Wednesday, 4 December 2013

Malnutrition and public health - it's not austerity that's the problem


Some "Doctors" have written a letter to the British Medical Journal expressing concerns about malnutrition:

In a letter to the British Medical Journal, David Taylor-Robinson from the University of Liverpool and six other academics warn: "This has all the signs of a public health emergency that could go unrecognised until it is too late to take preventive action."

They say they are particularly worried about the number of children with malnutrition because it can cause cardiovascular and other chronic diseases in adulthood.

And the newspapers and broadcasters lap it up without asking some simple questions - ones like "how many cases of child malnutrition are there?"

To help them, here are the figures from an answer to a Parliamentary question  - in 2008/9 there were 201 cases of children admitted to hospital where  the primary or secondary diagnosis was malnutrition. In 2012/13 this figure had soared to 205 admissions.

There is absolutely no evidence at all - other than anecdotes from teachers - to support the contention that child malnutrition is rising. The thing that should concern us is malnutrition among the elderly because this has risen significantly. The question is why?

Here's one stab at assessment that followed a report in The Independent earlier this month:

People with certain long-term health conditions can't always retain all the nutrients they need - particularly the elderly, who might also struggle to make the trip to the supermarket. With this in mind, the higher incidence of malnutrition might also reflect broader demographic trends, including the fact that the UK's population is ageing. The most recent Nutrition Screening Survey showed that those aged 65 plus were more likely to be malnourished than those who were younger. In addition, it may also be that hospitals are now more likely to screen a patient for symptoms of malnourishment. 

The reasons for increased malnourishment may be entirely unrelated to the current economic climate. Since the elderly are largely protected from the impact of welfare reform and make up the overwhelming majority of malnutrition cases, we should perhaps look elsewhere for the causes of the problem. There may be consequences from 'austerity' - reductions in social care visits, for example - that impact on the elderly eating properly but equally the rise may be a simple reflection of people living longer.

All this may not suit the political agenda of the people writing to the BMJ but we should perhaps pay more attention to the real challenges rather than write ill-researched and polemical letters that serve only to misdirect (and get a nice headline).


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