The Flying Doctors Service of East Africa sounds like an echo from a romantic, and bygone age. But its formation in 1957 was the first step in the creation of a major African health development organisation that has been given the World Federation of Public Health Associations’ Institutional Award at the 13th World Congress of Public Health in Addis Ababa. The African Medical and Research Foundation (AMREF) has a great story to tell; of how it works in the remotest communities in Africa and works alongside those communities to build the knowledge and skills to transform their own health, how it provides training every year to more than 10,000 health professionals, and how it set up the international campaign “Stand Up for African Mothers” with its demand that no woman should die giving life. Oh, and it still provides a flying doctor and emergency evacuation service over much of Eastern and Central Africa. more…

This is a tough time for public health internationally. The global financial crisis has had a deleterious effect on the social determinants of health as some governments have pursued austerity programmes differentially, which has had the greatest effect on some of the least well off in society. Organisations of public health professionals have suffered as well. The UK Public Health Association dissolved after government support was withdrawn, and similar financial pressures are affecting other national public health associations in a number of countries. In contrast, public health professionals in some lesser-developed countries have been able to develop and strengthen their organisations. more…

This month we published a report on risk of type two diabetes in East London, with an accompanying paper in BMJ Open, and underpinned by a previous systematic review in BMJ. We took a risk scoring algorithm, the QDScore, and used it on just over half a million electronic records to identify high risk groups. QDScore is validated based on certain risk factors. For example, deprivation, body mass index, and certain ethnicities result in a higher score.   more…

The 1920s and 1930s was an era of social and political revolution, and a switch of attitude on public health was indicative of the changing approach to public policy. The Wellcome Collection currently has an exhibition of cinematic work released by Bermondsey Borough Council’s public health department, which showcases the changed ideology on health provision in the 1920s. The borough created a number of short, silent, and informative films, screened for free in the open air on streets and other public domains, in an attempt to improve the health and wellbeing of the voting population. more…

The Lancet, the leading journal for global health, has mentioned feminism only twice in its 189 years . The BMJ hasn’t mentioned it at all. So that looks like some evidence that feminism has had no impact on global health, but all three speakers at a meeting at the London School of Hygiene and Tropical Medicine this week strongly disagreed.

(Ironically this paragraph illustrates the superiority of women over men. Richard Horton, editor of the Lancet and a man, told us that the Lancet had mentioned feminism only twice, and Tony Delamothe, deputy editor of the BMJ and another man, told me that the BMJ had no entries. I, a third man, didn’t check, but Jane Smith, another deputy editor of the BMJ and a woman, did. She found that the BMJ has had 102 mentions of “feminism” and 302 mentions of “feminist” and the Lancet has 23 mentions mentions of “feminism” but none of “feminist.” Thank God for women.)

One reason that the journals might not have mentioned it is because “feminism” is a taboo word within academic medicine, said Richard Horton, editor of the Lancet. Lori Heise, one of the speakers and a senior lecturer at the London School, said how she had to think carefully before “coming out” as a feminist. more…

What have marketing public health messages and marketing for alcohol and fast food corporations, such as KFC and Diageo got in common? The answer in the UK is Freud PR— a “strategic marketing and communications consultancy for consumer brands, public sector bodies and global corporations.”

The £1million a year contract from the Department of Health has been handed to Freud PR, which is largely owned by Matthew Freud—the husband of Elisabeth Murdoch, who is daughter of media tycoon Rupert—after a formal and “pretty robust” tendering process. more…

Last month we drew attention to three critical pieces of data that painted a picture of the piece by piece dismantling of the public health specialist workforce. Consultant appointment processes have dropped considerably in the last three years, registrars at end of training are failing to get substantive full time consultant posts, and academic public health seems to be declining. 

What’s really behind this is not clear, but findings in an important paper in this month’s Journal of Public Health continue to show this is a real stealth attack on the public health specialist workforce, and not just disparate pieces of unconnected information. Harrell and colleagues present a scholarly piece of research directly comparing recruitment in public health to that of hospital consultants.  more…

Wide gaps in life expectancy in the UK by social background have been widely recognised in recent years. With the current state of the economy, the scaling back of public services, and risks caused by fragmentation of the NHS, the elusive solutions to these complex problems may seem even harder to find.

Under the previous Labour Government, there were of course health inequalities targets–reducing inequalities in life expectancy and infant mortality. But alongside these were a range of policies targeting wider inequalities; the social determinants of health. Perhaps the most significant of these was the goal, established by Tony Blair, “to eradicate child poverty in a generation.” The pledge was a catalyst for a decade of investment and innovation, and ended just before the 2010 general election with all three main parties supporting the Child Poverty Act, a statutory commitment to work towards ending child poverty by 2020. In our new report “Decent Childhoods – Reframing the fight to end child poverty” – we review the approach under Labour, and, reflecting on its strengths, and weakness, suggest a route forward. more…

It is a typical busy, Thursday afternoon in the office in central London, as I recall the mental note I made to myself earlier that day: ring GP practice to arrange anti-malarial prescription. I am going to Nigeria on Monday and have resolved to make sure that I take my malaria prophylaxis rigorously this time.

I have not always been so scrupulous about taking these drugs on my regular visits home to Nigeria. Ten years ago, I came to the UK to study at the London School of Hygiene & Tropical
Medicine learning in great detail the science behind the need for prophylaxis and seeing first hand at the Hospital for Tropical Diseases the tragic consequences of not taking it. And yet, for those first few years, whenever I went back to Nigeria, I did not take any preventive medication. more…

Obesity, and its control, is high on the public health agenda. Recently the Lancet published a series of important papers on the science and social science of obesity and its prevention. According to conservative estimates the projected obesity trends in the UK to 2030 imply 5,450,000 new cases of diabetes, 330,000 cases of coronary heart disease and stroke, and 87,000 cancers leading to an overall loss of 2.2 million quality adjusted life years in the population, all this costing almost £2bn per annum extra in health service costs. more…