Study reveals alarming rates of postpartum depression among mothers in six countries

 

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By Vijay Kumar MalesuMay 19 2024Reviewed by Benedette Cuffari, M.Sc.

In a recent study published in the journal BMC Public Health, researchers determined the frequency of postpartum depression (PPD). They identified associated predictors and coping strategies among mothers in six countries from June to August 2023.

Study: Exploring predictors and prevalence of postpartum depression among mothers: Multinational study.

 Image Credit: KieferPix / Shutterstock.com

What is PPD?

PPD is a prevalent mental health issue that affects about 10% of women after childbirth, with some studies suggesting up to one in seven women are affected. PPD can develop within the first year postpartum and persist for several years, thus significantly differing from the short-term "baby blues" many mothers experience.

PPD often goes undiagnosed, with around 50% of cases unrecognized. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PPD include mood instability, sleep disturbances, and suicidal ideation.

Some factors that influence the development of PPD include marital status, social support, and unplanned pregnancy. Nevertheless, additional research is needed to better understand the varying prevalence, risk factors, and effective interventions for PPD across different cultural and demographic contexts.

About the study

The present analytical cross-sectional study involved 674 mothers from Egypt, Ghana, India, Syria, Yemen, and Iraq during the childbearing period. Conducted from June to August 2023, the current study included mothers who gave birth within the previous 18 months, were citizens of one of the targeted countries, and were between 18 and 40.

Exclusion criteria included multiple pregnancies, illiteracy, serious health issues in the baby, stillbirth or intrauterine fetal death, and mothers with medical, mental, or psychological disorders interfering with questionnaire completion. Mothers who could not access or use the internet and those who could not read or speak Arabic or English were also excluded.

Study participants were recruited using a multistage approach. Two governorates were selected from each country, with one rural and one urban area identified from each governorate. Mothers were surveyed through online platforms and public locations such as well-baby clinics, Primary Health Centers (PHCs), and family planning units. All study participants completed the questionnaire using tablets or cell phones provided by data collectors or scanning a Quick Response (QR) code.

The questionnaire, initially developed in English and translated into Arabic, was validated by healthcare experts and tested for clarity and comprehensibility in a pilot study. The final questionnaire included sections on demographic and health-related factors, obstetric history, PPD assessment using the Edinburgh Postnatal Depression Scale (EPDS), and psychological and social characteristics.

Study findings 

The frequency of PPD in the total sample using the Edinburgh 10-question scale was 13.5%; however, this prevalence significantly varies across countries. PPD was highest among mothers in Ghana at 26.0%, followed by India, Egypt, Yemen, Iraq, and Syria at 21.7%, 19.1%, 8.5%, 7.7%, and 2.3%, respectively.

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The current study included 674 participants, with a median age of 27, 60.3% of whom were between 25 and 40. About 96% of study participants were married, whereas 67% had sufficient monthly income and at least a high school education.

Health-related factors revealed that 40% of the study cohort smoked, 95.7% did not smoke, 54.2% received the coronavirus disease 2019 (COVID-19) vaccine, and 44.1% had previously contracted COVID-19. About 83% of the study cohort were not diagnosed with any comorbidities, whereas 92.4% did not have any history of psychiatric illness or family history.

PPD was significantly higher among single or widowed women at 56.3%, whereas 66.7% of PPD cases occurred in mothers with medical, mental, or psychological problems, and 35.7% reported previous cigarette smoking habits or alcohol use. Mothers charged for their own healthcare services had higher PPD rates.

Most mothers were not on hormonal treatment or contraceptive pills, with 46.1% experiencing unplanned pregnancies and 68.6% gaining 10 kg or more during pregnancy. About 61% of the study participants delivered vaginally, whereas 90.9% and 48.2% of mothers had healthy babies and were breastfeeding, respectively.

There was a significant association between PPD and mothers on contraceptive methods, those with one or two live births, and those with interpregnancy spaces of less than two years. Additionally, mothers with a history of dead children and those who experienced postnatal problems had higher PPD rates. About 75% of mothers were unaware of PPD symptoms, with 35.3% experiencing cultural stigma or judgment. Only 6.2% of affected women were diagnosed with PPD and prescribed medication.

Mothers with PPD often had a history of PPD, financial and marital problems, and cultural stigma. Despite receiving more support, 43.3%, 45.5%, 48.4%, and 70% of mothers felt uncomfortable discussing mental health with physicians, husbands, family, and their community, respectively.

Social norms, cultural beliefs, personal barriers, geographical disparities, language barriers, and financial constraints were among the causes of not receiving treatment, which was reported among 65.7%, 60.5%, 56.5%, 48.5%, 47.4%, and 39.7% of mothers, respectively. Logistic regression analysis identified several significant PPD predictors, including marital status, infant health, postnatal problems, nationality, pregnancy status, and psychological factors.

Journal reference:

• Amer, S. A., Zaitoun, N. A., Abdelsalam, H. A., et al. (2024). Exploring predictors and prevalence of postpartum depression among mothers: Multinational study. BMC Public Health. doi:10.1186/s12889-024-18502-0 

Full List of California Weed Recalls as Warning of Deadly Mold Issued

Published May 20, 2024 
By Matthew Impelli
Writer 
 Since th e start of this year, there have been several different weed recalls in California by the state's Department of Cannabis Control (DCC) for possible contamination of Aspergillus, a fungus that can grow on cannabis plants.

According to the Cannabis Science and Technology website, Aspergillus is a fungus that can grow on many different plants, including cannabis. Cannabis Science and Technology focuses on educating members of the cannabis community on "science and technology of analytical testing, quality control/quality assurance, cultivation, extraction, and processing/manufacturing."

"If cannabis is grown or stored in conditions that are conducive to mold growth, such as high humidity or improper drying and curing processes, it can provide an environment for Aspergillus to thrive," its website reads.

Newsweek has created a list of the 13 different products that were recalled for the contamination of Aspergillus from January 10 to May 17.

Marijuana plants are seen in Desert Hot Springs, California. Since the start of this year, there have been several different weed recalls in California by the state's Department of Cannabis Control.

ROBYN BECK/AFP VIA GETTY IMAGES/GETTY IMAGES

Recalls:

May 17: Lax Packs Premium Flower
May 6: Canndescent California 100% Whole Flower Pre-rolls
April 25: C-Creme Infused Pre-roll
April 19: 8 Track 1.0 Gram Pre-roll
April 9: Tyson Undisputed Cannabis Flower
March 25: UPNORTH 3.5 gram flower
March 20: Almora 14 half gram pre-rolls
March 11: JC Rad Flower
March 11: Passiflora Premium Flower
March 1: Grizzly Peak Premium Indoor Flower
February 21: LOWELL BIG BUDS Blueberry Kush Indica
February 21: Roundtrip Pistachio Flower
January 10: Gelato Orangeade hybrid

Earlier this month, the California DCC announced the recall for the Canndescent California 100% Whole Flower Pre-rolls "due to the presence of Aspergillus spp. and due to inaccurate labeling that reports more cannabinoid content than the product contains."

