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Air pollution kills more people in the UK than in Sweden, US and Mexico

People in the UK are 64 times as likely to die of air pollution as those in Sweden and twice as likely as those in the US, figures from the World Health Organisation reveal.

Britain, which has a mortality rate for air pollution of 25.7 for every 100,000 people, was also beaten by Brazil and Mexico – and it trailed far behind Sweden, the cleanest nation in the EU, with a rate of 0.4.

The US rate was 12.1 for every 100,000, Brazil’s was 15.8 and Mexico’s was 23.5, while Argentina was at 24.6.

The figures are revealed in the WHO World Health Statistics 2017 report, published on Wednesday, which says substantially reducing the number of deaths globally from air pollution is a key target.

The report reveals outdoor air pollution caused an estimated 3 million deaths worldwide, most of these in low- and middle-income countries.

Wealthy European nations had high levels of air pollution from fine particulate matter. The UK had an average of 12.4 micrograms of fine particulate pollutants (PM 2.5) for each cubic metre of air, which includes pollution from traffic, industry, oil and wood burning and power plants in urban areas. This is higher than the pollutant levels of 5.9 in Sweden, 9.9 in Spain and 12.6 in France. Germany had higher levels of particulate pollution than the UK at 14.4 and Poland’s was 25.4.

Dr Penny Woods, chief executive of the British Lung Foundation, said the report confirmed that deaths from air pollution were higher in the UK than many other comparable countries.

She said: “It is deeply tragic that around 3 million lives are cut short worldwide because the air we breathe is dirty and polluted. In the UK, air pollution is a public health crisis hitting our most vulnerable the hardest – our children, people with a lung condition and the elderly.

“Yet, we are in the fortunate position of having the technology and resources to fix this problem. It’s time to use what we have to sort this problem out as a matter of urgency and clean up our filthy, poisonous air. The next government needs to bring in a new Clean Air Act to protect the nation’s lung health.”

The worst countries for toxic air included India, where 133.7 deaths for every 100,000 people are attributed to air pollution, and Myanmar, where the rate was 230.6 deaths.

WHO said: “Outdoor air pollution is a major environmental health problem affecting everyone in developed and developing countries alike.

“Some 72% of outdoor air pollution-related premature deaths were due to ischaemic heart disease and strokes, while 14% of deaths were due to chronic obstructive pulmonary disease or acute lower respiratory infections, and 14% of deaths were due to lung cancer.”

The World Health Organisation said it was up to national and international policymakers to tackle the toxic air crisis

“Most sources of outdoor air pollution are well beyond the control of individuals and demand action by cities, as well as national and international policymakers in sectors like transport, energy, waste management, buildings and agriculture,” the WHO said recently.

More than a quarter of young adults in the UK do not drink alcohol – in data

Young adults in the UK are more likely to be teetotallers than their older counterparts, according to figures released this week. More than a quarter of 16- to 24-year-olds do not drink, compared with just over a fifth of the broader adult population.

Last year, just under 21% of people surveyed in England, Scotland and Wales said they did not drink alcohol, equivalent to around 10.6 million adults aged 16 or over. That’s two percentage points higher than in 2005, when the ONS first collected data on alcohol consumption.

But the proportion of 16- to 24-year-olds who say they do not drink has accelerated at almost four times that pace. Ten years ago, 19% of young adults said they did not drink alcohol, compared with 27% last year.

Conversely, teetotalism among those aged 65 and over is falling: in 2005, almost 30% of people in that age category said they did not drink; last year, it was 25%.

But while people in the youngest age group (16-24) are increasingly likely to be teetotal, drinkers in this age category were also more likely to binge drink – defined as men who exceed eight units of alcohol on their heaviest drinking day, and women who exceed six units.

When teetotallers are excluded, women aged between 16 and 24 were more likely than any other group to have binged in the week prior to the survey: 41% admitting to doing so, compared with 34% of men of the same age.

More generally, the proportion of adults who say they drink alcohol is at its lowest level since 2005. In 2016, just under 57% of Britons surveyed said they had drunk alcohol in the previous week, compared to almost two thirds (64.2%) in 2005.

In its commentary, the ONS noted that drinking behaviour is likely to be impacted by characteristics such as culture and ethnicity: the wider survey found that teetotalism is lower among white respondents (15.7%) than all other ethnic groups (56%).

alcohol use in the UK – in data

Ona Gritz: ‘I had spent more than enough time hiding and pretending’

There are ways to cover for the fact that you can’t run like the other kids, or skate, or climb fences, or ride your flowered banana seat bike without training wheels. My own strategy was to suggest alternatives, offering to bring out a board game, colouring books and crayons, or my brand new, unopened jigsaw puzzle with the picture of a farm scene on its box. If my friends countered by asking to play hopscotch, a game that would require each of us to stand first on one foot, which I could do fine, then on the other, which I couldn’t do at all, I’d act like the idea was too dull to consider. If they suggested we play cards, I’d say yes, but reluctantly, willing someone else to insist on shuffling since it takes two good hands to bend and riffle each half of the deck. More often I told them, truthfully, that I’d rather grab our dolls and play house or store or any other game of pretend.

Pretending, after all, was the thing I was best at. It was the magic that allowed me to inhabit any capable, agile, graceful body I chose.

In our crowded box of curled family photos there is only one picture that includes the leg brace I was made to wear because of my cerebral palsy, though even here it is barely visible. A slight bulge beneath the fabric of my pants, a hint of metal peeking from the hem, the single angled strap that attached it to my shoe. I’m three years old in the photo, the same age I was the first time I held it in my hand. “Oh,” I said. I’d seen posters for the March of Dimes with images of children leaning on crutches or sitting in wheelchairs, and now I saw that I was like them in some way. This struck me as nothing more than an ordinary fact. “Oh.”

Shortly after that picture was taken, my doctor decided I only needed to wear the brace in bed at night. Daytimes, it lived in the back of my closet, tucked in a brown paper grocery sack. My mother allowed me to leave it home whenever I slept at a friend’s house, or in its hiding place when a friend slept at mine. Maybe this was how I got the idea that my cerebral palsy could and should be kept secret. This, coupled with the fact that my father never mentioned it, and that my mother, when she did discuss it, said, “It’s nothing, hardly noticeable”, dismissively waving her hand. To me, my body was simply my body, the only one I’d known, and so I thought the brace was my disability. As long as I kept it out of sight, I fitted in with my friends.

“Let’s pretend we walk like people who limp,” Lisa Lowenstein suggested one muggy afternoon in our sixth summer. She slid off the stoop and began hobbling in a circle, and though the game made me uneasy, I got up and did my best to imitate her awkward moves.

