Public health’s big ‘panacea’

Physical activity is the “nearest thing to a panacea” in combatting an ”extraordinary range” of health problems, according to Professor Eugene Milne, director of public health at Newcastle City Council.

Routine activities such as cycling and walking are increasingly being seen by health professionals as preferable to “vigorous, organised exercise”. Incorporating routine activity into daily living is the most effective way of tackling a broad range of health problems, says Professor Milne. 

The public health system in England underwent a “fundamental shift” in April 2013 with its return from the NHS to local authority control, he explains. “Councils acquired a range of responsibilities, though few are mandatory and most are flexible in scope. 

“The overriding obligation for councils is to improve the health and wellbeing of the local population, and judgement of what best serves that aim is a matter for local choice.”

This marks a shift towards improving health rather than the treatment of illness. “Acute sector demands had been recognised consistently to trump prevention in short-term financial choices, though the larger part of shifts in health and wellbeing arose from broader societal and environmental change, not health care.” 

?A shift of emphasis to physical activity opens the way to more actively exploring the benefits of cycling and walking, he says, though unfortunately this has coincided with a period of austerity.  

“Despite ring-fencing of the public health grant to councils, this poses difficult choices for public health. At the same time, the NHS 5-Year Forward View envisages an increasing role for secondary prevention in NHS care – necessary both to optimise quality of life and to minimise future health care needs and costs. Physical activity is increasingly recognised as the nearest thing we have to a panacea – effective in avoiding and ameliorating an extraordinary range of problems.”

Professor Milne admits that achieving these behavioural changes will be far from simple. But he adds: “The new configuration of the English public health system offers the greatest chance of coordinating and facilitating such shifts in decades.”

Professor Milne will be speaking at Cycle City Active City