Consumers who purchased this product and other recalled products because of Aspergillus are encouraged to contact their physician if they are experiencing any symptoms. They are also told to check their package numbers and if they match to the recalled product, they should discard the product or return it to the retailer.

Newsweek has reached out to the California DCC via email for comment.

According to Cannabis Science and Technology, Aspergillus can pose health risks to consumers who use products that are contaminated with the fungus. Those with weakened immune systems and respiratory issues can face even higher risks.

"The issue with fungus spores and cannabis is when its spores are introduced into the lungs, for example, by smoking and inhaling contaminated product," its website states.

There are currently 24 U.S. states that allow the use of recreational marijuana, and 38 states permit its use in the medical context. As per the U.S. Drug Enforcement Administration (DEA), marijuana remains a Schedule I substance, in the same class as other drugs such as heroin, ecstasy and LSD.

However, the DEA recently announced plans to "reclassify marijuana from a Schedule 1 drug to a Schedule 3 drug," which would be considered on the same classification as drugs like Tylenol with codeine, ketamine and anabolic steroids, once its proposal has been reviewed by the White House Office of Management and Budget.

 

Tobacco corporation attempts to gain public trust in its science are having success – new research

Philip Morris International gains trust in industry-funded science by posing as a generous supporter and concealing its involvement through third parties

UNIVERSITY OF BATH

A new study suggests that the tobacco company Philip Morris International (PMI), is successfully increasing public trust in industry-funded science by portraying itself as a generous supporter of scientific research while simultaneously concealing its involvement through third parties.

The paper, published in Frontiers in Communication, was co-authored by researchers in the Tobacco Control Research Group (TCRG) at the University of Bath, University of Colorado and University of Bristol.

In 2017, whilst publicly proclaiming itself to have transformed into a transparent organisation funding robust science, tobacco producer Philip Morris International (PMI) launched a new scientific organisation: the Foundation for a Smoke-Free World (FSFW). On 13th May 2024, FSFW rebranded itself Global Action to End Smoking.

The new study aimed to understand the extent to which the public trusts PMI’s involvement in science, and whether channelling funds through the third-party organisation, FSFW, affected levels of trust in its science. 1,580 UK residents were asked to rate their level of trust in: PMI, FSFW, or Cancer Research UK (CRUK), on a scale from 1 (no trust) to 7 (complete trust). CRUK was selected as a control group as a highly trusted scientific organisation, wholly independent from the tobacco industry.

Key Findings:

• Overall trust in PMI was 4.66 on a scale from 1 (no trust) to 7 (complete trust), compared to 5.79 out of 7 in Cancer Research UK, indicating moderate trust in PMI's scientific endeavours.

• Overall trust for FSFW was 5.04 out of 7. After participants were informed that FSFW is funded by the tobacco industry, the overall trust rating dropped to 4.77 out of 7. This suggests that when research is funded through a third-party scientific group such as FSFW, people are more likely to trust the science that emanates.

Dr Tess Legg, Research Associate from the University of Bath’s Department for Health and lead author of the paper, said:

“This work is important because tobacco companies use their involvement in science as ‘proof’ that they are credible research organisations. They also funnel research funds through third-party companies and historically this has involved attempts to obscure their involvement in the resulting science.”

Up until now, there has been no clear understanding of whether – and to what extent – these two strategies work to build trust in the industry and its science. This study is the first in the UK to try to gain quantitative evidence of how effective these tactics are at making people trust the tobacco industry and its science.

The study's authors warn against the ongoing acceptance of tobacco industry funding and dissemination of scientific findings. They call for increased efforts to educate the public about the subtle yet harmful tactics employed by these industries. Dr Legg notes:

“As it stands, FSFW still has an immense amount of money from PMI at its disposal and so the risk of it continuing to further the industry’s interests is high. Our findings suggest that more needs to be done by the tobacco control and public health communities to help the UK public understand how underhand the tobacco industry’s attempts to rebrand really are, and to stop scientific front groups from muddying the water by lending the industry an air of credibility.

While the findings don’t make particularly happy reading for those of us working to counter the tactics used by the tobacco industry, it’s important to build up a quantitative picture of the effects the strategies used by industries to influence science are having.

Beyond this, at a time when the tobacco industry continues its abhorrent attempts to infiltrate science as part of its ‘pseudo-transformation’, we need to focus efforts on reforming science to ensure it works in the public interest.”

This work builds on TCRG’s previous work mapping the tactics that the tobacco industry (and other industries) use to influence science. It also builds on the group’s work on the FSFW which has demonstrated that the tobacco industry continues its attempts to influence the evidence base on its products and paint itself as a credible partner in science.

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JOURNAL

Frontiers in Communication

ARTICLE TITLE

The UK public’s trust in tobacco industry involvement in science – an experimental survey

Link between e-cigarette use and early age of asthma onset in US adults found through UTHealth Houston research

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

 

IMAGE: 

ADRIANA PÉREZ, PHD, MS, PROFESSOR OF BIOSTATISTICS AND DATA SCIENCE AT UTHEALTH HOUSTON SCHOOL OF PUBLIC HEALTH, FOUND A CONNECTION BETWEEN THE USE OF ELECTRONIC CIGARETTES AND EARLIER AGE OF ASTHMA ONSET.

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CREDIT: UTHEALTH HOUSTON

A significant link between the use of electronic cigarettes and earlier age of asthma onset in U.S. adults was reported by UTHealth Houston researchers May 17, 2024 in the Journal of the American Medical Association (JAMA) Network Open.

Led by first author Adriana Pérez, PhD, MS, professor of biostatistics and data science at UTHealth Houston School of Public Health, the research found that adults who were asthma-free at the beginning of the study and reported e-cigarette use in the past 30 days increased their risk of developing earlier age of asthma onset by 252%.

“While previous studies have reported that e-cigarette use increases the risk of asthma, our study was the first to examine the age of asthma onset,” said Pérez, who is also with the Michael and Susan Dell Center for Healthy Living at the School of Public Health. “Measuring the potential risk of earlier age of asthma onset as it relates to past 30-day e-cigarette use may help people from starting use or motivate them to stop.” 

The study team analyzed secondary data from the Population Assessment of Tobacco and Health Study, a national longitudinal study of tobacco use and how it affects the health of adults and youths in the U.S.

“The findings of the study underscore the need for further research, particularly regarding the impact of e-cigarette use on youth and its association with early age of asthma onset and other respiratory conditions,” Pérez said. “It also highlights the importance of modifying screening guidelines to incorporate recent use of e-cigarettes, which could lead to earlier detection and treatment of asthma, reducing the morbidity and mortality associated with the disease.”

