Qualitative Analysis Following the Delivery of a Farmer Lifestyle Program.

BACKGROUND: Irish farmers are adversely affected by noncommunicable diseases. Although there has been an increase in farmer health promotion activities in Ireland, farmers views on lifestyle programs are currently unknown. OBJECTIVES: To qualitatively analyze the impact of the previously mentioned 6-week physical activity and health education intervention on farmer health and to investigate how best to support this cohort moving forward. METHODS: A qualitative study was conducted online (two interviews, three focus groups) with fourteen Irish farmers (53.5 ± 6.5 years) who completed the 6-week program in December 2019. Interviews and focus groups were recorded, transcribed, and analyzed for themes. RESULTS: The main themes that emerged from this study were barriers, facilitators, and recommendations for lifestyle programs aimed to improve farmer health. Additional views on health and lifestyle behaviors were mentioned. Time of year was reported as the main barrier for farmers to engage in lifestyle programs. The key facilitators reported by farmers were the social health benefits obtained from the program and the farmer-specific nature of the program. Farmers suggested that physical activity and health education programs that are farmer-specific, delivered locally and catering for all fitness abilities should be more widely available to them. Although some farmers reported that they maintained the lifestyle behaviors they established during the initial 6-week program, follow-up supports are needed to encourage sustainable behavior change. CONCLUSIONS: Interventions that are farmer-specific, community-based, and feasible within the context of available resources may be effective in improving farmer health. Working in partnership with organizations that support farmers has the potential to improve farmer health.

Future trends in social inequalities in obesity in England, Wales and Scotland.

BACKGROUND: Previous studies have shown persistent or increasing socioeconomic inequalities in obesity in many European countries. The aim of this study was to project trends in social inequalities in obesity to 2035 in male and female adults (aged 16+) in the UK to ascertain if the gap is widening or narrowing. METHODOLOGY: BMI data for the UK were extracted from the Health Survey for England (2004-14), Scottish Health Survey (2008-14) and the Welsh Health Survey (2004-14), respectively. A non-linear multivariate regression model was fitted to cross-sectional risk factor data to create longitudinal projections to 2035 stratified by sex, and occupational status or education level. RESULTS: Individuals in routine and manual jobs are projected to have the highest prevalence of obesity by 2035 and to experience the highest increases in obesity prevalence to 2035. Social inequalities based on occupation are projected to widen (except in English females). Social inequalities based on education are projected to decrease (except in Welsh females). DISCUSSION: A population strategy of prevention focused on the structural determinants of obesity is needed to change the trajectory of obesity prevalence trends and to tackle health inequalities.

Application of the UK foresight obesity model in Ireland: the health and economic consequences of projected obesity trends in Ireland.

BACKGROUND: Given the scale of the current obesity epidemic and associated health consequences there has been increasing concern about the economic burden placed on society in terms of direct healthcare costs and indirect societal costs. In the Republic of Ireland these costs were estimated at €1.13 billion for 2009. The total direct healthcare costs for six major obesity related conditions (coronary heart disease & stroke, cancer, hypertension, type 2 diabetes and knee osteoarthritis) in the same year were estimated at €2.55 billion. The aim of this research is to project disease burden and direct healthcare costs for these conditions in Ireland to 2030 using the established model developed by the Health Forum (UK) for the Foresight: Tackling Obesities project. METHODOLOGY: Routine data sources were used to derive incidence, prevalence, mortality and survival for six conditions as inputs for the model. The model utilises a two stage modelling process to predict future BMI rates, disease prevalence and costs. Stage 1 employs a non-linear multivariate regression model to project BMI trends; stage 2 employs a microsimulation approach to produce longitudinal projections and test the impact of interventions upon future incidence of obesity-related disease. RESULTS: Overweight and obesity are projected to reach levels of 89% and 85% in males and females respectively by 2030. This will result in an increase in the obesity related prevalence of CHD & stroke by 97%, cancers by 61% and type 2 diabetes by 21%. The direct healthcare costs associated with these increases will amount to €5.4 billion by 2030. A 5% reduction in population BMI levels by 2030 is projected to result in €495 million less being spent in obesity-related direct healthcare costs over twenty years. DISCUSSION: These findings have significant implications for policy, highlighting the need for effective strategies to prevent this avoidable health and economic burden.