Majority of vapers have quit tobacco – survey

More than half of the estimated 2.9 million people in the UK who use e-cigarettes have given up smoking tobacco, a survey suggests.

But many people overestimate the relative health risks of vaping, which may have contributed to a slowdown in the numbers turning to e-cigarettes. Nine million people in the UK still smoke tobacco.

The number of people vaping or using e-cigarettes has quadrupled in the past five years, the annual Smokefree GB survey by Action on Smoking and Health (Ash) found, with many people turning to them for help with quitting or cutting down on smoking tobacco.

For the first time, more than half of vapers said they had quit smoking. Most of the remainder continued to both vape and smoke tobacco.

Ann McNeill, professor of tobacco addiction at King’s College London, said the finding was encouraging. “This year’s Ash survey finds that around 1.5 million vapers are ex-smokers, for the first time a larger number than those who continue to smoke,” she said.

“This is encouraging news as we know that vapers who continue to smoke continue to be exposed to cancer-causing chemicals. The message for the 1.3 million vapers who still smoke is that they need to go further and switch completely.”

But vaping’s rate of growth has slowed considerably in the past couple of years, and the survey found many people overestimated the health risks of vaping compared with tobacco.

In 2015, Public Health England concluded vaping was about 95% less harmful than smoking. But more than a quarter of respondents (26%) said they believed e-cigarettes were equally or more harmful than the traditional equivalents, with only 13% saying they were much less harmful than smoking.

Deborah Arnott, the chief executive of Ash, said: “It’s excellent news that the number of vapers who have quit smoking is continuing to grow, but there are still 9 million smokers compared to only 1.5 million vapers who don’t smoke at all.

“The rapid growth in e-cigarette use has come to an end while over a third of smokers have still never tried e-cigarettes, saying the main reasons are concerns about the safety and addictiveness of e-cigarettes. It’s very important smokers realise that vaping is much, much less harmful than smoking.”

The findings were based on an online survey by YouGov of 12,969 adults, weighted to be representative of the UK adult population.

Majority of vapers have quit tobacco – survey

Two in five GPs in south-west of England plan to quit, survey finds

About two in five GPs in the south-west of England are planning to quit, exposing a potential doctors’ crisis in the NHS. A survey of more than 2,000 GPs in the region revealed the impending healthcare problems.

Figures published last month showed there had been a drop in the number of GPs working in the NHS despite the government aim of recruiting 5,000 more by 2020.

The survey, carried out by the University of Exeter, also found that seven in 10 GPs intended to change their working patterns in a way that would mean less contact with patients. This included leaving patient care, taking a career break or reducing their hours.

The researchers said the data provided a snapshot of low morale which, if echoed in other regions, could point to a deeper and more imminent crisis than previously anticipated in relation to the worsening shortage of GPs nationwide.

John Campbell, a professor who led the research, which is published in BMJ Open, has called for a move away from “sticking plaster solutions” towards robust, joined-up, action to avert the crisis nationwide.

Campbell, a practising GP, said: “We carried out this survey because of a nationally recognised crisis in the shortage of GPs across the country, and our findings show an even bleaker outlook than expected for GP cover, even in an area which is often considered desirable, and which has many rural communities,.

“If GPs have similar intentions to leave or reduce their hours in other regions, as many are reporting, the country needs to take robust action more swiftly and urgently than previously thought.”

The research team sent surveys to 3,370 GPs across the region and received responses from 2,248, with 54% reporting low morale.

Campbell said: “We know that there’s an ageing workforce in general practice, with 30% of GPs being over 50 years old. Previous research has found that GP morale is low because of workload pressures, and many younger GPs do not want the financial risk and responsibilities of taking on a practice.

“Yet if the GPs we surveyed fulfil their intentions to leave or to cut back their patient contact, and no action is taken to address the issue, the south-west of England will experience a severe shortfall of GPs in the next five years.

“Whilst numerous government-led initiatives are under way to address recruitment, there is a need to address the underlying serious malaise which is behind this data.

“We are in a perilous situation in England, with poor morale of the current GP workforce, and major difficulties with recruitment and retention of GPs reflected in the stark overall reduction in the GP workforce. Reactive, sticking-plaster, approaches are not the answer.”

Campbell said GPs and their teams delivered nine in every 10 patient contacts with the NHS but attracted just seven pence in every pound of NHS spending.

“The government needs to work with the Royal College of General Practitioners, the British Medical Association and universities to obtain evidence on the causes of the problem, to develop and implement relevant strategy, and to effect fundamental change in healthcare resourcing and planning nationwide,” he said.

Two in five GPs in south-west of England plan to quit, survey finds

Less than half of women breastfeed after two months, survey finds

Almost three-quarters of women in England start breastfeeding after giving birth but less than half are still doing so two months later, according to NHS and Public Health England data.

PHE recommends exclusive breastfeeding for the first six months, as does the World Health Organisation, because it boosts a baby’s ability to fight illness and infection. But a comparison of initial breastfeeding rates and those after six to eight weeks in the final quarter of 2015 found that they were 40% lower for the latter (44% compared with 73%).

A survey of 500 mothers commissioned by PHE found that fears about breastfeeding among women included that it could be painful (74%), prevent them taking medication (71%) and be embarrassing in front of strangers (63%).

The PHE’s chief nurse, Viv Bennett, said:“We can all help women feel comfortable breastfeeding their baby wherever they are. Creating a wider culture of encouragement and support will help make a mother’s experience all the more positive.”

PHE has launched an interactive breastfeeding friend chatbot, accessed through Facebook messenger, to provide personal support for breastfeeding 24 hours a day. Bennett said it would help women through the “crucial” initial period, after which things generally became easier.

A study published in the Lancet last year found the UK had the lowest rate of breastfeeding in the world, with only one in 200 women breastfeeding their children after they reach their first birthday.

The WHO recommends that breastfeeding form part of a baby’s diet up to two years of age. As well as reducing the likelihood of babies getting diarrhoea and respiratory infections, breastfeeding also lowers a mother’s risk of ovarian and breast cancer and burns about 500 calories a day.

The PHE survey found that many women were not only embarrassed about breastfeeding in front of strangers, but also their partner’s family (59%) and around siblings and wider family members (49%).

The results, published on Thursday, suggested high-profile figures who promote breastfeeding can have a positive influence on other mothers. Just under half of respondents said the example of household names such as The Only Way is Essex star Sam Faiers, broadcaster Fearne Cotton and actor Blake Lively, who have recently championed breastfeeding on social media, had inspired them to do so themselves. About two-thirds (64%) said they felt more confident to breastfeed in public because of celebrity mums.

Other concerns raised by more than half of women were not being able to tell if their baby was getting enough or too much milk and that it could potentially place restrictions on the mother.

Jacque Gerrard, the director for England at the Royal College of Midwives, said: “Any initiative that goes towards helping mothers start and sustain breastfeeding for longer is positive as we know the health benefits from being breastfed last a lifetime.”

Less than half of women breastfeed after two months, survey finds

Three-quarters of older people in the UK are lonely, survey finds

Almost three-quarters of older people in the UK are lonely and more than half of those have never spoken to anyone about how they feel, according to a survey carried out for the Jo Cox commision on loneliness.

