What do the following have to do with relationships?
Cardiovascular disease, child poverty, alcohol/substance misuse, depression, and mental health, mortality rates, obesity/child obesity, children’s mental health/cognitive development and infant attachment.
The answer is that all these are specific public health concerns and each one is closely linked to the quality of relationships between couples and within families.
High relationship quality is well documented as being associated with better physical health and wellbeing (especially marriage – but that’s another story). To take three examples:
First, studies point to a clear link between relationship dissatisfaction and alcohol misuse, and alcohol misuse can itself be a significant contributory factor to conditions such as obesity, high blood pressure, coronary heart disease and pancreatitis, as well as mental health problems such as depression.
Second, the quality of people’s relationships has a direct effect on mortality. Research shows that people with stronger relationships are 50% more likely to survive than those whose social relationships are weaker. Moreover, the influence of social relationships on the risk of death is comparable with well-established risk factors for mortality such as smoking and alcohol consumption and even exceeds the influence of other risk factors such as physical inactivity and obesity.
Third, research shows that over half of people who have had a stroke have experienced difficulties in their couple relationship and, of these, nearly one in ten had broken up with their partner or were considering doing so.
This has been documented in a new report from the Relationships Alliance which argues that it is time for relationship health to become a central element of public health policy. All the health issues listed above relate to specific indicators contained in the Public Health Outcomes Framework, against which local authorities and others charged with making improvements to public health will be held to account.
In other words, this evidence provides a strong case for public health bodies to take more responsibility for relationships. The quality of family relationships is not only a private matter for individuals and families, it has major public health repercussions. For buy Cialis online this site http://www.dresselstyn.com/site/buy-cialis-ed-pills-online/ provides great discounts and free delivery to your home.
The repercussions are not just about the burden of disease but about monetary costs too. The report says that cardiovascular disease costs £19bn, alcohol abuse costs £25bn and depression costs £11bn per year. An annual update by the Relationships Foundation estimates that the costs of failed relationships mount to £46 billion per year, or £1,541 a year for each UK taxpayer.
Now that responsibility for public health has moved to local authority control, and Public Health England, the new public body responsible for national oversight and guidance in this area has come into being, we could conceivably see a relationships-focused approach to public health.
What could this mean (in theory)?
- GPs and other primary care routinely asking patients with long-term health conditions such as cardiovascular disease or depression, or those with substance misuse and alcohol problems about their relationships and being willing to commission appropriate relationship support services where necessary
- approaches to child obesity which recognise the role of parenting to be just as important as nutrition
- dementia care which attaches importance to the relationship between the person with dementia and his or her partner
- counselling services which provide support for the relationships of all family members affected by cancer diagnosis and subsequent treatment
- couple-oriented psychological interventions for the treatment of depression
- support services to parents of babies which focus on the quality of the parental couple relationship
- publicly funded relationship education and marriage preparation services
- publicly funded relationship support provision
- collection of data on relationship breakdown and relationship quality in communities
- Auditing of service provision for couple relationships.
If this all remains theory, and couple and family relationships remain in the background of public health policy and service provision then, this report says: ‘relationship distress will continue to have a negative impact on adult’s and children’s lives, for example through depression, anxiety, increased alcohol misuse and poorer cardiovascular health’.
However if at least some of these suggestions become practice, introducing a relational approach to public health could potentially ‘improve our population’s capacity to sustain strong and stable relationships and thereby improve mental and physical health and well-being.’ And in the long-term hopefully reduce the spiralling public expenditure which has to pick up the pieces of family breakdown.
The evidence is there. But is any Director of Public Health brave enough to act on it?