Pérez said the study highlights the need to address the health burden of asthma, which results in $300 billion in annual losses due to missed school or workdays, mortality, and medical costs according to the Centers for Disease Control and Prevention. Tobacco regulations, prevention, intervention campaigns, and cessation programs are needed to prevent early age of asthma onset due to e-cigarette use, the authors wrote.

Melissa B. Harrell, PhD, MPH, professor of epidemiology at the school, was senior author. Co-authors from UTHealth Houston included Pushan P. Jani, MD, MSc, associate professor of pulmonology in the Department of Internal Medicine at McGovern Medical School at UTHealth Houston, and Sarah Valencia, MS, statistician at the Michael and Susan Dell Center for Healthy Living.

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JOURNAL

JAMA Network Open

DOI

10.1001/jamanetworkopen.2024.10740 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Use of Electronic Nicotine Delivery Systems and Age of Asthma Onset Among US Adults and Youths

ARTICLE PUBLICATION DATE

17-May-2024

COI STATEMENT

Dr Harrell reported receiving personal fees from the state of Minnesota for serving as an expert witness in litigation that the state of Minnesota brought against JUUL and Altria outside the submitted work. No other disclosures were reported.

 

First US trial of varenicline for e-cigarette cessation shows positive results

MEDICAL UNIVERSITY OF SOUTH CAROLINA

 

IMAGE: 

DRS. BENJAMIN TOLL, LISA FUCITO AND COLLEAGUES DEVELOPED A STUDY TO MIMIC REAL-WORLD CONDITIONS OF PEOPLE TRYING TO STOP USING E-CIGARETTES BY USING VARENICLINE. 

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CREDIT: LISA FUCITO

The first U.S. trial of varenicline for e-cigarette cessation shows promising results and warrants larger-scale trials, the researchers say.  

Researchers from Yale Cancer Center and MUSC Hollings Cancer Center published the results of their clinical trial of varenicline to help adults to stop using e-cigarettes in the American Journal of Preventive Medicine on May 16.  

The results showed a significant disparity between the placebo group and the group receiving the medication. “We had a 15% difference in quit rates, with those in the medication group having a quit rate of 45%,” said Lisa Fucito, Ph.D., lead author and director of the Tobacco Treatment Service at the Yale Cancer Center and Smilow Cancer Hospital. 

Benjamin Toll, Ph.D., director of the Tobacco Treatment Program at MUSC Health and senior author on the study, said that the researchers designed the trial to mimic real-world conditions as much as possible – from the people who enrolled in the trial to the type of support they would likely receive from primary care providers.  

The publication of their results closely follows publication of a trial of cytisinicline for e-cigarette cessation. The two drugs work similarly. However, varenicline is already on the market in the U.S. in generic versions while cytisinicline has not yet received FDA approval and is not currently available for use by patients.  

Varenicline, perhaps better known by the brand name Chantix, is FDA-approved to help adults to stop smoking traditional cigarettes. But, despite the growing numbers of people who use e-cigarettes, there are no approved medication options to help them to stop using e-cigarettes.  

“People can get to very high levels of nicotine exposure with these e-cigarette products, and they can use them near constantly throughout the day. So, the question we all have is, ‘Can any pharmacotherapy stand up to this challenge?’” Fucito said.  

It’s a question of logistics. People who smoke cigarettes have to get a cigarette from the pack and light it. It’s easy to track use. There are also natural stopping points – when the cigarette is finished, it must be snuffed out, and when the pack is used up, it must be thrown away and a new one purchased and opened before the person can smoke again. E-cigarettes, however, can last for 5,000 or more puffs, making them harder to track intake but easier to use. Toll said he has patients who describe keeping their e-cigarettes under their pillows so they can vape right before going to sleep and then again immediately upon waking in the morning.  

Previous studies have shown that a majority of people using e-cigarettes want to quit. But it’s been unclear whether products used to stop smoking traditional combustible cigarettes would also work for e-cigarettes.  

“We need more pharmacotherapy treatments to help address the really strong physical dependence that can develop from e-cigarette use. People undergo significant withdrawal when they try to stop, and that withdrawal is so unpleasant and hard to manage with just behavioral support alone,” Fucito said.  

A recent Italian study married pharmacotherapy with intense weekly behavioral counseling sessions, and the trial of cytisinicline also included weekly 10-minute sessions with trained counselors 

In this study, however, the researchers wanted to see how well the pharmacotherapy could work given typical health care conditions – meaning, the patient would likely get a brief discussion with a primary care provider along with a prescription and information about resources for quitting but no follow-up counseling sessions.  

To recreate this, they developed a self-guided cessation booklet for patients, with practical tools and tips for quitting. A licensed health care provider also met with each patient to inform them of how to use the medication, offer brief advice and instruct them to set a quit date for one to two weeks after starting the medication.  

“We took a much lighter touch to reflect the behavioral support that you’d likely experience if you went to your doctor and asked for help with quitting e-cigarettes,” Fucito said.  

The study also included some patients with histories of depression. This was significant because Chantix, at one point, had a “black box warning” after reports linking the drug to psychiatric side effects. That warning was dropped in 2016 after a very large study showed the drug to be safe, but Toll and Fucito said the stigma of the warning remains in the minds of both health care providers and the general public.  

“There’s still some hesitancy to prescribe this very safe – now generic – drug, and it really shouldn't be that way,” Toll said.  

None of the participants in this study experienced serious side effects, although a larger study would be needed to verify this finding. Most of the side effects were along the lines of nausea, insomnia or vivid dreams.  

Another piece of good news – those who stopped vaping didn’t boomerang back to cigarettes.   

“If you have a former smoking history, one of the worries in the field is that you’re going to go back to smoking when you quit vaping,” Toll said. “And we did not find that.” 

On the other hand, one potential challenge that the researchers uncovered in the results indicated that people without a cigarette smoking history – in other words, those who have only ever used e-cigarettes – might have a harder time quitting. That could be because that group is more likely to use e-cigarettes continuously throughout the day, therefore getting more nicotine into their systems.  

Larger trials are needed to delve into these questions. But this trial, at least, should give health care providers some confidence in prescribing varenicline for patients trying to stop using e-cigarettes.  

“We want people to come back to this medication,” Fucito explained. “There are people who need help now and are likely to struggle to quit e-cigarettes on their own because the technology facilitates nicotine use on a level that we’ve never seen before.” 

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 

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About the Yale Department of Psychiatry 

The Yale Department of Psychiatry is a world leader in patient care, research, and education. The department prides itself on its diverse and talented faculty, including a cadre of compassionate clinicians, interdisciplinary teams of talented investigators, and numerous committed and dedicated teachers, as well as a network of able alumni that remain vital to its missions. The department not only provides the highest quality of patient care, but also leads the nation in discoveries that are transforming our understanding and treatment of mental illness and addiction. 

