Pre-conception Health
Pre-conception Health
Reproductive Health
Fertility
Mental Health
Family Planning
Contraception
Healthy Lives
Healthy People
Nutrition
Smoking Cessation
Chronic Disease Management
Health Education
Substance Use
Introduction
Pre-conception health refers to the health status of an individual before conceiving a child. Pre-conception health influences fertility, pregnancy outcomes and the long-term health of both parents and offspring. From a broader perspective; improving pre-conception health can break generational cycles of poor health and reduces health inequalities. Therefore, pre-conception health should concern populations as a whole, not just the conceiving individual.
Pre-conception health can be divided into three elements; physical, mental and behavioural wellbeing. Physical health could include modifying risk factors such as smoking cessation, maintaining a healthy BMI and accessing immunisations. Mental wellbeing involves stress management, maintaining supportive relationships and the management of any pre-existing mental health conditions. Similarly, behavioural wellbeing involves lifestyle factors such as practising safe sex, adopting healthy eating habits and maintaining an active lifestyle.
Throughout Derbyshire, lifestyle challenges such as smoking, excessive alcohol consumption and obesity continue to impact local communities and threaten healthy pregnancies and childhood outcomes. Improving Derbyshire’s health through smoking cessation, reducing alcohol intake and maintaining a healthy weight could have profound effects. Smoking been proven to significantly decrease the life expectancy of the individual but also to increase the risk of diseases such as cancer and heart disease in individuals passively exposed to smoke1. Similarly, reducing alcohol consumption has been shown to reduce the risk of hypertension – the single biggest risk of morbidity and mortality2. Obesity has also been linked to morbidity and premature death in children3; reversal of which has multiple long term health benefits4.
This key topic summary will explore what Pre-Conception Health means for our area and how we, as a population, can work towards a healthier Derbyshire both now and for generations to come.
Why is it important to Population Health?
Pre-Conception health affects Public Health in the following ways:
- Prevention of non-communicable diseases
Non-communicable diseases such as obesity, diabetes and mental health disorders usually result from lifestyle, environmental and genetic influences. Many of these influences begin before conception or during early development. Poor health of conceiving individuals can lead to epigenetic changes which predispose offspring to these types of disease and affect the developing fetus5. Furthermore, good pre-conception health can reduce the risk of pregnancy complications such as gestational diabetes or low birth weight. Such complications increase the risk of offspring developing non-communicable diseases later in life.
- Breaks cycles of health inequality
The King’s Fund defines health inequalities as ‘avoidable, unfair and systematic differences in health between different groups of people’6. Pre-conception health targets poor health behaviours early with the aim of improving these health inequalities before they are passed on to offspring. Through empowering individuals to make healthy lifestyle choices in this way; we have the opportunity to improve the health of the individual and the prospects of their offspring and generations to come.
- Encourages lifelong habits
Pre-Conception Health focuses on educating and motivating people to improve their health physically, mentally and behaviourally. Providing individuals with the knowledge of how they can lead healthy lifestyles equips them for life and allows them to make positive choices after conception too. People have the opportunity to learn practical skills such as how to plan balanced meals, practise safer sex and manage stress. People are encouraged to attend healthcare and screening appointments which, not only improve immediate health, but enable the establishment of meaningful, ongoing relationships with healthcare professionals. Early interactions build trust, familiarity and encourage individuals to seek help and engage in open discussions about their health. This allows healthcare professionals to monitor progress and identify concerns early on; therefore providing a gateway for referrals to wider support.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of pre-conception within The Derbyshire Population Health Approach:
• Prevention
Preventative action can be summarised into; physical, mental and behavioural actions.
Physical actions can include optimising healthy weight by engaging with initiatives such as Live Life Better Derbyshire’s healthier weight service7, accessing free support to help stop smoking with Livewell8 or accessing Derbyshire Community Health Services’ C-Scheme to help practise safer sex9.
Similarly, Joined Up Care Derbyshire’s Emotional Health and Wellbeing page10 signposts multiple emotional support organisations to aid with stress management and support mental wellbeing. The page provides a plethora of support links ranging from support for victims of domestic abuse to support for those with autism or hearing impairments.
Behaviour modification can include improving physical activity levels by getting involved in groups such as those described on the Walk Derbyshire page11. The NHS website also outlines the importance of even low levels of exercise and describes how to improve your physical activity level12.
• Population
Effective Pre-conception health addresses the population as a whole, not just individuals trying to conceive. Pre-conception is commonly considered a ‘woman’s issue’13 however it should be considered important for individuals of all sex and genders. Both sperm and egg quality are affected by lifestyle and environmental exposures and all conceiving individuals have the opportunity to contribute to the health of their offspring. Furthermore, societies surrounding the pregnant individual have the opportunity to play a social role through providing good support networks for the conceiving individual and supporting them in making healthy life choices.
As previously mentioned the intergenerational impact of pre-conception health and the influence of epigenetics means all members of a population have the opportunity to influence the health of the next generation. Furthermore, addressing pre-conception health can broadly reduce health inequalities and improve pregnancy and birth outcomes.
Pre-conception health overlaps extensively with general wellbeing; the maintenance of a healthy diet, exercise, and managing chronic conditions promotes public health as a whole. It is therefore in the interests of all members of a population to practice good pre-conception health choices.
• Evidence
Approximately 45% of UK pregnancies are unplanned14. Unplanned pregnancies have been linked to poorer early child development and higher offspring mortality rates15. The rates of unplanned pregnancies are a concern for Derbyshire where rates of adult smoking and alcohol use remain higher than the national average. This means many individuals may enter pregnancy with pre-existing lifestyle-related risk factors which could result in adverse outcomes for both parents and offspring.
• Causes
There are numerous causes of poor pre-conception health; these can again be categorised into physical, mental and behavioural causes.
Physical causes include poorly managed chronic conditions such as Diabetes and Epilepsy, sexually transmitted infections or weight concerns. Nutrient deficiencies, poor diet or exposure to drugs and alcohol can also affect outcomes.
Maternal mental illness is associated with fetal growth impairment and risk of pregnancy complications16 as well as affecting the parents’ ability to care for themselves and offspring after birth. Similarly, high levels of unmanaged stress, eating disorders, isolation, adverse childhood experiences and previous trauma can affect fertility and an individual’s ability to conceive17.
Behaviourally; smoking, alcohol and drug use can negatively affect the developing fetus. Practises such as safe sex, attending healthcare appointments, maintaining good sleep schedules and planning for a pregnancy can also all benefit outcomes.
• Collaboration
Pre-conception health is a concern for our population as a whole therefore the potential for cross-sector partnerships is vast and provides the opportunity to reach individuals from a variety of backgrounds. Multi-sector partnerships have the opportunity to ensure wide-reaching, consistent messaging is used to provide education around pre-conception health. It’s also important that individuals at risk who may not engage with traditional maternity services have the opportunity to connect either through GPs, community groups, youth services or schools.
Services such as smoking cessation groups, sexual health clinics or mental health organisations can also play key roles in optimising an individual’s health long before conception and helping to establish healthy lifestyle choices which will continue into the period of conception.
Latest Derbyshire Data
Trend Data
Derbyshire Quilt
Prevalence Maps of Derbyshire
The maps below illustrate various geographies for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.
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In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly. |
Slope Index
This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.
Further Analysis & Assessments
Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.
More Information & Resources
Here is a list of useful resources and information related to physical activity. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address physical activity as a population health topic.
Contributors
Dr Rebecca Dixon, Foundation year two doctor