Lisa paused to observe me. “Just walk like you always do,” she advised. “You walk like people who limp.”

“Oh,” I said, just as I had when I first saw the photo where I’m wearing my brace. Only this time my throat tightened around the word.

In middle school, I found it helped to carry novels in my backpack. That way, if my friends decided to pay handball at the park or zip around the neighbourhood on their 10 speeds, I could pull out my book and say, “I’m too caught up in this right now”, which, soon enough, would be true.

I also got good at finding the girls who were happy to sit inside, listening to records, and the few left who, like me, were slow to give up Barbies and other daydreaming kinds of games.

Ona, aged three, with the leg brace she had to wear.
Ona, aged three, with the leg brace she had to wear.

“What do you want to do?” Jody might ask me.

“I don’t know. You?”

“I don’t know.”

“Rock star wives?” one of us would finally ask, sighing like it was a last resort.

“I guess.”

After that we’d play for hours, immersed in the elaborate stories we created for Elton, Paul and beautiful grownup versions of ourselves.

Still, the next time Jody and I got together, whoever asked would be tentative about it, afraid the other would be the first to outgrow the game.

By high school, pretend games were no longer an option, unless you count pretending to have my period so I could sit on the sidelines in gym class. Or claiming to be too behind in homework to join my friends at the ice rink. Or acting as though my dislike of disco was the only reason I stood pressed against the wall at dances while the other girls mastered those perfectly synchronised steps.

“Why don’t we go to the movies?” I was always the one to suggest. There, in the comforting darkness, all I had to do was sit perfectly still, along with everyone around me. Row by row by row, we imagined together, lost in the drama of fictitious lives. The movies offered a means of playing pretend that was still sanctioned, a way to be social that asked nothing of my faulty limbs.

For college I chose a small, artsy school where the only team sport offered was Ultimate Frisbee and there were signs posted on the bulletin boards throughout campus that proclaimed It’s Okay to be Gay. I extrapolated from this that here, in this heady oasis, it was OK to be different. Among my classmates were girls with unshaven legs, boys who wore lipstick, kids of both genders with spiky magenta hair and splatters of safety pins on their clothes. Still, while I admired these outliers for their boldness and originality, I hid my uneven legs under long gauzy skirts in my usual attempt to blend in.

If my new classmates noticed my limp, or my childhood friends had seen through my excuses, they were kind enough not to say so. This allowed me to believe my own fabrications. I see it now as a wilful and instantaneous form of amnesia. As soon as I succeeded in avoiding a physical challenge or a potentially embarrassing moment, the memory, along with any thoughts about my disability, dispersed.

The young Ona: ‘If my new classmates noticed my limp, they were kind enough not to say so’


The young Ona: ‘If my new classmates noticed my limp, they were kind enough not to say so.’ Photograph: Leonard Gritz

Even so, as I settled in at college, an unnamed tension left me. I now lived in a place where I could curl up with my books hour after hour, not because my friends were off having adventures I couldn’t keep up with, but because this was the adventure. I majored in literature and had plans to become a writer. As I read and honed my craft, it felt as though the body, my body, with its limits and awkwardness, was the least of who I was. Finally, I could live the life of the mind. How perfect was that? Except, of course, it was only part of the story.

One afternoon in the campus library, I highlighted this line in my slim paperback copy of Virginia Woolf’s A Room of One’s Own:

“Women have served all these centuries as looking glasses possessing the magic and delicious power of reflecting the figure of man at twice its natural size.”

I marked the sentence, having brushed past and already forgotten this, from earlier in the same chapter, about the fact that so many men have written books about women:

“…it was flattering, vaguely, to feel oneself the object of such attention provided that it was not entirely bestowed by the crippled and the infirm…”

Had I, a 19-year-old crippled girl, flinched when I read this? Had it stung? I don’t know. I’d forgotten those words existed, and only discovered them now, decades later, while searching for the looking glass quote that has stayed with me all this time. This was precisely how my self-protective amnesia worked. Virginia Woolf devalued people like me in a chapter about the importance of confidence? But I loved Virginia Woolf, so the insult quietly left through some back door in my mind.

Ona at home


Ona at home: ‘A poetry workshop, I sat beside a man named Dan.’ Photograph: Gene Smirnov for the Observer

What did interest me that afternoon was the metaphor of the mirror, and the idea that men used us to build themselves up. I’d recently joined a feminist consciousness-raising group, and had begun insisting, sometimes petulantly, that I be referred to as a woman rather than a girl. When I marked Woolf’s words it was because they struck me as poetic and true. What I couldn’t yet see was that I had begun to use men similarly, not to reflect me at twice my natural size but as attractive enough. As OK.

This is where my college life wasn’t all disembodied intellect. I had also begun seeking validation through sex.

Here is another truth. I wasn’t at all beyond the prejudices expressed in Woolf’s forgotten passage. The young men I pursued had to be not just smart, creative and interesting, but handsome too. It went without saying that they were also able-bodied. Everyone I knew was able-bodied. There may have been a handful of other students with disabilities on campus, but I paid them no mind.

I chose men for the wrong reasons and, in turn, none of them chose me for anything more than an occasional intimate night. Then, when I was 25, I met Richard. He was athletic and handsome in the way of the popular boys who were completely out of my league in high school. The two of us had very little in common. Richard’s passions included skiing and mountain biking, and though I could never join him on either terrain, he was passionate about me too.

Richard was earnest, playful and affectionate. He was also hot-tempered and impossible to please. Nonetheless, I invited him to move into my apartment. Soon after, we got engaged. All the while, my friends looked on warily.

One friend told me she had always imagined that the man I’d wind up with would be someone she found amazing.

“Someone smart and really kind. The type of guy I’d love for myself, only I’d be so happy for you I wouldn’t be jealous.”

She watched me carefully and I realised that her comment had not just one subtext, but two. First, and most obvious, Richard, who was more conventional and less intellectual than my previous love interests, didn’t meet her expectations. Worse, it seemed she’d always believed that only someone amazing and really kind could possibly choose me. What hung in the air, unspoken between us, was the reason she thought it would take such a remarkable person to love me. I was defective. This made me cling to my handsome boyfriend all the more.

One weekend, while Richard was off mountain biking with friends, I decided to spend an afternoon in the city. After a movie and lunch at a cafe, I found myself following a strange woman down a winding street.

Is that what I look like? I wondered, carefully studying her from a distance. She’s pretty enough, but how much does her limp detract from that?

Over the following weeks and months, for the better part of a year, I kept an eye out for women with physical disabilities. When I found them, I trailed them. For a while, my curiosity remained on the surface. Could women who moved like me still be considered attractive? Did I find them so? But as I continued my stalkerish experiment, something shifted. I began to want to know about their lives.