About  MUSC Hollings Cancer Center 

MUSC Hollings Cancer Center is South Carolina’s only National Cancer Institute-designated cancer center with the largest academic-based cancer research program in the state. The cancer center comprises more than 140 faculty cancer scientists and 20 academic departments. It has an annual research funding portfolio of more than $50 million and sponsors more than 200 clinical trials across the state. Dedicated to preventing and reducing the cancer burden statewide, the Hollings Office of Community Outreach and Engagement works with community organizations to bring cancer education and prevention information to affected populations. Hollings offers state-of-the-art cancer screening, diagnostic capabilities, therapies and surgical techniques within its multidisciplinary clinics. Hollings specialists include surgeons, medical oncologists, radiation oncologists, radiologists, pathologists, psychologists and other clinical providers equipped to provide the full range of cancer care. For more information, visit hollingscancercenter.musc.edu. 

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JOURNAL

American Journal of Preventive Medicine

DOI

10.1016/j.amepre.2024.04.007 

ARTICLE TITLE

Varenicline for E-Cigarette Cessation in Adults: A Preliminary Placebo-Controlled Randomized Trial

ARTICLE PUBLICATION DATE

16-May-2024

COI STATEMENT

Unrelated to this study, authors report the following financial disclosures. Dr. Fucito has received funding from Imbrium Therapeutics, LLC for serving on an advisory board. Dr. Toll has testified on behalf of plaintiffs who have filed litigation against the tobacco industry. Dr. Gray has provided consultation to Indivior and Jazz Pharmaceuticals and has received research support from Aelis Farma. Dr. O'Malley has been a member of the Alcohol Clinical Trials Initiative (ACTIVE) Workgroup, which has been supported by Alkermes, Dicerna, Beam Diagnostics, Ethypharm, Lundbeck, Mitsubishi, and Otsuka. She has been a consultant to Dicerna, received medication supplies from Novartis/Stalicla, and is an inventor on a patent application with Yale and Novartis. Dr. Krishnan-Sarin has received free medication supplies from Novartis/Stalicla for investigations on alcohol drinking behaviors. SRB, NLB, AMP, and MJC have no financial disclosures to report.

 

Research supports Sunak’s ‘smoke-free generation’ policy but British ministers will miss key levelling up health targets

UK Government needs range of public health policies to close health inequalities

Peer-Reviewed Publication

CITY UNIVERSITY LONDON

The Government will miss key health inequalities targets that are a cornerstone of its levelling up agenda, new research suggests.

Although the study concludes that a notional immediate outright ban on tobacco sales would eventually increase healthy life expectancy by 2.5 years, it would not be enough for the Government to meet the targets for reducing health inequalities set out in its levelling up white paper. An immediate ban on smoking would, however, extend the working lives of both men and women, the paper concludes, with the greatest impact in more deprived areas.

Local government secretary Michael Gove’s 2022 levelling up white paper pledged to narrow the difference in ‘healthy life expectancy’ (HLE) between England’s most prosperous and most deprived local authorities by 2030, and to boost overall HLE by five years by 2035. HLE measures the number of years lived in at least reasonable health. In the UK it has risen more slowly than life expectancy in recent decades – meaning people are typically spending more years in poor health, with obvious implications for NHS and social care budgets.

The researchers, drawn from Bayes Business School (formerly Cass), Heriot-Watt University and LCP, analysed the likelihood of the 2035 target being met. They published their paper, The great health challenge: levelling up the UK, in The Geneva Papers on Risk and Insurance: Issues and Practice.

Lead author Les Mayhew, Professor of Statistics at Bayes Business School (formerly Cass), said: “It is clear that drastic smoking cessation intervention is necessary to increase healthy life expectancy across the population and to narrow pernicious health inequalities. The rolling ban proposed in the Government’s current legislation is a good first step but further research could strengthen the case for an outright ban.

“Policymakers need to commit to politically difficult policies even if improvements in population health are gradual and long-term. With an ageing population, the pressure on policymakers to intervene in behaviours that shorten working lives will become irresistible – as seen already with the current focus on sickness and disability benefits.”

The analysis confirmed that people who have never smoked typically enjoy an additional six years of HLE. Earlier research has shown that smoking kills around 78,000 people in England each year and leads to around 500,000 hospital admissions.

Recent research by the International Longevity Centre concluded that smoking cuts UK economic output by £19.1 billion, due to shorter working lives. Welfare and healthcare costs would boost that figure significantly.

The latest study also concluded:

• The nine year gap in average life expectancy between the richest and most deprived local authority areas almost doubles, to 17 years, for years lived in reasonable or good health.
• A 1-year improvement in health expectancy increases life expectancy by 4.5 months. This means the gap between lifespan and healthspan gets smaller so that people live both longer and in better health.
• Lung cancer deaths in different local authority areas revealed a correlation with the number of years spent in good health. HLE was lowest in cities, including London, the north of England and the midlands – and notably low in an arch linking Liverpool, Manchester, Leeds and Hull.
• A targeted campaign in areas with high levels of smoking would significantly reduce health inequalities but the results would take time to work through.
• Targeted smoking cessation policies would extend working lives, reduce the welfare bill and ease pressure on NHS and social care budgets.

Andrew Cairns, Professor of Actuarial Mathematics at Heriot-Watt University, said: "Our paper confirms that a smoking ban on those born in 2009 or later is one of the best ways to improve the health of people living in more deprived areas of the UK. The findings vividly illustrate the transformative impact of this measure on the health landscape. It coincides with a parliamentary debate, signalling a concerted effort towards a healthier future for all."

Mei Chan, Senior Statistician in LCP’s Health Analytics, said: “Our study has shone a light on the importance of measuring how much time people spend in good health rather than just focusing on life expectancy. While recent political events have put the issue of smoking into the spotlight, the UK Government already had ambitious targets in place. It’s clear that more needs to be done to meet the ambitious target to improve healthy life expectancy by five years and narrow the gap between the richest and poorest areas.

“The study also highlighted that lifestyle-related risk factors such as smoking, nutrition, alcohol consumption and physical activity are interconnected, particularly in more deprived communities. The rolling smoking ban is a promising start, though the use of joined-up policy approaches tackling multiple lifestyle factors would strengthen the long term impact of the smoke free generation policy.”

ENDS

 

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JOURNAL

The Geneva Papers on Risk and Insurance Issues and Practice

DOI

10.1057/s41288-024-00317-0 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The great health challenge: levelling up in the UK

 

Global life expectancy to increase by nearly 5 years by 2050 despite geopolitical, metabolic, and environmental threats, reports new global study

INSTITUTE FOR HEALTH METRICS AND EVALUATION

Global Burden of Disease 

The latest findings from the Global Burden of Disease Study (GBD) 2021, published today in The Lancet, forecast that global life expectancy will increase by 4.9 years in males and 4.2 years in females between 2022 and 2050.

