Country Profile for the United Kingdom Case Study - Health Management Assignment help

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Country Profile for the United Kingdom (UK)

Figure 1 Map of UK

Source Mapzone Blog 2016

The UK is a high income country in north-western Europe (Figure 1). Its constituent countries are; England, Wales, Scotland and Northern Ireland.

The UK has an aging population (Figure 2). Males and females are similarly distributed until the older age groups. This is seen predominantly in 90 year olds whereby the female population is nearly three times (71%) the male population. Shown in Table 1 female life expectancy is higher than males which helps to explain this difference.

UK life expectancy at birth has continued to increase. Between 1991-1993 and 2010-2012 it increased by 5.48 years in males and 3.86 years in females (ONS, 2015a).

A child born in 2015 has an average life expectancy of 79 years in males and 83 years in females (Table 1). Despite living longer people spend more of their lifetime in an unhealthy state. A child born in 2015 can expect to live 8.7 to 10.5 years in poor health (Table 1). Increasing morbidity has significant implications for the individual, community, health services and the wider economy including rising costs.

Life expectancy varies between and within constituent countries.There are significant differences between people in the most deprived deciles who experience lower life expectancy (Figure 3) and lower healthy life expectancy (Figure 4) compared to people in the least deprived deciles. Health inequalities are a key health challenge faced by the UK population.

Established in 1948 the National Health Service provides free health care to those living in the UK. In 2013 total healthcare expenditure was £150.6 billion of which 83 (£125.5 billion) was attributable to the public sector (ONS, 2015b). This accounted for 8.8% of gross domestic product (GDP). 2013 was the highest recorded expenditure increasing from £44.1 billion in 1997 and more than doubling the total healthcare spend per person.

The UK had the highest share of public sector healthcare expenditure of the high-income countries in the G7 group in 2013 (ONS, 2015b).

Despite a growing and aging population, total number of UK deaths have seen an overall decline of 13% between 1983 and 2013 (ONS, 2014). The age-standardised mortality rate was 1,002 deaths per 100,000 people in 2013 (ONS, 2014) which has reduced by 45% in males and 36% in females since 1983.

Non-communicable diseases accounted for the main proportion of UK all-cause mortality (89%) in 2012 (Figure 5). Communicable, maternal, perinatal and nutritional diseases accounted for 7% of deaths and injuries for 4%. In 2013 the three main broad disease groups were; cancers, circulatory diseases and respiratory diseases (ONS, 2014). Cancer was the leading cause of death in both sexes in 2013 (Figure 6) which has surpassed circulatory diseases as the most common mortality cause between 1983 and 2010 (ONS, 2014). Cancer caused 226 deaths per 100,000 people in 2012, which was the highest of the G7 countries (OECD, 2017a). The mortality rate from all three causes has shown a steady decline in this time period (Figure 6).

Health inequalities are linked to disease risk. For example deaths from cardiovascular disease in males in the most deprived decile were 2.7 times higher in England in 2001-2003 than males in the least deprived decile (Marmot et al, 2010).

Declines in risk factors contribute to declines in the associated disease burden. Tobacco is a major risk factor for cancer and circulatory diseases it also increases risk of respiratory disease. UK smoking prevalence declined from 49.5% to 19% between 1970 and 2013 (OECD, 2017b). Interventions to modify this behaviour includes smoking cessation services since 1999 and the Stoptober national awareness campaign from 2012. Smoke-free legislation to prohibit smoking in most enclosed work and public places was enforced after the 2006 Health Care Act and further legislation has followed.

While these main disease groups (Figure 6) have declined certain other diseases have seen a significant increase. Alzheimer’s disease for example increased by 137% between 1990 and 2010 (Murray et al, 2013). Alzheimer’s is a disease of ageing, as UK life expectancy increases it may therefore be expected to see an increase in the rate of this disease.

The main UK risk factors for Disability Adjusted Life Years (DALYs) in 2015 were tobacco smoke, high blood pressure and high body mass index (Forouzanfar et al, 2016). These were the same leading risk factors as in 2010 (Figure 7). Health inequalities relate to risk factors with lower socioeconomic status population groups often exhibiting more risky behaviours. UK smoking prevalence for example was highest in routine and manual workers (28.2%) compared to managerial and professional occupations (12.1%) in 2014 (ONS, 2015c).

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