The best way I knew to process this, as with most issues I grappled with, was through writing. Alone at my desk, I entered into a kind of dialogue with these strangers I was too reticent to approach in person. I did this by writing a poem in the voice of a nonverbal quadriplegic woman who was in the news at the time.

By now I had completed an MFA in creative writing and had found my place in a community of poets. One winter afternoon, I ran into an acquaintance who invited me to take part in a poetry reading and panel discussion for Women’s History Month. Each participant would be from a different cultural background, she explained. She’d already lined up an African American poet, a Latina poet, and she wanted me there to represent disability. My initial response was to take a step back when she said this. But then I felt a stirring of interest.

“I’ll be there,” I heard myself say.

I had the persona poem, and one about my mother helping me on with my nightbrace, and a third, titled What the Mirror Knows, that used my partial disability as a symbol for other ways I felt divided. At the reading, I surrounded these pieces with poems that made no mention of disability and that, to my mind, proved I led a perfectly normal and interesting life.

The panel discussion ended with questions and comments from the audience. There was one woman, seated a few rows back, whose insights caught my attention. She referred to writers I loved, and made connections that surprised and intrigued me. Afterwards, as I was gathering my things, I looked up to find her waiting to talk to me.

“I really liked your poems.”

“Thanks. I liked hearing what you had to say.”

We smiled shyly at each other. “Well,” she said, “I should probably use the bathroom before I head home.”

It wasn’t until the woman, who had introduced herself to me as Hope, started to walk away that I noticed her palsied gait. What could I do but follow her into the restroom?

Cerebral palsy is caused by damage, most often at birth, to a part of the brain that controls motor skills. There are various forms, and it affects people to widely differing degrees. Many don’t have enough balance to walk or need crutches to do so. Some have uncontrollable tremors. Some are intellectually disabled, while others are assumed to be because their facial muscles are affected and their speech is unclear.

Hope and I both have relatively mild cases and forms of the disability that affect only half our bodies. She has diplegia, which means the palsy is just in her legs. I have hemiplegia, which means the split is vertical. The muscles of my right limbs are tight and underdeveloped, and the fingers of that hand lack the dexterity, tactile sensitivity and fine motor skills of those on the left.

“It’s lucky she’s left-handed,” a doctor once told my parents during a consultation, “since she’ll always have to depend on that side.” I was nine at the time, old enough to resent being spoken about in the third person, and also to see the flaw in his logic. Maybe I was born left-handed, maybe not. The body learns to compensate, just like the mind.

Years later, I read an article suggesting that right hemiplegics are likely to be more creative and less practical than our counterparts whose disability is manifested on the left. The hypothesis is based on left /right brain differences. Left hemiplegics have undamaged left hemispheres, which is where pragmatism lives. Meanwhile, we right hemiplegics need to rely on our intact arty and imaginative right hemispheres.

The theory appealed to me. It fitted me so well. But then, just as I understood at nine years old, when it comes to cause and effect it’s hard to assess the true order. Certainly, my cerebral palsy and my drifty, daydreaming ways are connected. But to what extent is this due to the physical brain as opposed to the simple desire to escape the confines of a limited and disappointing body by imagining it away?

Hope and I spent several hours in a coffee shop that late afternoon, commiserating about what it felt like for each of us to be the one kid on the block who couldn’t run, climb fences, or ride a bike without training wheels. I learned I wasn’t the only one who coped by making excuses, hiding behind books, and living too much in my head. This was the first time either of us had ever spoken about these experiences. It was also the first time that I could remember when I wasn’t expending effort and energy to pretend my cerebral palsy didn’t exist.

While Hope took the fuel of our connection and almost immediately got involved in disability activism, I went home to Richard and my belief that his love for me meant that my cerebral palsy was, as my mother had assured me all those years ago, nothing, hardly noticeable.

A few months later, Richard and I married. With Hope now in my life, I had a growing consciousness about disability that came close to acceptance, but it was a place I visited, not yet one where I lived. More real to me was my marriage licence, which I saw as a kind of passport. It proved that where I really belonged was in the enviable world of the unscathed.

Something I had wanted since I was a child trying to coax my friends away from their games of hopscotch and tag to play house with me was to one day be a mother. Six years into our marriage, Richard and I agreed the time was right.

Through my pregnancy, my midwife never once mentioned my cerebral palsy, so neither did I. She did suggest a number of tests to rule out potential birth defects. Always I declined, feeling vaguely insulted, though I couldn’t have said why.


The daily and very physical tasks of caring for a baby forced me to recognise my disability for what it actually was

Our son Ethan was perfect: seven-and-a-half pounds, 14 inches, with active limbs, the right amount of digits, and a hearty cry. For the first hours after his birth, Richard and I sat together in the hospital room and stared at him in wonder. Eventually, a nurse came in to help me with breastfeeding.

“You need to lift your elbow so his head sits a little higher. Not working? How about we try the other side? Can you shift him so he’s in a better position? Let me show you something called the football hold…”

Nothing we tried worked so she brought in another nurse and then a third. They piled cushions around us until I could finally hold Ethan at the right angle and height.

“There we go,” the nurses said once he began to suckle.

“Problem solved,” Richard put in.

This tiny new person nuzzling at my breast depended on me. Yet, somehow, as I’d drifted through my pregnancy, daydreaming as usual, it had never occurred to me that I wouldn’t be able to meet his needs. Now, as I touched his cheek with the one hand that could really feel him, I understood that I didn’t have the balance or coordination to be this fragile, trusting person’s mom. I may have learned early in life to cover for being unable to run, skate or climb fences, but there would be no covering for being unable to safely bathe a newborn, carry him on stairs, or walk any distance while he flailed in my arms.

From that moment on, the daily and very physical tasks of caring for a baby forced me to recognise my disability for what it actually was. A set of very real and specific limitations I had to either work with or around. There were constant puzzles to solve, along the lines of, I’ve arrived home with a baby and a bag of groceries in his carriage and now I find that the one elevator in our apartment building has broken down. What do I do? Often the only answer was to ask for help from a neighbour. The first few times I did so, I stammered and felt myself flush. Then one day I simply stopped feeling apologetic. So, I had a disability. It was what it was.

Meanwhile, Ethan had begun reaching his perfect pudgy little arms towards me the moment we were together in a room. His absolute acceptance, despite my funny walk and clumsy touch, struck me as both lovely and familiar. It reminded me of my three-year-old self, noticing my brace in a photo without judgment.

It’s tempting to end the story here with the happy ending of a renewed self-acceptance. I would, except it gets even better.

It’s neither a surprise nor a tragedy that my marriage to Richard ended when Ethan was still small. Richard remains active in Ethan’s life and the divorce proved to be the best choice for us all.

