Do Blog

Life expectancy in your hands

Global medical research confirms significance of behaviour change for end-of-life health.

October 9th 2015

Professor Ben Fletcher, one of the founding psychologists at Do Something Different, has been reviewing new global research that highlights the urgent need to improve behaviour change interventions for better end-of-life outcomes.

Research led by Public Health England and funded by Bill and Melinda Gates Foundation published in The Lancet looked at health in England from 1990-2013 from the Global Burden of Disease (GBD) project. This measures mortality risk and  years lived with chronic health disability, a worldwide exercise to integrate the best possible knowledge about the causes of ill-health disability and mortality.  

The study has been widely reported in the media but those reports concentrated on the finding that diet is now more important than smoking in ill health prediction. This is important, but the study showed something much more significant in my view.

The results that may surprise you is the large role behavioural risks  played in health and disease.

The authors measured disability adjusted life years (DALYs) – a measure of life expectancy taking account of chronic disabilities due to disease.


  • Behavioural risks accounted for 28% of the DALYs  
  • Metabolic risks contributing 19.2%
  • Environmental and occupational risks only 4.7%.

Behavioural factors include diet, physical activity and smoking – things that each of us can make personal choices about.  Metabolic risks includes high cholesterol, blood sugar levels, high blood pressure and high body mass index. About half of the DALYs for metabolic risks also overlapped with the behavioural risks confirming interdependence.

Poor diet is a higher risk than smoking
The aspect of the research that caught the media attention was that – of the behavioural risks – diet was now more important than smoking, with low fruit and vegetable consumption, low intake of whole grains, nuts and seeds, high processed meat consumption and high sugar drinks all being responsible.

The researchers themselves stated: “Health in England is improving although substantial opportunities exist for further reductions in the burden of preventable disease… Declines in mortality have not been matched by similar declines in morbidity, resulting in people living longer with diseases. Health policies must therefore address the causes of ill health as well as those of premature mortality…”

Behavioural change is the key to reducing the health burden
This research confirms our belief that the behaviour change principles, embedded in programmes like Do Something Different’s Healthy Habits and Love Not Smoking are critical to improving the health and well-being of people around the world. Living a healthy life is as much about what you do, as what you’ve got. The choices that you make are key to living long and living healthily.

By focusing on behaviour change and giving people the tools they need to change their personal habits around things like diet and smoking, we could potentially improve the quality and length of life for many people, while reducing the cost of Public Health provision.

Do CHANGE – integrating behaviour change in patient care
Do Something Different is playing a pivotal role in a large project called Do CHANGE funded by the EU/Taiwan.

At the centre of the project will be new Do Something Different programmes to improve the health of patients with cardiovascular disease (heart attack patients, those with implanted defribrillators or ICD’s and those with heart  failure).

The Do Something Different programmes will introduce the behaviour change element so often missing in patient care and will be part of a new health infrastructure that integrated wearable tech, clinical support and medical devices.

Learn more about Do CHANGE