The poll by Gransnet, the over-50s social networking site, also found that about seven in 10 (71%) respondents – average age 63 – said their close friends and family would be surprised or astonished to hear that they felt lonely.

Gransnet is one of nine organisations – including Age UK, the Alzheimer’s Society and the Silver Line helpline for older people – working to address the issue of loneliness in older people, which is the current focus of the commission, set up by Cox before her murder last June.

They are urging individuals and businesses to look for signs of loneliness and refer people to organisations that can help. But they also want people to take time to speak to neighbours, family, old friends or those they encounter randomly.

The chairs of the cross-party commission, the Labour MP Rachel Reeves and Conservative MP Seema Kennedy, said there was a stigma around loneliness that must be tackled.

“We all need to act and encourage older people to freely talk about their loneliness,” they said. “Everyone can play a part in ending loneliness among older people in their communities by simply starting a conversation with those around you.

“How we care and act for those around us could mean the difference between an older person just coping, to them loving and enjoying later life.”

Almost half (49%) of the 73% who described themselves as lonely in the online poll said they had been so for years, 11% said they had always felt lonely and 56% said they had never spoken about their loneliness to anyone.

Laura Alcock-Ferguson, the executive director of the Campaign to End Loneliness – another organisation working with the commission – said the percentage of lonely older people had stayed the same for five decades, but an ageing population meant the number was increasing in absolute terms.

“Loneliness is a serious public health issue and dealing with it will take the strain off the NHS and social care services,” she said.

Common trigger events said to have contributed to feelings of loneliness were bereavement, retirement and children leaving home. Being shy, living alone or far from family and low income were other commonly cited contributory factors.

The rise of social networking to the detriment of face-to-face interaction has been blamed for contributing to an “epidemic” of loneliness, but the survey of just over 1,000 people found it could also offer solace.

Almost three in five respondents (59%) said social media helped people feel less lonely and about eight in 10 (82%) said talking about loneliness was much easier when anonymous and online.

While the results indicate the potential benefits of online interaction, the older people are the less likely they are to have access to the internet, particularly women.

The commission is encouraging supporters and followers to post #happytochat on social media to create discussion around loneliness and for people to wear badges with the same slogan. Ultimately, they hope some customer-facing organisations will encourage their staff to wear the badges.

Respondents highlighted greater public awareness – a key goal of the commission – as the best way to combat loneliness.

Caroline Abrahams, charity director at Age UK, said: “There are reasons to believe that we can all do something to change things for the better: a simple thing like saying hello and having a chat can brighten up an older person’s day and do more good than most of us would ever guess.”

In coming months the commission will focus on loneliness in other groups, including men, people with disabilities, carers, refugees, children and parents.

Three-quarters of older people in the UK are lonely, survey finds

LGBT seniors marked for removal from survey on elder care services

The US Department of Health and Human Services has proposed the elimination of data collection for LGBT seniors from an annual survey that helps determine how billions of dollars are allocated for vital care services.

The National Survey of Older Americans Act Participants (NSOAAP) collects information about services including senior centers, home-delivered meals and transportation. The proposed 2017 survey is missing a question about the sexuality of respondents, which has been included since 2014.

“It’s a very bad sign because to strip LGBT older adults out of the survey suggests that the federal government believes that the needs of this elder population do not matter,” Michael Adams, chief executive officer of Services and Advocacy for LGBT Elders (Sage), told the Guardian.

Alongside basic demographic data, NSOAAP respondents give information as detailed as how many servings of meat they eat per day and what level of help they need for activities such as walking, dressing and eating.

Such information is used to measure the impact of government-funded services and is included in a report in the annual budget.

Adams said it was important to identify LGBT seniors in the survey because they are underserved.

“It doesn’t matter, frankly, whether LGBT elders are eating chicken or steak or fish in a senior center,” he said, “but what does matter is: are they eating in a senior center at all? Are they receiving care management services? Are they receiving caregiver support?”

Sage and other groups lobbied the Obama administration to include a question about sexuality in the survey. One was introduced in 2014.

The surveys from that year, 2015 and 2016 asked: “Which of the following best represents how you think of yourself: lesbian or gay; straight, that is, not lesbian or gay; bisexual; something else [which respondents were asked to clarify later]; refused; and don’t know [which respondents were also asked to clarify].”

A notice to the Federal Register dated 13 March 2017 said “no changes” had been made to survey. However, in its draft form it does not include the sexuality question.

The health department’s Administration for Community Living (ACL) said on a link to the draft that it “does contain modifications from the currently approved collection”. The agency is accepting comments on the proposal until 12 May.

The health department did not immediately respond to a request for comment. Adams said he would welcome a dialogue with the White House.

“In recent years, we have made significant progress in including LGBT elders in federally supported elder services and we will be watching very closely for any efforts to roll that back,” he said.

The disappearance of the sexuality question comes after moves by the White House to eliminate two federal statistical programs, igniting fears among senior statisticians that data that does not fit with administration policy could cease to be collected.

Last month, the Trump administration rescinded an Obama-era protection that allowed students unfettered access to bathrooms and locker rooms that corresponded with their gender identity.

On Monday, Sage launched a campaign to get LGBT supporters to respond to the call for public comments on the survey draft. As of Monday afternoon, nearly 700 people had sent letters opposing the planned change.

LGBT seniors marked for removal from survey on elder care services

Few foods on track to meet salt reduction targets, survey reveals

Bread rolls are the only manufactured foodstuff likely to meet stringent 2017 salt-reduction targets, research has revealed.

The food industry will miss almost every salt target set to lower the amount of the “hidden killer” in processed food.

A survey carried out by Consensus Action on Salt and Health (Cash) found that the only food group likely to scrape into the 2017 target range is “bread and rolls”. This means that by the end of this year they should contain no more than 1.13g of salt per 100g.

After examining all 28 categories of processed food, researchers could not find any other foodstuff coming close to meeting that target.

The government set up the public health responsibility deal in 2011 with the aim of encouraging manufacturers to self-regulate.

Targets for 2017 were set out in 2014 and Cash agreed to monitor the scheme independently by recording the salt content of common foodstuffs in UK shops and supermarkets.

The recommendations were designed to get British consumers eating no more than 6g of salt a day.

Health campaigners are now calling on Public Health England (PHE) to urgently set new targets for 2020 and push food companies to meet this year’s recommendations.

In their latest survey, doctors and scientists assessed salt levels on the typical supermarket shelf. In one of their more surprising findings they discovered that Galaxy Ultimate Marshmallow Hot Chocolate is saltier than seawater. A single serving contains more salt than a packet of crisps.

Looking at a shopping basket of everyday food items, the group found that for every unhealthy high-salt option, healthier lower sodium alternatives were also available.

In comparing the two sets of groceries overall, they found that there was a difference of 57g of salt between them.

Graham MacGregor, a professor of cardiovascular medicine at Queen Mary University of London and chair of Cash, said the findings were a national scandal.

“The UK was leading the world in salt reduction, but PHE are doing nothing to ensure that the 2017 salt targets are met,” he said.