One holiday weekend, when Ethan was eight, he stayed at Richard’s while I went to a writers’ retreat. There, in a poetry workshop, I sat beside a man named Dan, who had a soft-spoken gentle manner and, I could tell from his responses to poems, an incisive mind. When he brought out his own poem to be critiqued, I liked him even more. His piece had rhythm, wit and heart. This was definitely someone I wanted to know.

I watched him read and take notes by tapping on a braille laptop, his guide dog sprawled at his feet. After the workshop ended we stayed in our seats an extra few minutes talking, then he slipped his hand into the crook of my elbow, and we strolled together to the next event. I wondered if he noticed the lilt in my walk, and actually hoped he did. I wanted Dan to know that, along with poetry, disability was something we shared.

A week later, Dan called me and we stayed on the phone for four hours. In many ways, it was like my first conversation with Hope in the coffee shop. We were so happy to share our stories with each other, and while, in this case, the details of our disabilities bore no resemblance, when I talked about the long and circuitous road I took to making peace with mine, he let me know he’d been there too.

Still, I thought about how, as a young woman, I’d considered my disability a cosmetic flaw, akin to having a bad complexion or being a bit overweight. My concern had been whether people noticed. Now, it occurred to me what an indulgence that was. Born blind, Dan never had the luxury to pretend.

When we met, Dan and I lived a hundred miles apart. This meant we only got to be together on weekends. The rest of the week, we talked on the phone, building our relationship on a foundation of ideas and conversation. From the start, I was captivated by how smart he was, and by how intently he listened. Of course Dan listens well. Hearing is the sense he relies on the most. But I’d never met a man who did so with such presence and interest, and somehow I knew that this had more to do with who he was and what he valued than with the fact that he was blind.

Long before Dan and I got to know each other, he’d begun to write beautifully and candidly about his life as a blind man. He also had a community of friends who were writers and artists with disabilities. I wanted in, and they embraced me without hesitation. Soon, I began to seriously take on disability as a subject in my work. It felt scary at first, a little like pulling my childhood brace out of the closet and putting it on display. But I had spent more than enough time hiding and pretending. I wrote as truthfully as I could about how it felt to live in my particular body, which allowed me to see how universal my experiences actually were.

Dan and I were married on a bright, breezy day in June. Hope slept on our couch on the nights bracketing our wedding day. Ethan stood with us at the altar, holding my palsied hand.

We have been together for 12 years now. The work we do includes disability awareness presentations, literary readings and panel discussions about disability poetics. During one such event at a large poetry festival, a member of the audience, a man with a visibly awkward gait, took the microphone during the Q&A portion and asked in a shaky voice, “How did you learn to like yourselves?”

There were four of us up on the stage and for a long moment we were silent, touched by the vulnerability in the question. I thought of Hope who’d approached me after hearing my first tentative poems about disability. I thought of Dan and our community of disabled friends, including those with us up on that stage. It struck me that, in some way, we were each a pleasing and accurate mirror for the others.

“Do you like us?” I asked.

The man nodded.

“Well, that’s a start.”

Ona Gritz is the author, most recently, of On the Whole: A Story of Mothering and Disability (Shebooks, 2014) and the poetry collection Geode, which was a finalist for the 2013 Main Street Rag poetry book award. Her essay, It’s Time, which appears in the Rumpus, was named a Notable Essay in Best American Essays, 2016

On mental health, the royal family is doing more than our government | William Davies

The public profile of mental health experienced another boost this week, thanks to some moving comments made by Prince Harry and the Duke of Cambridge about the impact of their mother’s death, nearly 20 years ago. The two royals are working for the Heads Together campaign, which seeks to combat the stigma surrounding mental health issues, and to encourage people to speak more openly about their difficulties.

Harry’s admission that he had ignored his own emotional distress for several years before eventually having counselling was a valuable contribution, from a figure more commonly associated with laddish machismo. William’s focus on male suicide statistics was also a good use of his celebrity.

The royal family cannot get involved in divisive party political issues, and so we can only conclude from these interventions that mental health is something that exists beyond the fray of politics. Breaking the “stigma” surrounding mental health issues is certainly not something that one would want to identify as a leftwing or a rightwing agenda.


There is no more damning indictment on British society in 2017 than the prevalence of mental distress among children

On the other hand, political parties have been keen to make the mental health agenda their own. Theresa May has established mental health as one of the key areas where she hopes to signal her government’s concern for everyday human suffering, making a high-profile speech in January that also stressed the importance of breaking the stigma that clouds the issue.

All of this presents something of a riddle. Mental health problems have risen in profile to the point where the prime minister and the heir to the throne are personally committed to combating them. Yet there is scarcely any public discussion about where they actually stem from. Losing a parent at a vulnerable age, as Harry did, is terrible and harmful – but epidemics do not arise purely out of private tragedies.

The stigma attached to mental health is a real problem in workplaces and schools, as are the benefits of overturning it. But stigma can scarcely be viewed as the cause of what it stigmatises.

The orthodoxy that has taken root since the 1980s is that mental health problems are disorders of the brain. The success of SSRIs since the launch of Prozac in 1987 has helped to entrench this view. This doesn’t mean that mental illness can’t be treated with “talking cures”, such as cognitive behavioural therapy or by being more open about one’s emotions, as Prince Harry has argued. But the idea that mental health problems are illnesses just like any other illnesses has become one of the main ways in which the stigma is challenged. Comparisons with cancer have become common.

The idea that one is simply “unwell” no doubt provides comfort to many people wrestling with their own depression or anxiety. But it also blocks out a whole host of more fundamental cultural, political and economic questions regarding the distribution of distress in our society – the sorts of questions that the Duke of Cambridge would be less likely to grapple with.

Theresa May


‘There is scarcely any public discussion about where [Britain’s mental health problems] actually stem from.’ Photograph: SilverHub/Rex Features

There is no more damning indictment on British society in 2017 than the prevalence of mental distress among children. Nearly a quarter of a million are receiving mental health treatment from the NHS, and those contacting Childline complaining of anxiety and exam-related stress have been climbing year-on-year. Rates of self-harm amongst young girls have risen by 42% in a decade.

Are we to believe that it was simply “stigma” that swept all this under the carpet in the past? Or might children be telling the truth, when they say they feel overwhelmed by the requirement to perform, excel, keep up? The NSPCC reports that some children are having to sit mock exams just a few weeks after returning from the summer holidays. Think about what that means and does psychologically. What does Theresa May have to say about that? British children have become damagingly competitive, and less forgiving of failure. Which minister will have the guts to stand up and say to children that being average is OK?

