It’s a barometer of the nation’s health

On 12 July,2022 | In Features

When Bupa was founded in 1947, no one could have anticipated just how much the healthcare landscape would evolve by the time it reached its 75th anniversary this year. But, just as in the post-war period when the insurer was created, clinicians once again face the challenge of finding ways to improve the nation’s health.

Dr Robin Clark, medical director for Bupa Global and UK, explains how Bupa is embarking on the first step towards this with the launch of its new Wellbeing Index

Ageing populations, huge leaps in science, digital technologies, not to mention consumerism and national mobility, have had a dramatic impact on our health and well-being.

Then came the biggest global health and societal challenge of a generation – the Covid-19 pandemic – which has dominated the lives of countries and communities around the world for the past two years, changing the way
we live, interact and decide our priorities.

While it now appears that the most intensive phase of the pandemic may now be behind us, its profound and ongoing impact on our mental and physical health, as well as how we view healthcare, will influence our way of life for many years to come.

Much may have changed since 1947; however, this new post-pandemic era has many parallels with the period when Bupa was founded. In 1947, the nation was also scarred – both physically and mentally – from the after-effects of World War II.

However, this created a renewed focus on the importance of providing good healthcare and finding ways to improve the nation’s health, which led to the creation of both the NHS and Bupa.

The Bupa Wellbeing Index

From the beginning, Bupa has been driven by a passion to pioneer, promote and improve healthcare. So as we emerge from seismic changes to our industry, we are launching the Bupa Wellbeing Index, which will prove a useful tool for all of us working in the healthcare sector.

Carried out by Censuswide, this rolling dataset will track five key health and well-being metrics for 8,000 UK adults each quarter, capturing a range of health, well-being, lifestyle and behaviour datapoints to help us and our healthcare partners understand more about the nation’s health.

As the Bupa Wellbeing Index builds quarter by quarter, it will create an in-depth data driven barometer of health and well-being in the UK, exploring how the pandemic has impacted us and shifted our expectations of healthcare.

The survey population is split by demographics, including sex, age and geographic location, which enables us to explore key trends and spotlight where there are potential issues, so that we can continue to design and deliver healthcare in the most impactful way.

It’s important that we take stock of the current landscape so that we know the challenges we are facing and where there are opportunities for improvement.

So our first Wellbeing Index explores the pandemic’s impact on the nation’s health, as well as looking at how attitudes and expectations towards health and well-being are changing, what this means for the future and the steps individuals are taking for more ownership of their health.

Benchmarking the barometer baselines

Physical health

Lockdowns during the pandemic meant many people in the UK had to adjust to homebound lifestyles, the abrupt disappearance of their commutes and a drastic increase in time spent sitting.

For some people, Covid-19 was a wake-up call to improve their diet and fitness; they became more active and cut back on alcohol. Others experienced the opposite effect: a shift to a more sedentary lifestyle led them to struggle with weight gain or become more dependent on alcohol.

Compared to 2019, for instance, there has been a 20% increase in alcohol-related deaths and a 21% increase in deaths from alcoholic liver disease.¹

The impact of the Covid-19 pandemic is clear from our Wellbeing Index data, which was collected between 18 and 24 March 2022. Only 51% of respondents rated their physical health positively, with 14% reporting very good health and 37% saying their health was ‘somewhat’ good.

As you would expect, these scores decline with age. People aged 16 to 24 were the most likely to say they enjoyed very good health (18%) and the over-65s were the least likely (11%).

When asked what worried them most about their personal health and well-being, respondents reported that their weight was the biggest worry (33%), followed by mental health problems (24%); back pain, joint problems and other musculoskeletal issues (23%) and fitness levels generally (21%).

While people were unwilling or unable to access healthcare during the pandemic, the research found that 54% of those surveyed had interacted with a healthcare provider in the three months before taking part in the survey.

Missed appointments

Dental treatment or advice was most commonly accessed (13%), but it’s unlikely this had much impact on the backlog of people needing treatment. Our data suggests the effects of missed appointments may already be emerging, as 6% reported a dental emergency and 7% had undergone an extraction.

One-in-ten women (10%) also sought medical help for female-specific issues around menopause, endometriosis and menstruation, yet despite the challenges around menopause, which every woman will experience, uptake was relatively uniformly spread.