Katharine Jenner, a nutritionist and Cash’s campaign director , described salt as the forgotten killer.

“The findings from our FoodSwitch shopping basket survey are alarming and we are shocked to see that many food manufacturers and retailers are still failing to meet the salt reduction targets, despite having had years to work towards them,” she said.

“We congratulate the other, more responsible manufacturers that have successfully achieved them, or are on track to meet them by the end of the year – which shows it is possible. With only nine months to go, action must be taken now.”

PHE’s chief nutritionist, Dr Alison Tedstone, defended the decision to allow the industry to self-regulate.

“The food industry has reduced the amount of salt found in our foods by 11% in recent years, which is encouraging progress,” she said.

“We know there is more to do. This is why we’re talking to retailers, manufacturers, and the eating out of home sector on how they go further and faster to reaching the 2017 salt reduction targets.”

A diet high in salt has been linked to high blood pressure, heart disease and stroke. NHS guidelines say that adults should aim to eat less than 6g of salt a day.

Last year, Cash recorded dangerously high levels of salt in dips and spreads commonly seen as healthy options.

It revealed that one supermarket brand of the hummus contained 1.6g per 100g.

Few foods on track to meet salt reduction targets, survey reveals

Constant restructuring of NHS is demoralising staff, survey finds

The number of NHS reorganisations in recent years is a key reason for the health service’s struggle to retain staff, a poll has found.

The NHS has been struggling to meet rising demand with a chronic shortage of staff and the results of a survey, published on Friday, suggest that a feeling of constant upheaval is at least partially to blame.

The poll by Wilmington Healthcare UK of more than 2,000 nurses, GPs and hospital doctors across the UK found that 64% blamed staff retention problems on the continuous and “demoralising” national changes in NHS workforce planning that had occurred since 2000.

The concerns about the state of flux are revealed as as the health service faces further big upheaval, in the shape of the controversial sustainability and transformation plans (STPs), which are intended to improve productivity and efficiency and so plug the NHS funding gap. The STPs will mean some hospitals and beds lost and more services being delivered in the community.

Wilmington Healthcare’s managing director, Gareth Thomas, said: “Our survey shows that continued changes in workforce planning since 2000 have been a major factor in NHS staff retention problems.

“This is of particular concern as the planned introduction of STPs in April 2017 is set to bring the biggest shake-up to NHS services since the publication of the Five Year Forward View.

“As the NHS moves towards a truly devolved health and social care system, it is clear that urgent action must be taken to support staff and help them manage the huge changes that are envisaged.”

Changes in NHS workforce planning, due to organisational changes, and said to have affected staff retention, included the establishment of primary care trusts, workforce development confederations and strategic health authorities, all since abolished (within three years of their creation in the case of WDCs). Primary care trusts were replaced by clinical commissioning groups.

Other key factors cited by respondents as adversely affecting the NHS’s ability to retain staff were low morale (92% of respondents) and poor pay and rewards (72%).

With concerns raised that the UK’s exit from the EU would exacerbate the shortage of NHS staff – 59,000 NHS staff are nationals of other EU countries – the survey also asked respondents about the impact of Brexit. Just under half (48%) said it would bemore difficult to recruit and retain staff, 45% said it would make no difference and 7% said it would be easier to recruit and retain staff. According to the Nuffield Trust, 10% of doctors and 4% of nurses are from the EU.

More than eight in 10 respondents (85%) said access to training and development was the key requirement of the future NHS workforce, closely followed by flexible working and career progression (both 78%).

An NHS England spokeswoman said: “This poll is wide of the mark and at odds with our own thorough and robust staff survey which garnered 423,000 responses. It found 80% of frontline NHS staff say they are able to do their job to a standard they are personally pleased with, 90% of staff say their job makes a difference for patients, and 92% of staff feel trusted to do their jobs, which does not seem to suggest a low morale workforce.”

Constant restructuring of NHS is demoralising staff, survey finds

Over half of NHS staff work unpaid overtime every week, survey finds

This past year has sent shockwaves through an already challenging working environment in the NHS. From the withdrawal of nursing bursaries and junior doctors’ strikes to the uncertain impact of Brexit on 58,000 EU nationals currently working in the health service, workforce pressures continued to build for an already overstretched service.

So what do the findings of the latest NHS staff survey, released on Tuesday, tell us about how staff are coping? Covering 316 participating NHS organisations, the survey is the biggest in the world, capturing the experiences of more than 423,000 healthcare professionals across the country.

The good news is that despite the tremendous pressures the NHS faces, nearly three quarters of staff remain enthusiastic about their job, while 70% said they would be happy with the standard of care provided by their organisation if a friend or relative needed treatment. The proportion of staff who reported feeling unwell due to work-related stress is at its lowest since 2012, down to 37%.

Responses addressing another key aspect of staff motivation – feeling empowered to contribute suggestions for improving work practices – also signalled positives. More than 70% of staff said that there are frequent opportunities to show initiative in their role, and 75% reported making suggestions to improve the work of their team or department. The survey did indicate room for improvement, however. Only a small majority of staff (56%) stated that these suggestions were actually acted upon – staff feedback does not appear to always translate into tangible change.

As is to be expected in such a pressured working environment, the survey does highlight some challenges for the NHS. More than half of staff (56%) report having attended work in the last three months despite feeling unwell, due to pressure from either their manager, colleagues or themselves. This is, however, a significant improvement since 2012, when 64% attended work despite illness. Most of this pressure comes from staff themselves (92%), rather than from managers (26%) or other colleagues (20%).

Generally, staff report feeling that managers are invested in their health and wellbeing. Most say that their immediate manager takes an interest in their health and wellbeing (67%) and that their organisation more broadly takes positive action on the health and wellbeing of staff (90%). These figures are on a par with those from last year’s survey and describe a workforce committed to working together and supporting one another to deliver high quality care – one that struggles more with heavy workloads and external pressures.

A key aspect of wellbeing is maintaining a healthy work-life balance and this is another area that contains some worrying figures. Staff report being satisfied with the opportunities to work flexibly – but 59% are, on average, working additional unpaid hours each week. Overall, the proportion of staff working additional hours is 72%, indicating that not enough has been done to alleviate workloads in light of similar results in recent years. The steady increase in both paid and unpaid overtime since 2012 is concerning as research repeatedly suggests that relying on tired and over-worked staff can lead to poorer standards of care.

The results of the 2016 staff survey suggest NHS staff are showing remarkable resilience despite the huge pressures that have been placed on the system. However, with external pressures such as Brexit likely to exacerbate existing problems in future years, a concerted effort is required from the government and NHS England to ensure that the positives to be found in staff motivation and engagement this year are not lost. NHS staff are subject to immense pressures that are unlikely to ease without significant support.

• Rory Corbett is a senior research associate at Picker, a charity that co-ordinates the NHS staff survey on behalf of NHS England
  

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Over half of NHS staff work unpaid overtime every week, survey finds

A quarter of young men self-harm to cope with depression, says survey

One in four young men are turning to self-harm as a result of depression, anxiety and stress, according to a YouGov poll.

