Staying mentally and physically fit in adulthood through into old age is important in reducing the risks of developing chronic conditions, stopping problems getting worse and tackling mental health and depression as a result of loneliness.
Professor Ronan Lyons, Dr Roxanne Cooksey and Soo Vinnicombe talk about their work in this important area of research.
Professor Ronan Lyons, Director NCPHWR, based at Swansea University
Changes to homes can help people live an independent and healthier life. Currently many homes are not suitable and it is important to adapt and improve in order to reduce health and social care costs. Poor-quality housing has been shown to have negative effects on residents’ health with cold houses thought to cause 33% of respiratory and 40% of cardiovascular diseases. There are an estimated 12.8 excess deaths per 100,000 occur due to living in inadequately heated houses.
Our research explored whether making upgrades to council housing and bringing housing up to a national quality standard could relieve the pressure on the NHS. The study looked at data from 8,558 council house residents in Carmarthenshire, between 2007 and 2016. Residents received improvements to their homes, including new heating and electrical systems, wall and loft insulation, new kitchens and bathrooms, windows and doors, and garden paths.
We found substantial decreases in the number of hospital admissions for those in the improved homes. Findings showed a substantial decrease of up to 39% in emergency admissions for cardiovascular and respiratory illnesses. This was for tenants aged 60 years and over, but there were similar results for all ages.
Our study provides a robust evidence base and can be used to inform local governments and policymakers – demonstrating that improvements to housing contribute to prevention – having significant positive impacts on society, the economy and public health.
Dr Roxanne Cooksey, NCPHWR Researcher, based at Swansea University
Many people live with long-term health conditions such as diabetes, asthma, arthritis and mental health conditions; this greatly affects quality of life and places a growing burden on health provision and associated costs. We need to get better at helping people manage their own conditions and to prevent problems from getting worse and support recovery.
My research focuses on arthritis, and recently I explored ankylosing spondylitis (AS), which is the second most common inflammatory arthritis after rheumatoid arthritis. Unlike rheumatoid arthritis, AS typically begins in the teenage years. Since the condition starts early on in the life course, education, employment and family prospects can be limited. The inflammation associated with the condition can result in the permanent fusion of the spine and greatly reduces mobility and quality of life for the individual. People with AS often live with great levels of pain, stiffness and fatigue.
The data enabled us to estimate the cost of AS which was around £20,000 per patient, per year. Knowing the true cost of conditions is important so that accurate cost-benefit calculations can be made and improve access to medications for those who need them. Recommendations from the study included treating individuals with AS with effective drugs early, in order to prevent structural damage and help reduce the severe symptoms of the disease. By using early severe disease flares as a marker, individuals can be identified as candidates for expensive and effective medications.
We also found exercise was effective at improving functional ability, particularly for those with severe disease. Therefore, encouraging exercise can help improve patient quality of life and reduce the cost associated with condition. Our studies have produced the most comprehensive assessment of the true cost of AS in the UK to-date and have been included in National Health guidelines on how to treat the condition.
Ankylosing spondylitis is a debilitating, life-long condition that starts early in the life-course. There is no cure, however advancements in treatment mean that patients’ symptoms can be controlled and the severity of the disease reduced. There is often a diagnosis delay of up to 10 years which means that people do not get treatment early on in the disease. We are investigating early signs and symptoms to detect the condition earlier which will help improve the quality of life for people living with ankylosing spondylitis.
Soo Vinnicombe, NCPHWR Researcher, based at Bangor University
Social prescribing is a way of connecting people to community-based groups, activities and services which can be used to improve health and wellbeing. Helping people live well and independently in the community is extremely important to help manage long term health conditions as well as to prevent and reduce isolation.
The aim of the All Wales Social Prescribing Research Network is to build critical evidence for social prescribing in Wales. The research network is having an impact on existing and developing social prescribing services through enhanced communication, building evidence on individual and community outcomes, social capital and value for money.
The Network brings together academics, practitioners, commissioners and other key stakeholders to agree research priorities, support coproduced research, and produce and evaluate grant submissions. It’s a way to connect organisations with a range of people necessary to promote community engagement and co-production in developing research for social prescribing. The Network also links with social prescribing networks outside of Wales to exchange experiences and work together on new research ideas.
The Social Prescribing Research Network, which only started in April 2018, is a great vehicle for bring together a wide range of people to discuss the many challenges around Social Prescribing. Social Prescribing definitely has the potential to revolutionize the way that people think about health and well-being by providing alternative routes for alleviating problems that don’t rely purely on medical solutions, with the aim of preventing more serious issues from arising at all. But a sound research and evaluation base is needed to ensure that money invested in Social Prescribing in Wales is spent and allocated as effectively as possible.