With increased awareness over the last few years following a number of high-profile campaigns, menopause issues are gaining visibility. To help boost support for women’s well-being, last year we launched the Menopause Healthline, a helpline for customers and employees. It offers access to menopause-trained nurses for advice and guidance on managing symptoms.

Our Health Clinics offer a Menopause Plan, which gives women access to primary care for symptoms through specially trained GPs.

And our Women’s Health Hub at www.bupa.co.uk/womens-health gives all women access to advice and guidance from resident health experts on topics spanning menopause and endometriosis to periods and fertility, whether or not they are Bupa customers.

The mental health impact

The Bupa Wellbeing Index found that people’s perceptions of their mental health were more positive, with almost a quarter (22%) saying their psychological health was very good, and a third (32%) rating it somewhat good.

However the correlation with age is reversed for this metric –older adults were far more positive, with 38% of over-65s reporting very good mental health, more than twice the number of 16- to 24-year-olds (14%).

It’s clear the pandemic had a more severe impact on the mental health of younger adults and women, a demographic who were already more likely to be struggling.²

Only 48% of women gave positive scores for their mental health, compared to 61% of men, and 28% of men describe their mental health as very good, almost twice the number of women (15%).

Family and caring responsibilities, as well as social factors, may have played a role in this. The Index found that women were more likely to be managing housework and childcare during the lockdown than men and there is evidence of an association between these adjustments and psychological distress.³

This is echoed by a poll of 1,030 UK mothers with children between the ages of 0 and 16 years carried out for us by Censuswide in January 2022. It found that 63% of the mums surveyed said that they have driven themselves to exhaustion with the pressure to be a ‘supermum’: one who successfully manages a home and raises children while working full time.

Driven by a fear of judgement and people seeing their imperfections, 31% of mums said it made them put on a facade of coping to appear infallible and 43% agree they struggle to ask even their partner for support.

Although 29% of the mums surveyed said they have sought help from a medical professional for mental health concerns, they kept it a secret from their loved ones.

Similarly, only 37% of 16- to 24-year-olds and 49% of 25- to 34-year-olds assessed their mental health as very or somewhat good, while three out of five (59%) 55- to 64-year-olds and almost three-quarters of over-65s (73%) were upbeat about their mental health.

Most robust

Over-65s reported the most robust mental health (38% stating very good), followed by 55- to 64-year-olds (26% stating very good) while Gen Z and the Sandwich Generation, who are juggling caring for parents and children, were the least likely to say their mental health was very good (14%).

Overall, 6% had begun counselling for a mental health condition, but there is a sharp gender divide, with 8% of women having started taking therapy sessions compared to 4% of men. This was mirrored in the statistics for those starting a prescription for a mental health condition.

Understanding how mental health conditions manifest themselves is key in being able to effectively identify when a patient may need some support, not least because people may be reticent about raising mental health issues.

At Bupa we offer a range of support and our health information is available for both customers and non-customers. Visit: www.bupa.co.uk/health-information/mental-health.

The good news

While the findings of our first Wellbeing Index paint a mixed picture in terms of the pandemic’s impact on the nation’s health, we know that many diseases can be preventable if patients follow optimal health behaviours.

The good news is that our data shows people are taking a more proactive approach to their health – 11% of those surveyed had undergone a health assessment, and this climbed to 15% in the 16 to 24-year-old age group.

A further 10% had started a new prescription for a health condition – and, unexpectedly, this was also slightly more common in the younger age groups.

There are a number of reasons why this might be: The prescriptions might be preventative and already improving respondents’ mental or physical health. For example, effective medication may lead someone to rate their mental health highly. Even the act of taking steps to improve health by getting a prescription could account for this.

Younger respondents might also be including prescriptions for skin conditions, allergies or contraception in their responses, all of these don’t necessarily mean ill physical health.

And finally, they will be more likely to have started a new prescription, as older respondents will likely already be on a repeat prescription.

We now need to build on this to reach those most at need of intervention. In these cases, it will be key for healthcare providers to embrace behaviour change techniques to encourage patients to make the healthier choices necessary to improve their overall quality of life and future health outcomes.

 In our next issue, Dr Clark (right) digs deeper into what this means for the future and the challenge for healthcare professionals trying to turn around the impact of the pandemic.

References

See ‘What Bupa is doing to go green’