Of the 500 men aged 16 to 24 surveyed, 24% said they had intentionally hurt themselves. The poll commissioned by three leading youth charities – the Mix, Self-Harm UK and Young Minds – also found a further 22% said they had considered self-harming.

Many said that when they felt under pressure they would turn to exercising excessively, controlled eating, pulling out their hair, punching walls and abusing drugs. When asked how they cope with stress, 21% admitted to drinking heavily, while 19% said they had punched walls and 16% admitted to controlled eating.

Experts say the figures are further evidence that self-harm is not confined to young women. They support NHS figures obtained by the Guardian last year which showed a sharp rise in hospital admissions for self-harm over the past decade.

The charities said the figures may be even greater, as many young men are unaware some of their negative behaviour is self-harm.

Chris Martin, chief executive at The Mix, a charity for under-25s, said: “What’s shocking about these results is the percentage of young men who are self-harming. Lately, we’ve seen a rise in young men accessing our mental health content, services and self-help tools.”

Chris Curtis, the chief executive of Self-Harm UK, said the issue needed to be urgently addressed “to help teenage boys deal constructively with the pressures they face”.

Dr Marc Bush, senior policy adviser at Young Minds, said: “Young men can find it hard to express their emotions because they need to be with the lads and have a sense of belonging. But they can have lots of issues with self-esteem and then have difficulty processing their emotions.”

Bush noted that many young men struggle with self-esteem issues due to the pressure to have a certain type of body. “Ten years ago we were worried about starvation, over-exercise and yo-yo dieting among women, but now we are seeing this in men. Young men think that these bodies are achievable and are doing anything to get them.”

Bush said some men become obsessed about exercise to cope with anxiety, working out to the point of doing physical damaging. “There are cases of men over-exercising and acquiring an injury and then carrying on despite their body saying ‘you’re hurting me’. Lots of young men in their 30s and 40s have done damage that way so they cannot do sports that they used to. Over-exercise can be a injurious activity.”

He added that more needed to be done to raise awareness about men’s mental health concerns, so young people can to talk about their experiences and learn ways to cope.

James Downs, 27, from Cardiff, turned to controlled eating and over-exercising to deal with difficult emotions as a teenager.

He said: “I started to retreat more and more into my eating problems and self-harming behaviours as a way of avoiding having to cope with my feelings. It was to numb the emotional pain I felt with physical pain.Things got so bad that I lost my friends, had to leave school and gave up my university place. I felt like I was a failure and this only made my damaging behaviour worse.

“Instead of blaming myself and isolating myself with my feelings I wish that I had been able to open up to others without feeling ashamed. Mental health and self harm weren’t topics that were ever mentioned in school or at home. They weren’t on the radar and that there needs to be much greater awareness and openness of these issues so that people don’t have to cope alone.”

The survey findings come after a dramatic rise in the number of children and young people self-harming in the past 10 years. There have been major rises among boys and girls.

An NSPCC spokesperson said: “A frightening number of children and young people are being driven to self-harm as a way of dealing with unresolved feelings, tensions and distress in their lives. Last year 18,778 children and young people in England and Wales were admitted to hospital for treatment for self inflicted injuries – a 14% increase over the last three years.

Sir Simon Wessely, of the Royal Psychological Society said it was worrying that reliable data also showed rates of self-harm among young men steadily increasing since 2000.

Downs said: “Life for a young person today is full of challenges that our parents didn’t have to experience. It’s fast paced, competitive and puts immense demands on our ability to remain resilient and cope in positive ways.”

A quarter of young men self-harm to cope with depression, says survey

65% of British public support new Clean Air Act, says survey

More than half of the British public believe air pollution levels across the UK are damaging to their health and almost two-thirds back proposals for new laws to tackle the issue, according to research.

Canvassing the views of 1,670 adults, the survey found that 58% believed the current levels of air pollution in the UK to be either harmful or very harmful to health, a figure that rose to 73% among Londoners. What’s more, 65% of those polled said they would support a new Clean Air Act to tackle the issue.

The study, undertaken by YouGov, was commissioned by the environmental law organisation ClientEarth on behalf of the campaign for a new Clean Air Act.

Launched this week, the campaign is a coalition of organisations, charities and activists – including Greenpeace, the British Lung Foundation and Sustrans – calling for fresh legislation to reduce air pollution.

“This poll clearly shows that people across the UK want the prime minister to get serious about the toxic and illegal levels of air pollution,” said James Thornton, the chief executive of ClientEarth which is leading the coalition.

“This is an urgent public health crisis over which the prime minister must take personal control,” he added. “She must listen to the country and come up with a credible plan that will reduce air pollution as soon as possible, so we are not choking on illegal levels of pollution until 2025 or beyond. The time for excuses is over.”

Poor air quality is a growing issue in cities around the world and is linked to a host of health problems, including heart failure, strokes and dementia.

“It’s no exaggeration to say that air pollution is a public health crisis. It contributes to up to 40,000 early deaths a year across the UK,” said Dr Penny Woods, chief executive of the British Lung Foundation. “Toxic air is a risk to everyone but hits those with a lung condition, children and the elderly hardest.”

The problem is acute. Last month it was found that parts of London had exceeded their annual legal limits for nitrogen dioxide (NO2) in the first five days of the year, while January’s cold, still weather exacerbated problems across swaths of the UK, with multiple regions rated as having high or very high pollution levels, and the capital put on high alert. Last week, the European commission announced it was escalating action against the UK for its failure to keep to agreed limits on air pollution.

‘The poll shows people want the prime minister to get serious about the toxic and illegal levels of air pollution,’ said James Thornton, CEO of ClientEarth. Photograph: Philip Toscano/PA

But while the study suggests the majority of Britons would back attempts to improve air quality, the fervour appears to be split along Brexit lines. Those who voted to leave the EU were less concerned about air pollution, less likely to support the banning of diesel vehicles in areas of high pollution, and were less inclined to place the burden of addressing the problem on the government’s shoulders; while 67% of remain voters held the government among those chiefly responsible for keeping our air clean, only 47% of leave voters felt the same. By contrast both camps strongly believed the motor industry and other businesses linked to air pollution should lead the way.

What’s more, while half of remain voters said air pollution had worsened over the last eight years, those who voted leave were more sanguine, with only 36% believing the problem had grown.

Although 57% of leave voters support a new Clean Air Act, with mooted measures including reducing traffic and shifting to low-emission vehicles, only 33% felt that when Britain leaves the EU, there should be stronger laws on air quality in Britain. More than half of remain voters said they supported stronger laws.

Simon Birkett, founder and director of Clean Air in London, part of the new coalition, stressed the need for action, adding that any legislation should ensure powers and responsibilities are given to the mayor and local authorities to tackle the problem.

“Sixty years after the first Clean Air Act, which fought respiratory problems from short-term exposure to visible air pollution from coal and wood burning, we need a new Clean Air Act to address newly understood health effects that include heart attacks and strokes from long-term exposure to invisible air pollution from diesel fumes,” he said.

A government spokesperson defended current plans to tackle the issue. “We are firmly committed to improving the UK’s air quality and cutting harmful emissions. We have committed more than £2bn since 2011 to increase the uptake of ultra-low emissions vehicles, we support greener transport schemes, and have set out how we will improve air quality through a new programme of clean air zones.