Increases are expected to be largest in countries where life expectancy is lower, contributing to a convergence of increased life expectancy across geographies. The trend is largely driven by public health measures that have prevented and improved survival rates from cardiovascular diseases, COVID-19, and a range of communicable, maternal, neonatal, and nutritional diseases (CMNNs).

This study indicates that the ongoing shift in disease burden to non-communicable diseases (NCDs) – like cardiovascular diseases, cancer, chronic obstructive pulmonary disease, and diabetes – and exposure to NCD-associated risk factors – such as obesity, high blood pressure, non-optimal diet, and smoking – will have the greatest impact on disease burden of the next generation.

As the disease burden continues to shift from CMNNs to NCDs and from years of life lost (YLLs) to years lived with disability (YLDs), more people are expected to live longer, but with more years spent in poor health. Global life expectancy is forecasted to increase from 73.6 years of age in 2022 to 78.1 years of age in 2050 (a 4.5-year increase). Global healthy life expectancy (HALE) – the average number of years a person can expect to live in good health – will increase from 64.8 years in 2022 to 67.4 years in 2050 (a 2.6-year increase).

To come to these conclusions, the study forecasts cause-specific mortality; YLLs; YLDs; disability-adjusted life years (DALYs, or lost years of healthy life due to poor health and early death); life expectancy; and HALE from 2022 through 2050 for 204 countries and territories.

“In addition to an increase in life expectancy overall, we have found that the disparity in life expectancy across geographies will lessen,” said Dr. Chris Murray, Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME). “This is an indicator that while health inequalities between the highest- and lowest-income regions will remain, the gaps are shrinking, with the biggest increases anticipated in sub-Saharan Africa.”

Dr. Murray added that the biggest opportunity to speed up reductions in the global disease burden is through policy interventions aimed to prevent and mitigate behavioral and metabolic risk factors.

These findings build upon the results of the GBD 2021 risk factors study, also released today in The Lancet. This accompanying study found that the total number of years lost due to poor health and early death (measured in DALYs) attributable to metabolic risk factors has increased by 50% since 2000. Read more on the risk factors report at https://bit.ly/GBDRisks2021.

The study also puts forth various alternative scenarios to compare the potential health outcomes if different public health interventions could eliminate exposure to several key risk factor groups by 2050.

“We forecast large differences in global DALY burden between different alternative scenarios to see what is the most impactful on our overall life expectancy data and DALY forecasts,” said Dr. Stein Emil Vollset, first author of the study who leads the GBD Collaborating Unit at the Norwegian Institute of Public Health. “Globally, the forecasted effects are strongest for the ‘Improved Behavioral and Metabolic Risks’ scenario, with a 13.3% reduction in disease burden (number of DALYs) in 2050 compared with the ‘Reference’ (most likely) scenario.”

The authors also ran two more scenarios: one focused on safer environments and another on improved childhood nutrition and vaccination.

“Though the largest effects in global DALY burden were seen from the 'Improved Behavioral and Metabolic Risk’ scenario, we also forecasted reductions in disease burden from the ‘Safer Environment’ and ‘Improved Childhood Nutrition and Vaccination’ scenarios beyond our reference forecast, said Amanda E. Smith, Assistant Director of Forecasting at IHME. “This demonstrates the need for continued progress and resources in these areas and the potential to accelerate progress through 2050.”

“There is immense opportunity ahead for us to influence the future of global health by getting ahead of these rising metabolic and dietary risk factors, particularly those related to behavioral and lifestyle factors like high blood sugar, high body mass index, and high blood pressure,” continued Dr. Murray.

Notes to editors

For interview requests, journalists may contact ihmemedia@uw.edu. For full study results, including the paper and related tables, finalized PDFs are available at https://bit.ly/GBD2021Forecast, embargoed until 23:30 UK, 6:30 p.m. EDT on May 16, 2024. The post-embargo link for the paper is https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00685-8/fulltext. An infographic summarizing the study’s findings can be found at https://bit.ly/4byxttL. Data tables containing estimates from the study are available at https://ghdx.healthdata.org/record/ihme-data/global-life-expectancy-all-cause-mortality-and-cause-specific-mortality-forecasts-2022-2050.

About the Institute for Health Metrics and Evaluation

The Institute for Health Metrics and Evaluation (IHME) is an independent research organization at the University of Washington (UW). Its mission is to deliver to the world timely, relevant, and scientifically valid evidence to improve health policy and practice. IHME carries out its mission through a range of projects within different research areas including the Global Burden of Diseases (GBD), Injuries, and Risk Factors; Future Health Scenarios; Cost Effectiveness and Efficiency; Resource Tracking; and Impact Evaluations.

IHME is committed to providing the evidence base necessary to help solve the world’s most important health problems. This requires creativity and innovation, which are cultivated by an inclusive, diverse, and equitable environment that respects and appreciates differences, embraces collaboration, and invites the voices of all IHME team members.

About the Global Burden of Disease Study

The Global Burden of Disease Study (GBD) is the largest and most comprehensive effort to quantify health loss across places and over time. It draws on the work of more than 11,000 collaborators across more than 160 countries and territories. GBD 2021 – the newly published most recent round of GBD results – includes more than 607 billion estimates of 371 diseases and injuries and 88 risk factors in 204 countries and territories. The Institute for Health Metrics and Evaluation coordinates the study.

---

JOURNAL

The Lancet

ARTICLE PUBLICATION DATE

16-May-2024

• UK
• Keir Starmer Unveils Tony Blair-Style Pledge Card As He Steps Up Bid To Become PM
• 
  Kevin Schofield
  Wed, 15 May 2024
  
  Keir Starmer appears on course to become prime minister. Ash Donelon via Getty Images
  
  Keir Starmer will today unveil a Tony Blair-style pledge card as he steps up his bid to convince voters to make him prime minister.
  
  The six “first steps for change” will include promises that a Labour government will deliver economic stability, cut NHS waiting times, crack down on anti-social behaviour and recruit 6,500 new teachers.
  
  The party leader will also vow to launch a new “border security command” to tackle the small boats crisis and set up the publicly-owned Great British Energy to produce gas and electricity in the UK.
  
  Starmer told a meeting of his shadow cabinet yesterday: “What is crucial about these commitments is that they are part of a long-term plan to get Britain back on its feet.
  
  “Each of the first steps would chime with voters’ aspirations, show a clear set of priorities and a powerful direction of travel.”
• 
  
  Starmer's pledge card Labour Party
  
  Starmer will unveil promises at a presidential-style event in Essex alongside other members of his frontbench team.
  
  The pledge card, featuring a picture of a serious-looking Starmer, has clear echoes of the similar list of retail policies produced by Tony Blair before Labour’s landslide 1997 general election victory.
  
  Starmer said: “These first steps make real our claim that a changed Labour Party is back in service of working people. They show our priorities, what we care about and what the British public cares about. Country first, party second.
  
  “If you’re waiting in pain for NHS treatment, if your child is at school and you want higher standards, if your local area is plagued by anti-social behaviour, if you want cheaper energy bills for good, these first steps show what a Labour government will do to help you.”
  
