Can our ills be cured by ‘lifestyle prescriptions’?

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In sickness and in public health


I think a lot about the public’s health. In 30 years as a pharmacist I have seen it change. More people are overweight, there are higher levels of depression, alcohol consumption has risen and two in 10 adults are smokers.

Someone in mid-life who smokes, drinks, doesn’t exercise and eats poorly is four times as likely to die over the next 10 years than someone who avoids those lifestyle choices. While the rate of multiple unhealthy behaviours has decreased overall, it hasn’t within the poorest parts of society.

The causes of death are changing – fatalities from heart disease and stroke have halved for men and women since 2001, but during the same period death rates from dementia and Alzheimer’s have increased by 60% in males, and doubled in females, partly due to our ageing population and greater awareness.

We are all living longer, with data for 2016 showing that a male baby born in England would live to 79.5 years, and a female 83.1 years. This is countered, however, by the extra time we spend languishing in poor health – around 16 years for men, and 19 for women. This impacts on families, our workplaces and increases pressure on health services.

Unhealthy lifestyles are a huge financial burden on the NHS. Smoking costs £5.2 billion, obesity £4.2 billion, alcohol £3.5 billion and physical inactivity £1.1 billion. Mental illness is by far the most common condition for people aged 15–44 years and the incidence rises as you get older; across all ages up to 65 years, mental illness is nearly as common as physical.

In the final analysis, it is hard to see how our NHS can cope.

I am passionate about the difference pharmacy can make to the health and wellbeing of our communities, with an estimated 1.2 million people walking through the doors in England every day. All healthcare professionals (HCPs), however, must work together to address the epidemic of long-term conditions caused by lifestyle issues.

What is the role for the pharmaceutical industry in all this? Paradoxically, people’s unhealthy lifestyles are driving growth in medicines use – we have a culture of taking a pill to cure our diseases. It is not unusual to see individuals on 8-10 medicines, and the most I have seen for one patient is 25.

Evidence is growing, however, that lifestyle interventions prevent disease and halt the progression of conditions such as hypertension and diabetes.

Could we see more lifestyle prescriptions? It is my belief that the pharma has a corporate and social responsibility to take a holistic view in supporting better health outcomes, and this includes combining improvements in lifestyle with medicines use.

The public’s health is my business, but is it yours?     


Deborah Evans is Managing Director ofPharmacy Complete, a specialist consultancy enabling a healthier future for pharmacy. Go to