“In addition, in the autumn statement, we announced a further £290m to support electric vehicles, low-emission buses and taxis, and alternative fuels. We will update our air quality plans in the spring to further improve the nation’s air quality.”

Guardian Cities is dedicating a week to investigating one of the worst preventable causes of death around the world: air pollution. Explore our coverage in The Air We Breathe and follow Guardian Cities on Twitter and Facebook to join the discussion

65% of British public support new Clean Air Act, says survey

Half of adult women in Brazil put off pregnancy by Zika virus – survey

More than half of adult women of reproductive age in Brazil have actively tried to avoid pregnancy because of the Zika virus epidemic, according to a survey carried out there.

Brazil has confirmed far more malformations of the brain in babies born to mothers who were infected with Zika than any other country.

So far, there have been 1,845 confirmed cases of what is now being called congenital Zika syndrome; a further 7,246 cases are suspected but the link to the virus has not yet been firmly established.

The survey carried out in June, led by academics in Brazil, shows that 56% of women who responded have tried to avoid becoming pregnant as a result. The numbers are no different among those who describe themselves as having religious beliefs – 58% of Catholics and 55% of Evangelicals in the survey said they were avoiding pregnancy.

In a letter to the Journal of Family Planning and Reproductive Healthcare, Dr Debora Diniz from the University of Brasilia and colleagues say there is an urgent need for Brazil to reconsider its policies on family planning and abortion, to help women who want to avoid the risk of having a baby with brain malformation.

“As indicated by the high proportion of women who avoided pregnancy because of Zika, the Brazilian government must place reproductive health concerns at the centre of its response, including reviewing its continued criminalisation of abortion,” they write.

The government should ensure better access to contraceptive methods and information, they say, arguing for a wider range of methods to be made available. Long-lasting reversible contraception such as intrauterine devices are scarce, they say, and hormonal implants are unavailable through the public services.

Women’s groups are attempting to challenge Brazil’s abortion restrictions through the courts, arguing that those infected by the Zika virus should be permitted a termination.

The team conducted a face-to-face survey of more than 2,000 women, who are literate and between the ages of 18 and 38, which corresponds to 83% of the female population.

They found that 27% had not tried to avoid pregnancy and 16% were not planning to become pregnant anyway, regardless of the Zika epidemic.

The response reflects the geographical impact of the epidemic, with a higher proportion of women from the hard-hit north-eastern region (66%) trying to avoid pregnancy than in the south (46%).

“Black (64%) and brown (56%) women were more likely to report avoiding pregnancy than white women (51%), which also likely reflects the disproportionate impact of the epidemic among the most vulnerable racial groups,” they write.

An estimated 174,000 Brazilians are said by the ministry of health to have been infected with the Zika virus, although the last updated figure was in early July.

Half of adult women in Brazil put off pregnancy by Zika virus – survey

Risk of poverty and suicide far higher among transgender people, survey finds

Transgender people are substantially more likely to have attempted suicide, to be unemployed, and to be living in poverty than the broader US population, according to a landmark new survey by the National Center for Transgender Equality (NCTE).

The survey of more than 28,000 trans individuals by the Washington DC-based advocacy organization suggests that along with a battery of health and economic indicators, transgender people face persistent discrimination and a litany of other challenges.

“Responses revealed pervasive mistreatment, harassment and violence in pretty much every facet of life whether that be in the schools, the workplace or family life,” said survey project manager Sandy E James.

The results on mental health were of particular concern. Thirty-nine percent of respondents said they had experienced “serious psychological distress” in the past year, compared with 5% of Americans.

Forty percent of those surveyed said they had attempted suicide in their life, almost nine times the US overall attempted suicide rate. Seven percent said they had made an attempt within the last year, more than 10 times the national prevalence.

“We have already known that these are issues … in the trans community but now we actually have a tool that we can reference to [say] these are the numbers,” said NCTE executive director Mara Keisling. “That can be a useful instrument for creating transformative change in the lives of transgender people.”

Nearly one third of respondents said they were living in poverty, about twice the rate of Americans nationwide. Respondents also reported an unemployment rate of 15%, three times higher than than the national rate. Trans people of color were the most likely to experience high rates of unemployment. Researchers said they intentionally shaped survey questions to be comparable to survey data regarding the broader US public.

A quarter of those employed over the last year said they had experienced discrimination in the workplace, and more than three quarters of those who were “out” or perceived as transgender during school recall experiencing “some form of mistreatment”, including sexual assault and verbal and physical harassment.

James said NCTE plans to repeat the effort every five years to keep tabs on the challenges that transgender individuals face over time. The study released this week is the second such report, following a less expansive effort in 2011.

This year’s study also looked at what could be considered the most visible aspect of the battle for trans rights in the US today, public restroom accommodations. Legislation like North Carolina’s HB2, which restricts individuals to using only the bathroom reflective of the biological sex listed on their birth certificate, has turned the issue into a flashpoint for transgender rights.

The most visible recent debate over transgender rights has surrounded North Carolina’s so-called ‘bathroom battle’. Photograph: Mandel Ngan/AFP/Getty Images

“I can speak first hand for how critical [it is] for transgender people to have safe and private bathroom access just like everyone else”, said Sharron Cooks, a trans woman and activist. Cooks added that when she was in high school, she was banned from the women’s room, calling the experience “crushing”.

“It made it impossible to learn and it severely delayed my academic career,” Cooks said.

The study found that Cook’s experience is far from unique. More than half of survey respondents said they had avoided using a public restroom in the past year because they “were afraid of confrontations or other problems they might experience”. 32% said they had limited the amount they ate or drank in the previous year specifically to avoid using the bathroom.

But Keisling cautioned that while the bathroom issue is important, “we have a lot of issues … that are missed when all we talk about is bathrooms.”

Keisling added: “Every minute we spend talking about it, we’re not talking the problems in real people’s lives. We’re not talking about the economic marginalization and we’re not talking about people being alienated from their faith communities and families.”

Risk of poverty and suicide far higher among transgender people, survey finds

Four in five UK councils struggle to provide older people"s care – survey

Four in five UK local authorities have insufficient care for older people in their area, with the shortage most acute for some of the most vulnerable in society, research suggests.

The Family and Childcare Trust surveyed councils across the country and found they are struggling to meet needs amid a background of growing demand, budget cuts and recruitment difficulties.

The survey is published on the same day as an undercover investigation by BBC Panorama is to be broadcast, exposing shocking neglect at two Cornwall care homes, including vulnerable people being left unattended and a nurse saying she will use morphine to “shut up” a resident.

The deficit identified by the Family and Childcare Trust means more than 6.4 million people aged 65 and over are living in areas that do not have enough older people’s care to meet demand.

Only one in five councils reported having enough older people’s care in their area to meet demand, the survey found.

Just under half (48%) of the 182 councils (out of 211) that responded said they had sufficient availability of home care and a similar proportion (44%) reported having enough places in extra care homes, which allow people to live independently with 24-hour emergency or on-site support.

Only a third of local authorities said they have enough nursing homes with specialist support for dementia, which is predicted to affect one million people in the UK by 2025.