  He added: “The contrast at the election is going to be stark. A Tory Party that gets nothing done, can’t deliver – struggles to get to the end of the week. And a Labour Party, sleeves rolled up, fixing problems with a long-term plan for change.
  
  “These steps can only be achieved if we pull together, with a sense of common purpose, ending the years of division, and rebuilding the country in partnership.”

UK's Labour sets out plans for government

Peter HUTCHISON
Thu, 16 May 2024 

Labour leader Keir Starmer outlined his plan for government (Oli SCARFF)


Britain's main opposition Labour party on Thursday set out its stall for this year's general election with six key pledges to voters in a de facto campaign launch.

The official five-week election campaign only starts when Prime Minister Rishi Sunak names a date. So far, he has only said it will be in the second half of the year.

Nevertheless, both Sunak, who heads the ruling Conservatives, and Labour leader Keir Starmer have switched to campaign mode.

On Monday, Sunak urged voters to keep faith with the Tories even after 14 years in power marked by austerity measures, Brexit, bitter political in-fighting and scandal.

Labour has been consistently polling well ahead of the Conservatives for the last 18 months, putting Starmer on course to become prime minister as the leader of the largest party in parliament.

He laid out Labour's "first steps" for government at an event in Essex, a key battleground area in southeast England.

Starmer promised economic stability, shorter health service waiting times and a new border security command to tackle irregular immigration.

He also vowed to establish a publicly owned clean energy company, crack down on anti-social behaviour with more neighbourhood police and recruit 6,500 new teachers.

"I'm not going to give you gimmicks," said Starmer, who paced the stage in a white shirt, sleeves rolled up.

"There's no quick fix to the mess that the Tories have made of this country. But this is a changed Labour party with a plan to take us forward."

- Labour's 'missions' -

The pledges, largely made before, are intended to add some flesh to the bones of five "missions" Labour says will spur a "decade of national renewal" after four consecutive terms of Tory rule.

Many commentators likened them to the pledge cards brought in by Labour's most successful leader, Tony Blair, whose 10 years as prime minister began with a landslide victory against the Tories in 1997.

They are set to feature on advertising vans and billboards in target constituencies across England in what Labour says is its most expensive ad campaign since the 2019 general election.

At that vote, Labour under the leadership of left-winger Jeremy Corbyn suffered its worst defeat in nearly a century, as Boris Johnson romped home with his promise to "Get Brexit Done".

Starmer, a centrist pro-European former lawyer, has since moved Labour to the centre ground to make the party a more palatable electoral force.

The Conservatives meanwhile have replaced their leader twice, turning on Johnson after his handling of the Covid pandemic and one scandal too many, then forcing out Liz Truss after just 49 days.

Former finance minister Sunak, 44, has sought to repair the damage caused by Truss's disastrous mini-budget of unfunded tax cuts, which spooked financial markets and sank the pound.

But he goes into the election with the Tories' reputation for economic competence tarnished, and riven by ideological splits between moderates and anti-immigration, free market right-wingers.

- 'Tough spending rules' -

Starmer, 61, promised to implement "tough spending rules" to prevent further misery for people who have seen their household budgets squeezed by high inflation and mortgage hikes.

Sunak, who is hoping for better economic conditions by the end of the year, has to hold an election by January 28, 2025. He is using the time to try to keep his party together and revive its fortunes.

On Monday, he warned that Labour would jeopardise UK security, insisting his party could still win the election.

Johnson's predecessor as premier, Theresa May, said Thursday she believed a Labour win "is not a foregone conclusion".

It would require a massive swing to secure a majority, she told reporters, adding that the voters she met were less enthusiastic about Starmer than they were about Blair.

"The view on those doorsteps is different to the feel pre-1997," May insisted.

pdh-phz/jj

Labour Party manifesto 2024: Keir Starmer’s election promises

Amy Gibbons
Thu, 16 May 2024 

Labour Party manifesto 2024: Keir Starmer's likely election promises

Sir Keir Starmer has announced the policies at the heart of his election campaign in the clearest indication yet of what we can expect to see in Labour’s 2024 manifesto.

The Labour leader made six key pledges at a campaign rally in Essex, one each on his five “mission” areas – the economy, energy, crime, education and the NHS – plus a newly added priority on immigration.

Sir Keir and Rachel Reeves, his shadow chancellor, are seeking to position Labour as the fiscally responsible party that would drive growth in Britain, allowing them to invest in public services such as the NHS.

Here The Telegraph sets out the pledges the party is expected to include in its general election manifesto.

NHS and social care


Tax


Economy


Environment, energy and net zero


Education and childcare


Defence


Pensions


Policing and crime


Migration


Housing
NHS and social care

Two million more operations, scans and appointments in first year


Train thousands more doctors, nurses and midwives


Specialist mental health support in every school


Extra 700,000 dentist appointments and supervised tooth brushing for three to five-year-olds


New “neighbourhood health centres” with joined-up services

Labour has pledged to get the NHS “back on its feet” by reforming the health service rather than “pouring ever-increasing amounts of money” into it.

As an “immediate priority”, it would focus on tackling the “massive” waiting list backlog, with an extra two million operations, scans and appointments in the first year. This would be achieved by paying NHS staff more to work overtime, boosting availability across evenings and weekends.

These policies formed the basis of Sir Keir’s second key pledge to “cut NHS waiting times with 40,000 more appointments each week, during evenings and weekends.”

In a shake-up of primary care, the party would trial “neighbourhood health centres”, bringing together a wide range of services – including doctors, nurses, care workers and mental health specialists – to cater for millions of patients currently clogging up overloaded A&E units. It would also use spare capacity in the independent sector to speed up treatment.

It has also vowed to “bring back the family doctor” – with GPs paid more for ensuring patients can see the clinician of their choice. Labour has said it would use the NHS App to “end the 8am scramble” for GP appointments and allow patients to book directly for routine checks, while boosting self-referrals and cutting red tape in pharmacies.

It would provide an extra 700,000 urgent dentist appointments each year and introduce supervised tooth brushing in schools for three to five-year-olds, while offering “golden hellos” of £20,000 to newly-qualified dentists who agree to work in areas struggling to recruit.

To tackle the mental health crisis, the party has said it would introduce specialist support in every school and provide an open-access hub for young people in every community.

It would also conduct an assessment of all NHS capital projects to identify any inefficiencies before committing any more money to fixing the “crumbling” estate.

Labour has pledged to double the number of medical school spaces to 15,000, a target also proposed by the NHS and endorsed by the Government, and provide 10,000 extra nursing and midwifery placements.

It would also train an additional 700 district nurses and 5,000 health visitors each year, and recruit 8,500 more mental health professionals.

To boost retention, the party would “consider the case for looking more broadly at how public sector pay is set”. It would also introduce a “targeted scheme” to incentivise senior doctors to stay in work.