Adult mental health problems may present themselves as medical and be treated as such, but they are not immune to sociological analysis. Researchers have found that adult mental health is worse among those who frequently moved house as a child. Today’s housing crisis is tomorrow’s mental health crisis.

Rising household indebtedness is another major culprit, especially the kinds of problem debts that are associated with week-by-week financial precarity. Children suffer when their parents are too stressed or depressed to listen to them or play with them. Debt problems break up families.

Austerity has been disastrous for the nation’s mental health. The British Psychological Society has called for a termination of benefit sanctions (which are effectively designed to produce anxiety); academics have shown the deep emotional harm wrought by the bedroom tax. Teachers, who live under the constant spectre of monitoring and performance assessment, are seeking medical help for stress in shocking numbers.

The seductive concept of “public sector productivity gains” conceals thousands of personal tragedies among doctors, paramedics and local government service providers, many of whom cling to a dream of exiting their profession. And these are the same people who look after the wellbeing of our children and mental health patients.

No doubt mental health will feature prominently in party manifestos, now that it’s gone mainstream. Whether any of the above gets a look-in remains to be seen. Labour should be shouting about it, and not allow the hypocritical architects of austerity an inch of this territory. Next time a Labour politician is patronised as being too leftwing by a journalist, the evidence on what inequality does to our minds should be slung back.

So, yes, we need to talk more. And, yes, stigma surrounding depression and anxiety makes things worse. But it’s not just ourselves and our medical histories we need to talk about. We also need to talk about what sort of society we’ve built, and what the alternative might look like. For all their good intentions, Harry and Wills might need to sit that one out.

British teenagers more competitive than peers but more likely to bullied

British teenagers are highly motivated about their school work, but are more anxious, more likely to be bullied and are less satisfied with life than many of their peers elsewhere in the world, according to a survey.

Almost a quarter of British pupils who took part in the poll say they are being bullied a few times a month, while more than 14% say they are bullied frequently, making the UK the fourth worst affected of all 34 countries surveyed.

Anxiety levels are also high in British classrooms with seven out of 10 pupils (72%) admitting they feel anxious before taking a test, even if they are well prepared – the third highest in the survey. Girls are particularly badly affected, with 81% reporting anxiety before exams, compared with 63% of boys.

Possibly compounding the problem, UK students are also shown to be highly ambitious and competitive at school, with 90% claiming they want to be the best in whatever they do, compared with an average of 65% across the countries surveyed.

UK students are also among the highest users of the internet, with one in four 15-year-olds admitting to spending six hours online outside school hours on a typical weekday – the second highest of any country, and far higher than previous studies have suggested, prompting experts to call on the government to look at possible links between internet use and wellbeing.

The global survey of half a million 15-year-olds, carried out by the Organisation for Economic Cooperation and Development (OECD), will add to growing concern about the mental health and wellbeing of young people in the UK.

Particularly worrying is the increased risk that disadvantaged teenagers face, according to the survey, with pupils from less privileged families worse affected by high rates of bullying, unhappiness and anxiety than their wealthier peers.

Three in 10 UK pupils from less privileged backgrounds said they had been bullied, complaining of being physically abused by other students, made the target of negative rumours and deliberately left out of things.

There are also wide variations of expectation about higher education. Across OECD countries, 44% of students expect to complete university, but that number rises to three in four students in Colombia, Qatar and the US.

And while students from an immigrant background fare well in the UK, their experiences are less positive elsewhere. In 2015, 12.5% of students in participating countries were from an immigrant background. In some countries, those from an immigrant background were more likely to report feeling like outsiders, which impacts on satisfaction levels.

In the UK, while 42% of pupils polled expect to complete a university degree, less than a quarter of disadvantaged pupils expect to do so, compared with more than two-thirds of the most advantaged pupils.

The study, part of the OECD’s programme for international student assesment, also reveals that young people in the UK experience lower than average life satisfaction. Just 28% describe themselves as very satisfied with their lives, compared with an OECD average of 34%. Girls again fare worse with 28% very satisfied, compared with 33% of boys.

Students in a restaurant in La Candelaria, Bogotá


Students in a restaurant in La Candelaria, Bogotá. Colombian teenagers reported high levels of life satisfaction. Photograph: Alex Segre/Alamy

Elsewhere in the world there are huge disparities in life satisfaction among students. While in the Netherlands fewer than 4% are dissatisfied with their life; in Korea and Turkey the figure rises to 20%. In Montenegro and Latin American countries, including Colombia, however, more than one in two students reported high satisfaction levels.

The report also shows that despite reported links between eating a good breakfast and improved attainment, almost 30% of 15-year-olds in the UK do not eat breakfast before school – with the figure rising to more than 35% for the most disadvantaged pupils. Girls once again are worse affected, with more than two-thirds skipping breakfast compared with 22% of boys.

Natalie Perera, executive director and head of research at the Education Policy Institute (EPI), which hosted the launch of the report on Wednesday, said the findings on UK teenagers were stark, particularly for those from poorer backgrounds.

“Disadvantaged pupils are more likely to be bullied than their peers, and are more likely to skip breakfast before school – with the gap between the proportion of advantaged and disadvantaged pupils in the UK doing so the second biggest out of all 34 countries.”

Emily Frith, EPI director of mental health, said: “The findings show UK pupils have lower than average levels of life satisfaction, high levels of anxiety in the classroom, and are more likely to be bullied, compared to children in other countries.

“The government should explore how children’s wellbeing can be improved, including through the education system. It should seek to understand the causal relationship between internet use and young people’s wellbeing, and look to implement a strategy help young people develop the resilience and skills they need to live safe, digital lives.”

Responding to the report, a Department for Education spokesperson said: “These findings show young people have the motivation and desire to go as far as their talents can take them and that their parents are supporting them throughout their time at school.

“Assessment is an important part of education but it is also important that the test period is managed so students feel supported throughout. Our reforms have also put a stop to the endless treadmill of exams for young people, giving them more time to gain a greater understanding of the subject.”

More than 800 women sue NHS and manufacturers over vaginal mesh implants

More than 800 women are suing the NHS and the manufacturers of vaginal mesh implants after suffering serious complications.

Some women reported that implants had cut into their vaginas, with one woman saying she was left in so much pain that she considered suicide. Others have been left unable to walk or have sex, according to the BBC.

However, the medical regulator said that the best current evidence supports the continued use of mesh implants to resolve health conditions that could themselves cause serious distress to patients.

The implants are used to treat incontinence after childbirth or pelvic organ prolapse, where the womb or bladder bulge against the walls of the vagina.

Between April 2007 and March 2015, more than 92,000 women had vaginal mesh implants in England, NHS data shows. About one in 11 women suffered complications. The issue reached prominence in Scotland last year after women with painful and debilitating complications formed a support group.