Claire Harding, head of research at the Family and Childcare Trust, which works closely with the government and local authorities, said: “It is inexcusable that vulnerable people are left unable to find the care that they need.

“We urge government to make sure there is enough care for everyone who needs it. In order to do this, we need robust data on where there are gaps in care, a funding system that truly meets the cost of providing care, and clear information for families.

“Without these steps, families will continue to struggle to find care and to meet the numerous care costs on their shoulders.”

The survey also highlighted large regional variations, with just 7% of outer London councils reporting enough older people’s care to meet demand. The only area where more than half of local authorities reported sufficient care was the north-east, where 57% responded positively.

The findings will add to the sense of crisis surrounding social care, with delayed transfers of care – when patients are medically fit to leave hospital but unable to be safely discharged – at record levels.

Council and NHS leaders, as well as the Care Quality Commission, have called for urgent action, with the chancellor, Philip Hammond, facing pressure to increase social funding in Wednesday’s autumn statement.

Inner London councils pay the highest rates for residential care for older people, at £649 a week per place, compared with the lowest rate of £464 in north-west England, according to the survey. The UK average for a residential place was revealed to be £27,113 a year.

A Department of Health spokeswoman said: “This government is committed to making sure older people throughout the country get affordable and dignified care. That is why we are significantly increasing the amount of money local authorities have access to for social care, by up to £3.5bn by 2020.”

Monday’s Panorama sees reporters go undercover at Clinton House in St Austell, and St Theresa’s, in Callington, near Plymouth, both owned by the Morleigh Group.

Hidden camera footage captured one resident left on a bed pan for 40 minutes and an out-of-date prescription supplement relabelled for use by another resident.

Clinton House is being closed as a result of safety concerns and St Theresa’s is under investigation by authorities along with two other Moreleigh Group homes.

Moreleigh Group said it had already removed the staff involved and reviewed its systems and procedures, prior to receiving information from Panorma. Cornwall council apologised for the failings.

Four in five UK councils struggle to provide older people"s care – survey

Three-quarters of labour wards lack consultant cover at night – survey

About three in four labour wards do not have on-site overnight cover from consultants, figures suggest.

A survey of 165 maternity units found that in 2014-15 about 27% of labour wards had consultants physically present overnight on weekdays, falling to 15% at the weekend.

The census by the Royal College of Obstetricians and Gynaecologists (RCOG) also found the number of consultants may have reduced since figures were first recorded in 2013 and some recommendations on early pregnancy care had not been implemented.

Edward Morris, the vice-president of clinical quality at the body, said: “The RCOG recommends that trusts should ensure the adequate provision of consultant cover to deliver high quality, safe care to women. It is important to highlight that all consultant-led maternity units currently have 24-hour access to consultant obstetricians on call, some with resident working where needed.

“Ultimately, local trusts need to look carefully at the mix of their patient load, risk profile and staffing to decide whether their particular unit needs more frequent consultant presence.”

The RCOG said slightly fewer units had provided responses to the latest census, so the data had to be interpreted with caution.

The number of consultants had reduced since the survey was first carried out. However, the body said this was likely to be a reflection of a fall in the number of responses.

However, it found recommendations to increase the low number of weekend early pregnancy services had not been put into effect. “It is not clear why this remains the case as in the interest of patient care this would be considered one of the first services that could be provided seven days a week,” the RCOG said.

Some studies have suggested that round-the-clock cover by consultants is only necessary on the busiest labour wards.

An NHS England spokeswoman said: “Having a baby is now safer than it has ever been and the vast majority of mothers report that they get great NHS maternity care.

“Researchers at Oxford University have shown that overnight consultant obstetrician presence isn’t proven to improve care, and a national diktat to that effect would mean the closure of many smaller units, which is another reason why it wouldn’t necessarily be a good idea.”

Three-quarters of labour wards lack consultant cover at night – survey

NHS is most widely held concern of UK adults, survey finds

The NHS has narrowly replaced immigration and Brexit as a key issue facing Britain in the minds of most voters, according to a new survey of public opinion by pollsters Ipsos Mori.

Two out of five (40% of) people mentioned the health service, hospitals or healthcare as a concern to them – more than cited any other issue. That was just ahead of the numbers who identified immigration or immigrants (39%) as either the most important or an important issue.

The European Union or Europe was mentioned the third highest number of times (35%), according to the poll of 980 adults chosen to be representative of the whole population.

Europe was also identified by the largest number of respondents (23%) as the single most important issue of all facing Britain today, ahead of immigration/immigrants (20%). Using that measure of concern the NHS was only the third most often-cited issue (10%).

The firm’s latest “issues index” monthly tracker poll of what people think is important shows that 4 percentage points more people identified either immigration or the EU last month as a concern when their views were sought compared to those who had done so in August. However, an even larger monthly rise in the number of voters who mentioned the NHS – 9 percentage points – made it the most-mentioned issue. It is the first time that it has been the most widely-held concern since June 2015, when 44% cited it.

“The NHS in particular saw a rise in concern this month, as fieldwork for this survey took place as media attention was focused on the planned and then cancelled junior doctors’ strikes”, said Gideon Skinner, Ipsos Mori’s head of political research.

“But even so, this tallies with other research which suggests [that] while satisfaction with NHS services is holding up, concern about the future of Britain’s favourite public service is growing, with record levels expecting it to get worse over the next few years, while worries over waiting times and funding are perennial underlying factors,” he added.

Voters were not asked why they had specified certain issues when fieldwork for the latest survey was undertaken on 2 and 22 September. But the threatened series of five-day strikes by junior doctor in England over the new contract that has just been imposed on them, missed waiting time targets for treatment and a general unease about the health service’s future amid the rising financial and demand pressures it is under, may explain why the NHS emerged as the commonest concern.

“Although some of the increased concern about the NHS is likely to be driven by the dispute between junior doctors and the government, it shows that concerns about the huge financial and operational pressures facing the NHS are filtering through to the public,” said Professor Chris Ham, chief executive of the King’s Fund health thinktank.

“The public are right to be concerned, as the NHS is under huge financial pressure and waiting times are getting longer.”

Anxiety over increasing rationing of NHS care may also be a factor. September saw media coverage of various NHS bodies in England denying patients access to IVF treatment for infertility, cataract removal operations and breast cancer drugs costing just 34p a day. A major report by doctors also warned that the NHS was “underfunded, underdoctored, overstretched.”

Ham, a Downing Street adviser on the NHS in the early days of the coalition government, urged politicians to be more upfront about the state of the NHS and stop pretending that the extra £10bn ministers have pledged to give the service in England during this parliament will be enough.

“Politicians of all parties need to be honest with the public about the NHS, as it is not credible to suggest it can continue to meet demand for services and maintain standards of care at the same time as staying within the current budget,” Ham added.

The economy dropped five points between August and September; one in four people (25%) said it was an important issue. But education rose five points to 19%. Unemployment and poverty and inequality were each cited by 16%, while and housing fell seven points to 15%, despite widespread concern about the growing unaffordability of property.

Just 13% mentioned crime, law and order or antisocial behaviour, while the numbers citing defence, foreign affairs or terrorism fell from 19% in August to just 11% in September.