Labour has pledged to double the number of state-of-the-art CT and MRI scanners and streamline recruitment for clinical trials.
‘Prevention first’ approach

As part of a “prevention first” approach, it would ban the promotion of junk food to young people and back the Tories’ incremental ban on smoking.

The party would establish fully-funded breakfast clubs in every primary school in England and implement a compulsory “balanced and broad national curriculum with a wide range of physical activities”.

It would also introduce stricter legal targets on air pollution and oversee the retrofitting of millions of homes to help keep them warm and free of damp, while guaranteeing the right to sick pay from day one to minimise the spread of illness in the workplace.

At the same time, Labour would work towards a locally-delivered “National Care Service”.

To tackle staff shortages in social care, it would introduce a “fair pay agreement collectively negotiated across the sector”.

And to raise standards, it would require all providers to demonstrate financial sustainability and responsible tax practices, to value their staff, and to deliver high quality care before they are allowed to receive contracts from local authorities or gain registration from the Care Quality Commission.

It would also give people in care homes a new legal right to see their loved ones and support unpaid carers by offering them paid family carer’s leave.

Labour originally said that much of the health plan would be paid for by abolishing the non-dom tax status but the strategy was thrown into disarray when Jeremy Hunt, the Chancellor, announced the same move at the Spring Budget.

The party has since said it will pay for NHS improvements by going further than the Tories and closing an inheritance tax loophole for non-doms while cracking down on tax avoidance.
Tax

Close inheritance tax loophole for non-doms


Crack down on tax-avoiders


Impose VAT on private school fees


No rise in corporation tax


Overhaul business rates and review tax reliefs

Sir Keir’s first key pledge included a vow to keep taxes “as low as possible”, without committing to specific cuts.

This was broadly in line with Labour’s tax policy to date, which has been vague. However the party has been explicit about a few things.

It had promised to scrap the “non-domiciled” regime, which allows people living in Britain to avoid paying UK tax on money they make overseas for up to 15 years – but this policy has been snatched by the Tories, leaving a hole in Labour’s finances.

The party has since pledged to go further by closing the inheritance tax loophole for non-doms and target tax-avoiders to pay for its spending commitments on schools and the NHS.

Elsewhere, the party would implement 20 per cent VAT on private school fees, with the proceeds funnelled into state education.

Ms Reeves has also promised not to raise corporation tax for the duration of the next Parliament and said she would overhaul the business rates system and review all tax reliefs.

Sir Keir has made clear that he would like to reduce the tax burden on “working people”, while Ms Reeves has hinted at cuts for high earners, vowing to ensure “success is celebrated” under a Labour government.

She has attacked the Tories over their decision to freeze income tax thresholds in the face of rising inflation, but not committed to changing this, insisting it would be “irresponsible” to pledge tax cuts without pinpointing how they would be funded.

Ms Reeves has said she has “no plans” for a wealth tax but the party has explored closing a loophole for second homeowners.
The economy

Bid for highest sustained growth in G7


Tough new fiscal rules and enhanced role for the Office for Budget Responsibility (OBR)


New Office for Value for Money


Invest heavily in green projects


New deal for working people

Sir Keir’s first pledge to keep taxes low was contingent on a promise to “deliver economic stability with tough spending rules, so we can grow our economy”.

This drew on existing policies, with Labour having already set an aim to secure the highest sustained growth in the G7. To do this, it would adopt a new approach it has coined “securonomics”, or “modern supply side economics”.

This would involve bringing in “tough” fiscal rules with a new “enhanced role” for the OBR and establishing a new Office for Value for Money to ensure taxpayer cash is being well spent.

The party originally pledged to invest £28 billion in the drive towards a low-carbon economy every year until 2030 but has since dramatically scaled down the spending plan following sustained criticism from the Conservatives.

The proposals include an £8 billion national wealth fund, which would aim to “unlock billions of pounds of private investment” to support the energy transition.

The party would also reform the planning system to fast-track “priority growth” projects, such as battery factories, labs and 5G infrastructure.

And Labour has vowed to deliver a “new deal for working people”, featuring a “genuine living wage”, a “right to switch off”, a ban on zero hours contracts, and an end to fire and rehire.
Environment, energy and net zero

Clean power by 2030


New publicly-owned energy company


End de-facto ban on onshore wind


Expand windfall tax on oil and gas producers


Upgrade five million homes in five years


Extra £23.7 billion spent on green projects over first term

Labour initially vowed to borrow £28 billion per year from day one to invest in its flagship green prosperity plan.

But this pledge has been significantly watered down over time. Ms Reeves first admitted that the annual sum would not be hit until at least the second half of Labour’s first term.

Then Sir Keir cast further doubt on the scale of the investment, saying it would be subject to the party’s fiscal rules. In a major U-turn, he downgraded the spending commitment to just £4.7 billion a year after admitting it was unaffordable.

Under the new, slimmed down blueprint, public funding for a major home insulation drive was reduced by nearly 80 per cent, from a planned £6 billion a year to just £1.3 billion.

As a result, Labour says only five million houses would benefit from the scheme over the course of five years, compared to the original plan of 19 million across a decade. This is the only project the party has said would be scaled down as a result of the change.

The overarching aim is to turn the UK into a “clean energy superpower”, with a zero-carbon electricity system by 2030. To help achieve this, Labour would set up Great British Energy, a publicly owned body that would invest in green projects like wind farms, with a budget of £1.7 billion a year.

This formed the basis of Sir Keir’s fourth pledge, to “set up Great British Energy, a publicly-owned clean power company, to cut bills for good and boost energy security.”

The new national wealth fund would also put money into gigafactories, clean steel plants, “renewable-ready” ports, green hydrogen and energy storage, with funding of £1.5 billion a year.

The green plan, which now amounts to £23.7 billion over five years, would be on top of £50 billion already committed by the Tories, which Labour has promised to match.

It would be partially funded by expanding the windfall tax on oil and gas producers, which was introduced by Rishi Sunak when he was chancellor to help pay for energy bills support.

Meanwhile, Labour has pledged to overturn the de-facto ban on onshore wind in England, set councils binding targets for how quickly they approve green energy projects, and establish a “British jobs bonus” to incentivise firms to build their supply chains in the UK.

Before it announced the U-turn on the £28 billion fund, the party had claimed the green reforms would take £1,400 off annual household bills and £53 billion off energy bills for businesses by 2030, while creating over a million jobs in 10 years.
Education and childcare

Overhaul childcare system


Delivery of ‘more effective’ Ofsted system


Recruit 6,500 more teachers


Review school curriculum and assessment


New register for children in home education


Reform student loan repayments

Sir Keir’s sixth pledge is focused on education, with the Labour leader vowing to “recruit 6,500 new teachers in key subjects to prepare children for life, work and the future, paid for by ending tax breaks for private schools”.