Claire Cooper began to experience pain three years after her operation. Doctors initially thought the discomfort was related to the removal of her womb, a procedure she had undergone aged 39.

When the pain continued, she said a GP told her she was imagining it. This, and the severity of the pain, resulted in suicidal thoughts, which she said she only overcame because of her children. Her constant pain has forced her husband to become her carer.

Cooper said she and her husband have not had sex for more than four years. “This stuff breaks up marriages,” she told the BBC. “I wouldn’t at all be surprised if there are mesh-injured women that have taken their own lives and didn’t know what the problem was.”

Another woman, Kate Langley, described the surgery as “barbaric”. She told the BBC that a surgeon who examined her “could see the [mesh] tape had come through my vagina – protruding through”.

Data from the Medicines and Healthcare products Regulatory Agency (MHRA) for 2012 to 2017 shows there were 703 adverse incidents relating to patients who had been given the implants to treat stress urinary incontinence, where urine leaks when the bladder is under pressure. A further 346 adverse incidents were reported for patients who had been given a mesh support to prevent pelvic organ prolapse.

The MHRA said the figures did not necessarily indicate a fault with any particular device and said evidence supported the continued use of vaginal mesh surgery for certain conditions.

A spokesman said: “What we have seen, and continue to see, is that evidence supports, and the greater proportion of the clinical community and patients support, the use of these devices in the UK for treatment of the distressing conditions of incontinence and organ prolapse in appropriate circumstances.”

A study published in the Lancet in December found that women who were given mesh implants were roughly three times more likely to suffer complications and twice as likely to need follow-up surgery compared with women who had the traditional version of the surgery, where stitches are used to provide support for the organs.

Rachael Wood, a consultant in public health medicine for NHS National Services Scotland and the lead author of the Lancet study, said: “The results were quite clear that women do suffer a higher complication rate and that it is no more effective. You can make quite a clear recommendation that it shouldn’t be the first line of treatment for prolapse.”

However, Wood said that the results on incontinence surgery were less clear, and for incontinence the study found fewer short-term complications when mesh surgery had been used compared to traditional treatment, which involves major surgery.

She said: “There’s no doubt that some women have had very poor outcomes. It is worth saying that nothing is without risk. There are also bad outcomes from traditional surgery and from doing nothing.”

Revealed: 100,000 wait more than two weeks to see cancer specialist

More than 100,000 patients a year are “having their worst fears dragged out” by having to wait longer than the stated maximum of two weeks to see a cancer specialist to find out if they have the disease, new NHS figures obtained by the Guardian reveal.

A total of 102,697 people in England did not get to see a consultant within 14 days of being urgently referred by their GP last year – a key patient right in the NHS constitution. Some 25,153 people had to wait more than the official target of 62 days to start their treatment.

Macmillan Cancer Support said growing delays to see a specialist, have a diagnostic test and start treatment meant that “thousands of people are being left in an appalling state of limbo”. The Royal College of Radiologists said it feared that long waits beyond the supposed maximums may also reduce patients’ chances of survival and risk some cancers becoming untreatable.

The findings are contained in an analysis of cancer waiting times performance in 2016 undertaken by the House of Commons Library at the request of the shadow health secretary, John Ashworth. “These statistics should be a badge of shame for Theresa May. It’s a national disgrace that this Tory government’s sustained failure to properly fund cancer services has left thousands of patients waiting longer than expected for treatment they urgently need,” he said.

Dr Nicola Strickland, the president of the Royal College of Radiologists, said: “Any delay in diagnosis or time to start therapy risks a growth in the cancer, potentially making it incurable. These delays increase the anxiety experienced by patients and their relatives at this difficult time.”

Diagnostic services’ difficulty in meeting demand means that 230,000 patients a year are also waiting more than a month for the results of X-rays and CT and MRI scans, she said. NHS cancer services are hobbled by chronic shortages of radiologists and clinical oncologists, she said.

The Commons research also breaks down the month-by-month performance by about 150 NHS hospital trusts and several private sector organisations which provide NHS-funded cancer services against the three main cancer targets. They specify that 93% of patients must see a specialist within 14 days of being referred for suspected cancer, 96% should have their first treatment inside 31 days and that 85% of those feared to have a new primary cancer should start treatment within 62 days.

“These targets exist for a reason. If cancers are caught early, survival rates improve. Behind every single one of these figures is a family having their worst fears dragged out for even longer,” said Dr Ann McMahon, the professional adviser to the Royal College of Nursing and Breast Care Nursing Forum.

The analysis shows that 25 out of 157 providers, almost one in six, failed to ensure that the required 93% of patients urgently referred by their GP last year saw a specialist within 14 days. The troubled Worcestershire Royal Acute Hospitals NHS trust recorded both the worst monthly performance – seeing just 39.4% of patients – and also the worst overall performance across the year against that standard, with only 74% of patients seen on time.

It provided 13,100 people with an appointment with a specialist within 14 days, but it failed to do so with 4,605 other patients, by far the largest number of any hospital trust or private firm. The Shrewsbury trust has been involved in controversy recently after two patients died in early January during the NHS’s worst winter crisis in years, reportedly after long waits on trolleys to get a bed. The Care Quality Commission said that month that safety standards were inadequate.

FEighty-six of of all 155 providers, or 55%, breached the 62-day target.

“A cancer diagnosis is a devastating, life-changing moment in many people’s lives. Every cancer patient should be given the comfort of knowing they were diagnosed and treated as quickly as possible, but as these data show, thousands of people are being left in an appalling state of limbo each year,” said Moira Fraser, Macmillan’s director of policy, public affairs and campaigns.

“Extended waits to start treatment can have a serious impact on someone’s mental wellbeing and we are concerned may ultimately harm someone’s long-term health outcomes.

“Unless you have been through it, it is impossible to imagine the stress and uncertainty of waiting for treatment, treatment you know could be the only chance for you or a loved one. We are seeing more and more referrals, which is to be welcomed, but investment in cancer services has not been keeping pace,” McMahon said.

A spokesman for the Department of Health said: “Cancer survival rates are actually now at a record high, and the NHS treated over 110,000 patients – 82% – within the target of 62 days last year, as the NHS rises to the challenge of an increase in urgent referrals for suspected cancer of over 90% compared to 2009/10.

“To build on this progress we have announced up to £300m a year to meet our new target for patients to be given a definitive diagnosis, or the all-clear, within 28 days of a GP referral‎.”

‘It can’t be much worse than licking a battery.’ What it’s like to have ECT

I have had depression and anxiety, mainly depression, on and off since I was a teenager. After dealing with it for 10 years I had a particularly bad winter when I was working almost 24-hour shifts at work.