“Mrs May is facing a very different public mood to her predecessor when he began his premiership. When David Cameron took over in May 2010 the economy dominated all other topics, but since then it has dropped down the agenda and the importance of issues such as the NHS, immigration and housing has grown,” Skinner added.

“The NHS is of course a traditional strength for Labour, but although this rise in concern may give them an opportunity it doesn’t mean an automatic boost for them. First of all, Conservative supporters are just as likely to say the NHS is important to them as Labour supporters, and secondly when forced to choose the single most pressing issue, the public say Brexit and immigration are more on their minds.”

A recent poll by Britain Thinks found that while 30% of voters trusted Labour leader Jeremy Corbyn to protect the NHS, even more – 38% – said that Theresa May would do so.

NHS is most widely held concern of UK adults, survey finds

Doctors" political views can affect advice given to patients, says survey

Doctors’ political beliefs can skew the advice they give patients on sensitive issues such as abortions and cannabis use, according to new research.

A survey of more than 200 doctors found that those with conservative views were more likely than others to discourage patients from having an abortion in the future. They also handed out more stern warnings over the legal and health risks of using cannabis.

The results suggest that doctors’ political leanings can spill over into the guidance, and even the treatments, they offer to patients under their care. The findings build on previous work that has highlighted gender and race biases in the medical treatment different people receive.

“Doctors need to think through these kinds of issues, because if they are dealing with politically sensitive issues, this is unavoidable,” said Eitan Hersh, a political scientist at Yale University. “If we can get this out to physicians, they can be more aware of it.”

“If you’re a patient and you are choosing a new doctor, you might want to know their views beforehand,” Hersh said.

Writing in the journal, Proceedings of the National Academy of Sciences, Hersh and his colleague Matthew Goldenberg, describe how they linked more than 20,000 primary care doctors in 29 US states to their political party affiliations using public voter databases. From these they selected more than 200 doctors, half Democrat, half Republican, to receive a survey from Yale medical school, rather than their own Institution for Social and Policy Studies, to disguise the political nature of the study.

In the survey, the doctors were asked to rate the seriousness of nine scenarios presented by patients. The vignettes included references to drinking too much alcohol, smoking cigarettes, using marijuana, being depressed, visiting sex workers, riding a motorbike without wearing a helmet, storing guns in a house where there were children, and having had two elective abortions in the past.

The doctors more or less agreed on the seriousness of the less politically-charged issues, such as alcohol abuse and not wearing a helmet. But they differed substantially in their reaction to more sensitive issues, such as cannabis use, elective abortions and having guns in the home. The Republicans were more concerned than Democrats about patients having future abortions and using cannabis. Meanwhile, Democrats were more vexed than Republicans at patients having guns in the home.

A similar split emerged when doctors proposed how they would treat each patient. The survey found Republican doctors were more likely to warn patients about the health risks of using too much cannabis. They raised the legal risks of the drug too, and urged patients to cut down. They took a stronger line on abortions, too, the researchers found.

“As a patient, it’s useful to ask ‘is my doctor telling me this because it’s what the medical evidence says, or is it because of their world view?’” Hersh said. “Doctors sometimes say they think of themselves as mechanics, that whatever patient comes in they will treat them the same way. But it’s obvious that’s not true. It’s never the textbook scenario.”

Hersh says the findings point to a need for greater transparency. With that in mind, he is considering setting up a website that links doctors to their political affiliations, an idea he said did not appear to be popular among doctors he had spoken with. “There’s a strong economic incentive for them not to close off half of their business because they are with what patients might regard as the wrong party,” he said.

Doctors" political views can affect advice given to patients, says survey

Self-harm, PTSD and mental illness soaring among young women in England – survey

Rates of self-harm, post-traumatic stress disorder (PTSD) and chronic mental illness are soaring among young women in England aged 16 to 24, according to the biggest NHS survey of mental ill-health and treatment since 2007.

One in eight young women (12.6%) within that age group has PTSD, according to the study. That is three times the 4.2% rate found when the government-funded adult psychiatric morbidity survey was last conducted in 2007.

PTSD graphic

Researchers found a similarly worrying upward trend for the number of 16- to 24-year-old young women who self-harm – almost one in five. That has risen three-fold from 6.5% in 2000 to 11.7% in 2007 to the 19.7% found in 2014.

The same age group also has the highest rates of common mental disorders such as anxiety and depression of any group in the population. Overall 28.2% of young women told researchers they had some form of mental health condition, almost three times higher than the 10% of men from the same age group who did so.

Mental health graphic

Experts said that violence and abuse, including rape, as well as near-death experiences such as car crashes, and a loved one being killed or committing suicide were part of the explanation for the sharp rise in PTSD.

Although the definition of what constitutes trauma has remained unchanged since the survey was last conducted in 2007, the researchers said that their use for the latest survey of a new screening tool for PTSD, which is thought to be more accurate than its predecessor, may help explain the big jump in those with that disorder.

Sally McMahon, the lead researcher behind the survey, said: “We know that there are things like violence and abuse that are strongly associated with mental illness.”

Graphic

But, she added: “This is also the age of social media ubiquity. This is the context that they [young women] are coming into and it warrants further research.”

She described 16-25 year olds as the “first cohort to come of age in social media ubiquity”.

She pinpointed mobile phone use as another potential driver if the alarming trends revealed in the report, published on Thursday by NHS Digital.

Self-harm, PTSD and mental illness soaring among young women in England – survey

Northern Ireland is happiest place in UK, finds wellbeing survey

Northern Ireland is the most contented region of the UK, while London is the most anxious and least satisfied, according to statistics on local wellbeing published on Tuesday.

It will be little comfort to stressed-out, dissatisfied Londoners that their overall satisfaction has improved faster than other parts of the country.

The survey by the Office for National Statistics (ONS), which is part of the larger labour force survey with 158,000 respondents, asks people to rate out of 10 their overall satisfaction with their life, the extent to which they feel things they do are worthwhile, how happy they felt yesterday, and how anxious they felt the previous day. The national data, published in July, shows wellbeing has improved each year since 2011, but this masks regional differences.

These differences are not large, but taken together they paint a nuanced national picture. In Northern Ireland, for example, people ranked their life satisfaction at 7.85 out of 10 on average. In London this was 7.51. Londoners rated their own anxiety at 3.04 out of 10, while those in the West Midlands put it at 2.75. Those in Northern Ireland put their happiness at 7.70, while for those in the north-east it was 7.36.

The data includes almost every local authority, but sample sizes for many are very small, meaning comparing the regional picture is more reliable. The Northamptonshire town of Corby came bottom on life satisfaction and worthwhile measurements. However this was based on responses from 80 people.

In London ‘the very poor and extremely rich live within sight of one another’. Photograph: Photofusion/Rex Shutterstock

The national “wellbeing index” was one of David Cameron’s flagship policies when he entered Downing Street. “It’s time we admitted that there’s more to life than money and it’s time we focused not just on GDP but on GWB – general wellbeing,” he said, and ordered the ONS to start gathering data.