Labour’s plan for schools also includes scrapping single-word Ofsted judgments and replacing them with “report cards”, and commissioning an expert-led review of curriculum and assessment with an emphasis on “life skills”.

Meanwhile, the party has said it would give the regulator new powers to monitor pupil absence rates and legislate for a new register of children in home education. Elsewhere, it has pledged to overhaul Britain’s childcare system and rethink vocational education.

The aim is to ensure half a million more children hit the early learning goals by 2030, deliver a “sustained rise” in school outcomes over the next decade, and expand “high-quality” training routes.

Labour has yet to confirm its plans for childcare, having commissioned a review by Sir David Bell, the former Ofsted chief inspector, into delivering a more effective system.

It has said it wants to build capacity in the sector but has not specified how it would do this beyond removing “legislative barriers to local authorities opening new childcare provision” and supporting the workforce through high-quality training.

Bridget Phillipson, the shadow education secretary, has previously said she wants to move away from the current free hours model, and twice failed to rule out bringing in changes to means-testing.

But Labour has since welcomed Rishi Sunak’s decision to extend free hours to younger children, suggesting it could keep the existing system in place, at least to start with.

The party has said it will not take away new entitlements granted by the Tories, which include 15 hours of free care per week for two-year-olds.

To support older students, Labour would train more than 1,000 new careers advisers and deliver two weeks of work experience for every young person at secondary school or college.

It would also reform the student loan repayment system to make it “fairer”, with scope for a “month-on-month tax cut” for graduates.
Defence

Boost defence spending to 2.5 per cent of GDP


Commit to Nato and nuclear deterrent


Review defence and security to assess need


Create new armed forces commissioner

If it wins power, Labour would aim to raise defence spending to 2.5 per cent of GDP, matching the Government’s existing target. But Sir Keir has said he will only spend the extra money if it is achievable within the party’s borrowing rules.

Labour has also said it would make an “unshakeable commitment” to Nato and Britain’s nuclear deterrent, in a clear departure from the Corbyn years.

It has pledged a new “triple lock” commitment to build at least four new nuclear submarines at Barrow, keep the continuous at-sea deterrent and fund any future upgrades needed to the fleet.

The party would conduct a review of “strategic defence and security” in its first year to “fully understand the state of our Armed Forces, the nature of threats we face and the capabilities needed”.

And it would legislate to establish an Armed Forces commissioner as a “strong independent voice to improve service life”, while ensuring military homes are fit for purpose.

John Healey, the shadow defence secretary, has also said Labour would shift procurement onto an “urgent operational footing” to support Ukraine and replenish British stocks for any future conflicts.
Pensions

Bring back lifetime cap on pension savings


Commitment to the triple lock


Pensions review to ensure best value for savers


New powers for regulator to tackle under-performing schemes

Labour has said it would bring back the lifetime cap on pension savings abolished by Mr Hunt.

Like the Tories, it has committed to retaining the triple lock, which raises the state pension every year in line with whichever is highest out of wage growth, inflation or 2.5 per cent.

It has also pledged to conduct a review of the pensions system to ensure best value for savers, while giving new powers to the regulator to consolidate schemes where they are under-performing.
Policing and crime

Halve serious violent crime in 10 years


Extra 13,000 bobbies on the beat


Reintroduce strengthened anti-social behaviour orders (Asbos)


Scrap £200 rule on shoplifting


New bravery medal for police killed in line of duty

For his fifth pledge, Sir Keir vowed to “crack down on anti-social behaviour, with more neighbourhood police paid for by ending wasteful contracts, tough new penalties for offenders, and a new network of youth hubs.”

The party has promised to halve serious violent crime and raise confidence in the police and criminal justice system to its highest levels, all within a decade.

Specifically, it wants to halve the level of violence against women and girls and incidents of knife crime.

To protect women and girls, the party would put rape units into every police force and domestic abuse experts in 999 control rooms, as well as specialists in the court system. It would also introduce a new domestic abuse register.

To tackle knife crime, it would put youth workers into A&E departments and custody suites and set up 90 new youth hubs to give teenagers the “best start in life”.

And to raise confidence in the police, Labour has pledged to recruit an extra 13,000 neighbourhood and community support officers. It would also introduce compulsory anti-racism training and a new standards regime.

Meanwhile, the party would reintroduce tougher Asbos with powers to make arrests and force fly-tippers to clean up their mess.

It would also scrap the current £200 threshold to ensure all shoplifting crimes, no matter how small, have to be investigated by police.

And it would introduce a new bravery medal for officers who are killed in the line of duty.

To ensure more criminals are brought to justice, Labour would boost the number of crown prosecutors and force the police to recruit detectives directly from industry.
Migration

Treat people smugglers like terrorists


New cross-border police unit


Extra 1,000 caseworkers to cut asylum backlog


Possible returns deal with EU


Repeal Rwanda Bill

Sir Keir’s third pledge is to “launch a new Border Security Command with hundreds of new specialist investigators, and use counter-terror powers to smash the criminal boat gangs.”

It draws on Labour’s plan to address the small boats crisis, which has two main planks: cracking down on the “vile” people-smuggling gangs, and reducing the asylum backlog.

Sir Keir has also indicated that he would be prepared to do a deal with the EU that would involve taking a quota of migrants who arrive in the bloc in exchange for the ability to return those who illegally cross the Channel to England.

The Labour leader has said he would treat people smugglers like terrorists by giving the National Crime Agency expanded powers to freeze their assets and place restrictions on their movement. He would also work more closely with Europe, creating a new cross-border police unit to “tackle gangs upstream”.

Meanwhile, Labour would recruit more than 1,000 caseworkers to cut the asylum backlog, fast-track decisions on applications from “safe” countries, namely Albania and India, and create a new returns unit, again backed by 1,000 staff, to speed up removals.

The party has vehemently opposed the Rwanda deportation scheme and vowed to repeal it.

But Sir Keir has indicated he would be willing to consider other options to divert migrants abroad. In December, he said he would look at offshore processing, used by countries such as Australia, in a significant hardening of his stance on border controls.
Housing

Build 1.5 million homes


Utilise “poor quality” green belt land


Set home ownership target of 70 per cent


New mortgage guarantee scheme

Labour has pledged to build 1.5 million new homes within its first five years in power, underpinned by a “blitz of planning reform”.

The central policy is to rip up “restrictive” laws to allow construction on “poor quality” green belt land. Dubbed the “grey belt”, this would include areas such as “disused car parks” and “dreary wasteland”.

Labour would also build “the next generation of new towns” across the country, devolve power to local mayors to kick-start development, and give young buyers “first dibs” on new properties in their areas.

Sir Keir has set a home ownership target of 70 per cent and promised to get more people on the housing ladder with a new mortgage guarantee scheme.

The party has also pledged to deliver the biggest boost to affordable housing “in a generation” by strengthening existing rules to prevent developers “wriggling out of their responsibilities”.



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