Scaling up prevention – an STP thought experiment 

Here’s a thought experiment on smoking, poverty, inequality and the economy
Yesterday I set a challenge for the leaders of the health and care system in South Yorkshire 

I suggested it would be rather ambitious to get smoking prevalence to 10% 
(Yes those that don’t “do” lifestyle stuff…. I agree there’s far more to it than lifestlye but bear with……..)
Of course that’s hopelessly ambitious, but…….
We are going to overtly focus this in high need areas (obviously)

We are going to focus on policy type of interventions – theses are more efficient and equitable etc, we are still going to do individual level interventions 

 

 

 

So, I got thinking –  looking at the numbers – for Sheffield, I haven’t yet done for South Yorkshire as a whole

That’s 17-10% in Sheff is c45,000 smokers, or 45,000 who won’t smoke in the future compared to those that do smoke now.

Obviously that’s not evenly spread across the city.

 
Poverty issues

At £3k annual cost per 20 a day, that turns into £135m that wont be spent on cigarettes.

Can this be framed as an anti poverty strategy – I’d not turn my nose up at an additional £3k to spend.

 
Economy issues

That £3k may be spent on other goods, much of it locally – giving a boost to local economy

Some of which might be health enhancing – so much the better.

Some of which if spent locally keeps folk in jobs etc (multiplier effect)

 

So £135m is 1.2% of the economy of Sheffield (c£11bn)

Boost to economy

(Yes I know it’s considerably more complex than this)

 
Health issues.

Of the 35,000 people – the difference between now and the future.

Half of those who smoke will be killed by this

That may be preceded by lots of expensive to treat diseases

Etc etc

 
Risk of diseases goes down reasonably rapidly once stopped. And obviously if folk don’t start, all the better…..

So cost avoided, or averted altogether

 
Also if they don’t have all those illnesses, they will be better able to work and for them not be in the poverty related to unemployment, have better mental health etc, and for the economy – make for a more productive economy

 

Back to the economy ………

Caveats

Of course I’m aware that the above number crunching is all a bit fag packet – term used advisedly – and many will argue with it. That’s ok, it’s a thought experiment not an exercise in economic accuracy.
Cleverer people than me will hopefully improve it.

So ……Dear NHS leaders

Save lives

Help solve poverty

Reduce health inequalities

Boost the economy, especially productive workforce

 We know what to do, we underimplement this – you can do it!

 

We can, and should, make same case in lots of other areas pertinent to the “prevention agenda”

 

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