Annie Quick, who leads inequality and wellbeing work at the New Economics Foundation, a thinktank that has championed the gathering of such data, said London’s gloom may be understandable. “There are real challenges about living in cities,” she said. “Commuting is very bad for wellbeing: the long periods of time spent travelling to work are … bad for our families, and bad for community cohesion.”

The deeply unequal nature of London, where the very poor and extremely rich live within sight of one another, adds to dissatisfaction, she added.

But Northern Ireland’s apparent contentment has the experts confused – one press officer blurted out, “Really?” when the Guardian explained the ONS’s findings.

Quick said: “Northern Ireland is really interesting: if you go to Northern Ireland and talk to them, they are very surprised. We don’t have the answer.”

The local authority of Mid and East Antrim in Northern Ireland tops the table on “life satisfaction” and “worthwhile” measures and is second on the “happiness” measure. Its mayor, Audrey Wales, said she was delighted with the finding.

“Ensuring the good health and wellbeing of our citizens is a key strategic aim for Mid and East Antrim borough council and we are delighted that this survey shows that we are certainly going in the right direction.”

She added: “With a rich heritage and culture, our borough is a beautiful, welcoming and unique place with a huge offering for its citizens and visitors alike. What sets us apart is our strong community spirit and the diversity of our citizens.”

Quick said the things that affect wellbeing are well known: good-quality housing and environment, stable jobs, and functioning communities. Simply asking people how happy they feel incorporates these factors, she said, but “it’s a very sensitive measure that picks up all sorts of other things … The challenge is for local authorities to look at those things.”

Dawn Snape, a quality of life officer at the ONS, said: “We have seen personal wellbeing improving on a UK-wide basis over the past five years. But today’s data paints a richer picture, enabling people to explore what’s been happening in their local area.

“This will help individuals, communities and local authorities to look at wellbeing locally alongside other more traditional measures of progress.”

Quick said the UK is a “world leader” at gathering these statistics. But she added: “We need to embed this thinking into devolution debates: these are often focusing on maximising economic growth but building the economy is a means to an end. What could be more important than making sure we have good quality of life?”

Northern Ireland is happiest place in UK, finds wellbeing survey

Half of UK parents allow children to drink alcohol at home, says survey

Half of parents with children under the age of 14 allow them to drink alcohol at home, research by Churchill home insurance has found.

It also found that 34% of parents with children under 14 used alcohol as a bribe to encourage good behaviour, while 11% of parents with children aged five to seven allowed them to drink at home. A quarter of those surveyed who let their children drink said they saw nothing wrong with it.

Related: Should you be worried about your student son or daughter’s drinking?

While it is not illegal for children aged five to 16 to have alcohol at home, the Chief Medical Officer’s report states that children under 14 who drink have increased health risks – including suicide attempts, involvement in violence and alcohol-related injuries.

Almost a third of parents said that allowing their children to drink at home let them monitor their child’s alcohol consumption. The research also suggested that one in five parents would allow minors who are not family members to have alcohol in their house.

Martin Scott, head of Churchill home insurance said: “The relationship between children and alcohol in Britain always seems more fraught than for our continental cousins. Many parents want their children to have a responsible attitude to drinking and introduce alcohol in a safe, controlled environment.

“The challenge any parent will recognise is how to prevent excessive drinking, especially amongst teenagers … Whenever people are drinking in the home, there is a greater risk of injury or property damage as alcohol has a significant impact on co-ordination.”

Joanna Simons, chief executive at Alcohol Concern, said: “We know that many parents start from the best intentions when they introduce children to alcohol at home, but all the research indicates that the younger that children start drinking, the more likely they are to have problems with alcohol in later life.

Related: Alcohol-related deaths in England up 4% in one year

“Parents are really important role models for their children and the more that they can keep an eye on the number of units they’re drinking, and have a few days off drinking each week, the more that their children’s attitude to alcohol will be shaped in a safer way.

“The Chief Medical Officer advises that an alcohol-free childhood is the safest option and that those under 15-years-old, ideally, should not drink at all.”

Rosanna O’Connor, director of alcohol, drugs and tobacco at Public Health England, said: “Advice from the Chief Medical Officer for England is that an alcohol-free childhood is the healthiest option.

“Most parents are aware of the dangers of children and young people consuming alcohol from an early age and evidence points to the fact that starting to drink alcohol before the age of 15 can affect their health and wellbeing in the future.”

Half of UK parents allow children to drink alcohol at home, says survey

Survey: 25% of UK architecture students treated for mental health problems

More than a quarter of architecture students in the UK are receiving or have received medical help for mental health problems related to their course. Another quarter feel they may have to seek help in future.

Anxiety over the student debts accrued during the seven-year course, and workloads that frequently require all-nighters, were the primary sources of stress identified by undergraduates.

Poor-value university courses, architectural practices demanding they work for free and sexual and racial discrimination were the other issues highlighted by respondents to the survey carried out by the Architect’s Journal.

More female students reported seeking medical advice for mental health than male students. Nearly one in three women in the survey, 29%, reported receiving mental health treatment over issues directly related to their course, compared with 23% of men.

Nearly 90% of the 447 respondents said they had had to work through the night at some point. Almost one-third said they have to do it regularly.

Related: Six things students can do to boost their mental health

Two-thirds of undergraduates said their debt at the end of their course would be £30,000 or above. Despite that, almost a third said they had been asked to work in practice for free.

Students taking part in the survey reported seeing friends suffering from hair loss as a result of stress. One respondent reported that two course mates had committed suicide, though the Architectural Journal was unable to verify that report. Another student wrote: “I feel so emotionally drained, without any confidence in my ability.” Another said: “A culture of suffering for your art is promoted within education.”

Anthony Seldon, vice-chancellor at the University of Buckingham and a mental-health campaigner, said: “Britain has a near epidemic of mental health problems among its students. Those studying architecture appear to be under added burdens, emanating perhaps from the very length of the course and time taken before earning a proper income.

“Much could be done to rethink the courses so they align with the architectural education needs of the future rather than the dictates of the architectural big cheeses of the past.”

Almost a third of architecture students in the survey said they had been asked to work in practice for free. Photograph: Alamy

University staff, too, are noticing the emotional strain of architecture education on their students. Timothy Smith, architecture course director at Kingston University, said there has been a rise in the number of students applying for “mitigating circumstances or extensions” in recent years, adding that the requirement for many to work part time means there is a “great deal of pressure” on them.

Nam Kha Tran, a student at the Sheffield School of Architecture, said mental health problems are the “disease of our generation”.

Stephen Buckley, head of information at the mental health charity Mind, says university students are not only burdened with the stress of exams and coursework deadlines but also with high student loans and debt. He reports a surge in calls to the charity’s helpline from those struggling with financial problems in the last few years.

Jane Duncan, president of the Royal Institute of British Architecture, is urging architecture students struggling with mental health problems to seek help, stressing that they “are not alone”. She said that long hours, a heavy workload and intense design scrutiny were embedded in the culture of architecture education.

Duncan added: “I am concerned that the combination of tuition fees, rising student debt and the necessity for many students to take on paid work outside study can trigger or exacerbate mental health problems.”

Survey: 25% of UK architecture students treated for mental health problems