Quantifying the case for prevention: disease burden and cost-effective interventions in UK

BACKGROUND: Modifiable risks-tobacco use, poor diet, alcohol consumption, physical inactivity and mental ill-health-drive substantial disease in UK. NICE evidence on preventive interventions targeting these risks and estimates of eligible populations and disease burden demonstrate the potential for prevention and reducing health inequalities. METHODS: Deaths and DALYs from behavioural risks and mental health conditions were estimated using GBOD 2021 data. Prevalence by deprivation quintile came from national surveys. NICE guidelines were reviewed to identify cost effective preventive interventions. RESULTS: In 2021, tobacco and dietary risks caused the highest mortality and disease burden: tobacco nearly 58 000 deaths and 1·4 million DALYs; diet 48 000 deaths and 1.05 million DALYs. Mental health had low mortality (5·7 deaths) but high DALYs (1·45 million), especially in younger people. Alcohol and inactivity had lower death counts and moderate DALY impacts. Most risks were more prevalent in deprived areas. NICE-recommended interventions such as smoking cessation, alcohol brief advice, obesity treatments, and psychological therapies, are relevant to millions, especially high-need groups. CONCLUSION: (Re-)investing in prevention and equitable strategies could substantially reduce disease burden and address inequalities, with the greatest gains likely to arise from sustained and targeted investment in populations and areas that have been left behind.