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Tackling health inequalities remains key

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Physical activity is key to a healthy life Physical activity is key to a healthy life

Viv Bennett, the director of nursing for public health, and the DH have called for primary care and community nurses to capitalise on the legacy of the Olympic and Paralympic Games by taking every opportunity to pass on healthy living advice to patients.

The Olympics has led to a flurry of welcome initiatives attempting to piggyback on increased interest in physical activity, but also those meant to improve health behaviours more generally and to give a push to the government's every 'contact counts programme' which urges health professionals to question and advise patients about their lifestyle at every meeting.

The King's Fund has published a new analysis of how the 'every contact counts' behaviours - smoking, alcohol consumption, fruit and vegetable consumption and physical activity - have changed in the English population, and where in the population these behaviours are concentrated. There is some really positive news; the proportion of adults with three or all four behaviours fell from about one in three of the population in 2003 to one in four in 2008. But much of this improvement was in the higher socio-economic and educational groups, widening inequalities over time.

In 2003, those with no qualifications were on average three times more likely to be smoking and not meeting government guidelines on the other behaviours than someone with the highest qualifications; by 2008 that had increased to five times more likely. The government's developing vision for the role of nurses in 'every contact counts' needs to take into account that most contacts will benefit from advice on more than one behaviour. That in turn is likely to depend on building relationships for the long-term, more 'every relationship counts'.

Better understanding the dynamics of behaviour change when people have multiple unhealthy behaviours, especially in those groups where success is traditionally hard to come by, will be critical if nurses are to fulfil their promise in securing an Olympic legacy for health.

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