I went to visit my aunt overseas because I got a few weeks’ sick leave. I thought I’ll go, I’ll decompress, but while I was there I got sicker and sicker.

The GP there prescribed something called Lyrica [an anti-seizure medication also known as pregabalin]. I don’t know whether that had anything to do with it, but I went into a psychotic episode – I thought I was going to be deported, I had a lot of paranoia.

I suddenly started getting very, very anxious – and took an overdose. That landed me in hospital. I was a voluntary patient but I think I would have been forced if I wasn’t voluntary.

I was there for a really long time – a couple of months. I saw a lot of people come and leave and I wasn’t really able to do anything. They had an ECT [electroconvulsive therapy] clinic downstairs and the psychiatrist kept on suggesting it.

Eventually it came to the point where they had tried all these medications that weren’t working and I was an absolute nightmare – I was really difficult and I couldn’t do anything. After being really reluctant I finally gave in. I thought either I am going to die this way, or ECT might help. My aunt was like: “Well, we have tried everything else.”

They scheduled it super quick. We said yes on Friday and they scheduled it for Monday, then they did it three times a week for two weeks.

At first I was worried because of the image you get from the horror films of people being strapped up and electrocuted. Then I learned a little more about it, although I couldn’t do any reading on my own because I was so anxious – I couldn’t even cope with the phone. But I talked to my aunt who put it in really simple terms and talked about all the side-effects.

The thing that scared me the most was the memory loss. I went to an elite university and I really pride myself on my brain, so I was worried. Was this going to make me stupid? But I reached the point when I said: “Well, I don’t care if I am stupid. If I’m stupid and happy it’ll be fine.” So that is what made me go for it, even though I had a very bad perception of it.

The doctors talked me through the entire process. I had never been under general anaesthetic before and because I was anxious and paranoid about not being in control of my body, that was something I was really afraid of. I agreed to do it if my aunt could be in the room – but she wasn’t allowed in the room when they gave the electric shock because it is so traumatic for loved ones.

Before the ECT, they showed me the equipment and said: “The amount of electricity we are putting through your brain is enough to light a lightbulb for a second.” I was thinking: “How is that going to do anything? It can’t be much worse than licking a battery.”

After the first session all the nurses said: “You are so much calmer. I think this is really working. This is really good.” I thought: “I don’t know what you are talking about. I am still super-anxious and I hate my life.”

But looking back, the change happened almost immediately. After the first week I had hoped that I was going to leave the hospital and by the end of the sixth session, after two weeks, I was ready to get on with my life.

I had problems though – mainly short-term memory. I compensated for that by using a journal. Whatever my therapist advised, I’d write down and look over every day and try to do it. But I constantly found myself being told that I had already just told people something I had said. I had to monitor my medication very carefully. The memory issue went away in the course of the month. The benefit of ECT stayed for about six months and I needed to keep taking medication to prevent a relapse. But it didn’t work.

I was hospitalised again – this time in the UK.

I really wanted ECT. But they said the memory effects can be worse if you do it again and again and at that point I wasn’t psychotic. It is much harder to reach someone once they are psychotic because you can’t really rationalise with them, whereas I did what people told me to do, so that drastic measure of ECT wasn’t really necessary. But as soon as I mentioned ECT to any medical practitioner in the UK they said: “Oh my God, seriously?” The only semi-positive reaction I had from one of my GPs was: “Wow, how was that? I have never met anyone who had it.” He wasn’t judgmental, just really surprised and fascinated. In hindsight, I don’t think ECT was the right thing to do.

Sometime later I relapsed again. This time I had ECT on the NHS. They then diagnosed me as bipolar.

After I first had ECT I was really freaking out about whether I was going to tell people. But because of my short-term memory problems I was forgetting who I had told what and it was getting really stressful. It got to the point where I was anxious to meet people because I was wondering: “How much do they know? What do I say?” Which is why I put it up on Facebook, because that way everyone knows the same thing. But I am quite reluctant to tell people that I had psychosis. Because although mental health issues are more accepted and depression is quite common, psychosis is like really crazy. Taking medication is more accepted now, going to therapy is more accepted, but ECT … I think people think of One Flew Over the Cuckoo’s Nest.

There is definitely a lot of concrete evidence of ECT working. My aunt was absolutely floored by the results and she talked to the nurses and they said: “It is almost like a miracle but we see it every week.”

(*Name changed for confidentiality)

‘End PJ Paralysis’ is more symptom than solution | David Mitchell

You don’t have to be seriously ill to realise the NHS is in trouble. In fact, ironically, some forms of serious illness would preclude the realisation. I’m sure that, as I type, delirious patients on trolleys in superbug-infested corridors are among a tiny minority of British citizens oblivious to the healthcare crisis. Let’s hope they get the treatment they need to bring into focus the desperate surroundings in which they’ve somehow got the treatment they need.

Research published last week in the medical journal BMJ Open says that two in five GPs are planning to quit their jobs within five years in what has been dubbed, perhaps in celebration of Passover, an “exodus of GPs”. Though in this case, the plagues will come after they’ve left.

The flaw in the research is that there’s no control: what’s the percentage of the UK’s overall employed population who are planning to quit their jobs within five years? It’s going to be quite high: everyone within five years of retirement, plus everyone from other EU countries who suspects they’ll have to (or will want to) return home, plus everyone who dislikes their job.

Because that’s what you say if you dislike your job but need the money: “I tell you what, I’m definitely quitting within five years.” You want to assert that this isn’t how life is going to be and yet you know you won’t quit now. And quitting within a year seems a bit close and scary. And quitting in 10 years seems too remote and dismal. So “within five years” is a nice, vague, woolly resolution to change.

So let’s assume that among those who, say, work for McDonald’s, the number who imagine quitting within five years is higher than two in five. But also that among those who, say, live their childhood dream of earning their living directing live opera or managing a large acreage of ancient woodland or being leader of the opposition, fewer than two in five envisage moving on in so little time as half a decade.

If you average that out – and since there are probably more in the former group than the latter – I wouldn’t be amazed if the overall rate of people with jobs saying they want to quit within five years isn’t also about two in five. I’m just guessing. I haven’t had research commissioned by a careers advice website or anything. But I don’t sniff Britain and get waves of job satisfaction pheromones coming off the workforce. And I live in London, where the streets are paved with oligarchs’ discarded onyx worktops and we’re all so rich we don’t hate immigrants.

Then again, GPs’ annual earnings are on average about £100,000, a salary that usually militates against dissatisfaction. Which makes the two in five figure more worrying again: it’s a well-paid job, and a worthwhile one, and it’s not physically dangerous, yet 40% of the people who do it want to stop. The unavoidable conclusion is that it’s horrible. Like Egypt under Pharaoh.

