital at the school level: college enrolment was related to the average number of students that reported that most or all of their friends planned to attend college, and average parent-initiated contact with the school about academic matters (Perna & Titus, 2005).
These findings highlight that policymakers should look for ways to use the powerful role of social networks to support young people in their decision to stay in education.
The report presents 18 specific policy recommendations. Below we provide just one key take-way:
Cognitive load test: We argue that policymakers should not reduce the value of their investments in anti-poverty programmes through complex and stigmatising application processes and eligibility checks which absorb cognitive bandwidth. We all have limited mental processing capacity to reason, to focus, to learn new ideas, and to resist temptation. The worries involved in making ends meet every day already deplete bandwidth so government services aiming to tackle disadvantage – such as savings schemes, employment advice and parenting programmes – should be required to pass a cognitive load test to ensure these services do not make it harder for people on low incomes to make good decisions for themselves.
Investing in traditional forms of capital – economic and human – remains important for reducing poverty in the UK but understanding how less tangible forms of capital influence decision-making is useful in two respects: first, it can help to explain why some well-intentioned interventions may fail; and second, it can open up a new set of tools to address poverty.
You can read a summary of the findings from this report here.
October 20, 2016 Kizzy Gandy
The Royal Society for Public Health (RSPH), the world’s longest established public health body, is celebrating its 160th anniversary this year. To commemorate this milestone, RSPH commissioned artist Thomas Moore to reimagine William Hogarth’s infamous 1751 cartoon Gin Lane – which depicts the debilitating effects of the gin crisis then sweeping London – for the 21st century. The new artwork, which reflects some of the biggest public health challenges now facing British society, was unveiled on Wednesday 19 October 2016 at RSPH’s Annual General Meeting and can be seen at the RSPH’s historic home at 28 Portland Place, London.
Shirley Cramer CBE, Chief Executive of RSPH, said: “The original Gin Lane depicts concern with some of the leading challenges to the public’s health in the 18th century – not just alcoholism, but other leading killers of the time including infectious diseases and malnutrition. The leading threats to the public’s health have changed over time with infectious diseases now supplanted by the growth in non-communicable diseases such as those caused by obesity, as well as a growing awareness of the importance of mental wellbeing.
“On our 160th anniversary, Gin Lane 2016 gives us a valuable opportunity to reflect on the challenges to the public’s health that we now face and will inspire us to find new and innovative solutions to tackle these problems. We hope that when we look back on this piece of artwork in another 160 years, many of the health issues it depicts will be a thing of past.”
Artist Thomas Moore said: “When I contacted the RSPH for this commission, I told them that – as an avid Hogarth fan with an interest in public health – I was the man for the job. After being commissioned for the piece, I can honestly say that I’ve given it everything. Hogarth was the grandfather of the cartoon, so I treated this project with the respect it rightly deserved. Recreating Gin Lane over the past few months has completely consumed me. Hogarth – I hope you approve.”
The overall scene is the same street as in the original Gin Lane, but has been developed and modernised so that it is representative of a typical street scene in London, or indeed anywhere in the UK today.
- The central character has been reinvented. Where the original depicts a mother who is drunk and too pre-occupied with taking snuff to care for her baby, Gin Lane 2016 instead shows the mother preoccupied with eating junk food, which she has also fed to her child.
- A pawnbroker is one of the significant and thriving businesses in the original piece. In the modern version, this has been replaced by one of the payday lenders which have become a feature of many high streets, and are perhaps a 21stcentury equivalent. The desperation of one of the customers leaving the payday lender represents the mental ill health associated with debt.
- The chicken shop is a representative feature of the obesogenic environment which is at the heart of Gin Lane 2016 – busy, vibrant, and packed full of glum looking customers.
- The man contemplating throwing himself off the top of a building is a nod to the original in which a barber is seen hanging, having committed suicide because his customers could no longer afford a haircut. Suicide is now the single biggest killer of men under 45 in the UK.
- The original arch has been converted into Gin Lane tube station, with commuters glued to their smart phones – a depiction of a busy, potentially lonely existence.
- Junk food adverts provide another reflection of the ubiquitous power of marketing in our obesogenic environment.
- The distillery from the original has become a busy pub with rowdy drunk customers.
- A news vendor hands out a paper with a headline about the threat posed by obesity.
A new study has highlighted the scope of computerised cognitive behavioural therapy (CBT) tools available worldwide and outlined their impact on people with mental health needs.
The study from RAND Europe, commissioned by the education and social service company Ingeus, showed that computerised cognitive behavioural therapy tools, which are online platforms or mobile applications to help tackle common mental health illnesses such as depression, anxiety or insomnia, have grown significantly in the past two years. These tools are available in a number of countries, including Australia, China, Denmark, Ireland, Japan, Norway, Spain, Sweden, the Netherlands, the UK, and the U.S.
Cognitive behavioural therapy is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel.
Computerised cognitive behavioural therapy tools aim to address a variety of mental health conditions, with the study finding that these largely had a positive impact on users. It also found that condition-specific tools could reduce the symptoms of other conditions. For example, a tool to help those with insomnia could simultaneously reduce symptoms of depression.
Despite the overall positive impact, the study revealed that some groups with mental health needs are less likely to participate in treatment (or trials) of computerised cognitive behavioural therapy tools than others. For example, the average user was a woman in her late 30s with a university degree and in full-time employment. However, computerised cognitive behavioural therapy tools specifically focused on people with depression had a more equal proportion of male and female participants, while those specifically for people with anxiety disorders had somewhat younger and less-well-educated participants.
A previous RAND Europe study in 2014 suggested that providing access to online mental health assessment and support, such as computerised cognitive behavioural therapy tools, could help to reach a large proportion of the UK population with mental health needs at a relatively low cost. Common mental health problems affect over a quarter of adults in England (26 per cent) and incur increasing costs to individuals, employers and governments. However, access to mental health services is limited.
Chris van Stolk, lead researcher and vice president at RAND Europe, says: “Computerised cognitive behavioural therapy offers a range of promising solutions to support those with mental health needs. These can help people less likely to talk with their GP or therapist. However, our study showed a risk that these solutions could be failing to reach certain groups, such as unemployed men.”
He continues: “There are a range of computerised cognitive behavioural therapy applications and other platforms available worldwide that meet a diverse range of mental health needs. These are not the ‘silver bullet’ to solving common mental health problems, but are largely effective at providing a sufficient level of support to those with mental health needs.”
Barry Fletcher, chief operations officer for Ingeus, says: “This informative and timely report provides a useful insight into the rapidly changing market for computerised cognitive behavioural therapy tools, as well as the ways in which they can be best utilised to support individuals with mental health needs”.
He continues: “One thing that we are learning both from this report and from our own experience of delivering services across a range of sectors, is that for individuals with complex needs, often the best solutions can be found in blended support, including greater use of technology. This report provides a useful evidence-based guide as to how services in the future might utilise these innovative new technologies that are now developing a strong evidence base.”
The report provides a systematic assessment of post-2013 literature on computerised cognitive behavioural therapy platforms. The aim was to have up-to-date evidence, particularly around the availability, use and effectiveness of computerised cognitive behavioural therapy platforms.
To view the report visit Randeurope:
– ENDS –