Chapter 10: Strengthen the role and impact of ill-health prevention
Impact of the pandemic on self care and healthy behaviours
The focus of ill-health prevention has had to shift to tackling Covid since early 2020.
The pandemic has significantly disrupted the daily routines of citizens, with the requirement to stay at home and avoid close contact with others.
Conditions in key social determinants of health have deteriorated and COVID-19 containment measures appear to have resulted in some changes to health behaviours such as smoking and diet choices, increasing inequalities and causing concerning deteriorations in mental health.
In a Gateshead Council survey, in February/March 2021, nearly two thirds of residents said that their health and wellbeing has got worse during the pandemic.
During lockdowns and with a more sedentary lifestyle for those working from home, eating and exercise habits have changed for some. According to Public Health England research, four in 10 (41%) adults in England say they have put on weight since the first lockdown in March 2020. Almost over half a stone (4.1kg) was gained on average by those who put on weight, with one in five (21%) reporting putting on a stone or more. (Gov.uk (26 July 2020) Press release: Campaign launched to help public get healthy this summer). Exercise and positive mental health are also linked.
"So suddenly being captive in front of the TV, I think I've worn the carpet out to the fridge you know. TV, fridge, TV, fridge. And you don't realise you're doing it until you've got this great welt of fat around your middle and you think oh god, where did that sneak up?"
"So, I know with the Tai Chi that my back is going to feel better after that. And when I do Dancercise, I feel energised. And because I feel energised, I feel motivated to do other things and I feel capable."
Participants, Gateshead Older People's Assembly
Another side-effect of the pandemic has been impacts on dietary habits. With most people stuck at home and children absent from school, there are concerns that sugar consumption and snacking behaviours increased. We know that the main cause of tooth decay is the frequent consumption of sugary foods and drinks, so it is likely that we will see the effects of this in people's oral health in the future.
Lorenzo Iafrate, Dental Core Trainee 3 in Dental Public Health and Dr Rhiannon O'Connor, Specialty Trainee in Dental Public Health
There has also been a change in smoking behaviours.
During lockdown we saw an increase in the number of young people starting smoking but there were also increases in the number of existing smokers making quit attempts which has kept our smoking rates stable. National lockdowns severely affected the provision of local stop smoking services; however, our providers have worked extremely hard to adapt their ways of working and continue to provide support to smokers who need it.
Gemma King, Public Health Programme Lead, Gateshead Council
In a survey of families and friends of someone with an alcohol, drug or gambling problem, nearly half (42%) said that their family members' alcohol, drug use, or gambling has increased during lockdown. (Addiction (2020) Families in Lockdown (opens new window) The effects of the Covid-19 lockdown on the family and friends of someone with an alcohol, drug or gambling problem)
The UK was already at crisis point with alcohol long before Covid, but the pandemic saw a tipping point. Cheap alcohol together with the terrible anxieties of Covid created a 'perfect storm' which resulted in millions more drinking at risky levels, problems for families and heavy use turning into dependency. In the North East alone, around 855,000 adults and 60% of male drinkers were drinking above low risk limits during 2020 and nearly one in four heavier drinkers ended up drinking more. Deaths from alcoholic liver disease increased by a staggering 20.8% during the Covid-19 pandemic, by far the highest yearly increase on record - fuelled by rising consumption of wine and spirits; and the North East suffered the most, with the biggest increase in alcohol specific deaths, particularly in the most deprived groups of the population.
It is clear that people in Gateshead recognise the serious problems associated with alcohol and there is strong support for more national action to tackle alcohol harms in our communities.
We believe that the Government needs to introduce an evidence-based alcohol strategy, which tackles the cheapest strongest alcohol, restricts promotion and availability and funds treatment, to bring an end to the rising burden of alcohol-harm and death.
Sue Taylor, Head of Alcohol Policy, Fresh and Balance
"I found home-schooling really hard, being a parent and a teacher. I used alcohol more. I live with my mam so when my mental health was bad, I couldn't talk about it because I didn't want to worry her."
Service user, Tyneside Women's Health
We can evidence a link between substance misuse and mental wellbeing. The impact of COVID-19 has seen a significant increase in the amount of people referring into substance misuse services, this has been for a range of substances used. Data would identify that alcohol and non-opiate referrals are the substances which have seen the most significant increase. Regular communication with our mental health colleagues would suggest other providers may have also seen an increase in referrals.
Sarah Beat, Service Manager, Gateshead Recovery Partnership
Service users have continued to receive support throughout the pandemic, although the way services have operated has had to change.
I'm a Geordie, an addict and living with HIV in Dunston. I know how it feels to be full of fear about a deadly virus; worried you could catch it, die from it, infect someone else and possibly kill them too. Fortunately, Gateshead Recovery Partnership helped me address my addiction issues in 2019 and Sexual Health services helped me clear the Hep C and get the HIV back under control (Undetectable, hence Uninfectious). I also found connection through 12-Step anonymous fellowships and HIV support groups.
At the start of the Covid-19 pandemic in 2020, I was terrified of catching another deadly virus and of the prospect of being isolated in my home again (where the worst of my drug addiction had taken place). But I had learnt to fight fear with faith, place trust in others for help, practice patience, find acceptance and follow suggestions (including Public Health guidelines).
The response from all the organisations supporting me was incredible. Telephone consultations with my GP Surgery, HIV Clinic, Psychotherapist and home delivery of medication kept me safe and well. Gateshead Recovery Partnership, Blue Sky Trust, Crisis Skylight and Narcotics Anonymous switched to online support groups I could attend from the comfort of my own living room. I suddenly found connection all around the world with other human beings with shared experiences, giving each other strength and hope. Food bank home deliveries were also greatly appreciated. And I got to talk to neighbours more from a safe distance over the garden fence. I even had the godsend of a local cat that started hanging about for company.