This report is just one recent example of troubling news about the health service, which also includes nurses balloting for strike action, a cluster of “avoidable” infant deaths, the number of people waiting more than 18 weeks for surgery “set to double” and new cancer drugs being ruled too expensive. Despite Trump, Brexit and Syria, the NHS is clinging to its share of column inches as doggedly as Mel B’s love life, and is just as bleak.

It’s clear that a solution must be found before the whole thing collapses into an enormous heap of rubble, crutches, wheelie drip-stands and little cardboard dishes of vomit. Well, it has been! Last week came news of a campaign, pioneered by Nottingham university hospitals NHS trust that aims to get patients out of bed, dressed and walking around. Obviously, in a sense, the whole NHS is supposed to be a campaign to do that. But the difference with this scheme, referred to as “End PJ Paralysis”, is that it aims for patients to do it before they’re necessarily better.

Illustration by David Mitchell.


Illustration by David Mitchell.

The premise of the scheme is that lying around in bed feeling sorry for yourself becomes self-perpetuating. So staff are encouraging patients to get dressed, move around and in general act like they don’t feel terrible. At a time when the NHS is under unprecedented pressure to free up beds, this is a refreshingly direct approach. “Get out of that bed!” say the staff. The patient does. The bed is freed up. It’s much more efficient than waiting for them to die in the bed, at which point you have to send for a couple of guys and a trolley.

Instinctively I believe this idea works. We’ve all done it: just decided we can’t be ill, either because there’s stuff we have to do or because we’re fed up of the sweaty sheets, the daytime TV, the endless Lemsip. By getting up and pretending everything’s normal sometimes it becomes so. You get distracted from the symptoms and by the time you remember them, they’ve receded or disappeared.

This idea has much in common with alternative medicine. In that field, because patients are listened to, given time and respect in a comforting environment often involving a CD of wind chimes, they frequently feel better despite it having been proved that the actual treatment doesn’t do any good. It’s an effective mood-changer for someone who doesn’t feel 100% but is basically fine.

“End PJ Paralysis” is doing the same thing in a different way. It’s the “Pull yourself together!” to reflexology’s “I’m so sorry to hear that” and is much less costly in time, staffing and vaguely oriental-looking indoor water features. Like homeopathy, it absolutely cannot fail unless accidentally applied to someone who happens to be actually ill.

Some people’s recovery will be helped by greater pressure to get dressed and move around. But can we be sure patients will succumb to this pressure according to whether they’re really up to it, rather than because of their own personality – their instincts to obey authority or deny the seriousness of their condition?

The principle that people who have been hospitalised should restart normal life as soon as they can is already well established. So it’s suspicious that a campaign exclusively pushing the idea of getting up and going home should coincide so precisely with the NHS’s dire shortage of money. It feels like a treatment it’s financially convenient to prescribe.

UK eats almost four times more packaged food than fresh

The UK eats almost four times as much packaged food as it does fresh produce, according to new data, with most of western Europe and north America following a similar pattern.

The packaged food revolution – which includes ready meals and calorific cakes and biscuits – is held at least partly to blame for the rise in obesity in the US and Europe. Fresh food has played a smaller and smaller part in some families’ lives as the pace of life has speeded up over recent decades, working hours have increased and more women have entered the workplace. Set against this is the rise of ever more tasty instant meals.

Euromonitor has analysed data from 54 countries and shown that the balance has shifted from fresh to packaged food in the most developed. In some of the other populous but less developed nations – China, India and Vietnam – the nutrition transition, as obesity experts term it, has not yet reached tipping point and they are still getting most of their calories from fresh food.

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In 2015, the data shows, 85% of the countries Euromonitor looked at consume more calories from packaged food than from fresh. The data relates to sales, but there is an assumption that most food that is bought is also eaten.

Brazil’s population consumed the highest number of calories per person per day as fresh food, out of the nine major countries in the survey, at 1,065 calories. The UK was second to bottom, at 405, above Japan which consumed just 247 calories from fresh food.

The UK bought the second highest calorific load of packaged food – 1,547 per person per day in 2015. Belgium was top, on 1,670 calories. China, Vietnam and India bought the least, with India buying just 164 calories in the form of packaged food.

Taking packaged and fresh food together, Belgium’s population buys the most calories per head, at nearly 2,600. India buys the least, at just over 760 calories per head in 2015.

Sara Petersson, nutrition analyst at Euromonitor International, said that the rise of packaged food was not necessarily all bad. “It is kind of the way we are today. The food we eat today is convenient. It is fast to consume and we don’t have to prepare it. Much of it is high in salt, sugar and fat but there are so many healthier packaged foods coming out all the time,” she said.

Food companies are now looking at reformulating food, to reduce the salt, sugar and fat content, reducing the pack size – which in the case of confectionery will probably result in smaller chocolate bars – and they can direct their customers to healthier lines, such as reduced sugar soft drinks.

But the rise of packaged food is cause for concern among obesity experts.

“Sadly, processed, packaged foods tend to be less healthy,” said Dr Tim Lobstein, director of policy at the World Obesity Federation.

“Better profits can be made from products with a long shelf-life and that can be formulated and branded as a commercial commodity. Fresh and perishable foods have a tough time competing with processed, additive-laden, brightly-packaged products. The logic of mass production means that the least healthy foods will often be the cheapest, and will be widely promoted in lower-income urban areas.”

Last month a professor of neuroscience who won an award for his work on the brain’s reward system advocated that high calorie food should be sold in plain packaging to be less attractive to shoppers.

“Colourful wrapping of high energy foods of course makes you buy more of that stuff and once you have it in your fridge, it’s in front of you every time you open the fridge and ultimately you’re going to eat it and eat too much,” said Wolfram Schultz, of the University of Cambridge.

Euromonitor also reveals that in many countries – 28 of the 54 its analysts examined, including the UK – more calories are bought in the form of alcohol than soft drinks.

“With the current obesity crisis, a lot of bad press has surrounded soft drinks, especially sugar-sweetened beverages,” said Petersson. The government’s proposed sugary drinks tax is aimed at reducing child obesity. However, she said, the data on alcoholic drinks suggests that sugar-sweetened drinks are not the only problem when it comes to adults.

“Of course, the relationship between sugar consumption and obesity/diseases is still crucial,” she said. “However, given the even stronger evidence for the relationship between alcohol consumption and morbidity, this data cannot be disregarded. Instead, this data could be used by soft drinks companies to argue against statements such as ‘soft drinks are primarily to blame for the obesity crisis’ or by policy makers/public health organisations to strengthen incentives against alcohol consumption.”