title: Health planning for the future: comparative risk assessment of five major lifestyle risk factors: evidence from the Wirral, UK.
abstract: BACKGROUND
  The aim of this study was to quantify and compare the burden of disease attributable to five major lifestyle-related risk factors in a UK Primary Care Trust (Wirral) using World Health Organizations' (WHO) comparative risk assessment (CRA) methodology to demonstrate its practical utility for informing local policy initiatives.
  
  
  METHODS
  WHO CRA methodology was adopted using exposure data from a local lifestyle survey, disease risk factor relationships published by the WHO and local mortality data to calculate risk factor attributable deaths and years of life lost (YLL).
  
  
  RESULTS
  Smoking remains by far the leading cause of deaths followed by overweight and obesity and low fruit and vegetable intake. Alcohol ranked last by number of deaths, but second by YLL indicating its high contribution to deaths at younger ages.
  
  
  CONCLUSIONS
  We have demonstrated the utility of WHO CRA methodology to influence health-related policy-making at a local level. Primary prevention should remain high on the agenda of government initiatives to reduce the future burden of ill health. Future research in this area could look at more in-depth national data to cover a wider range of risk factors addressing some of the methodological and data shortcomings identified in this study.
authors.affiliation: School of Management, University of Liverpool, Liverpool L69 3BX, UK. holger.moller@liverpool.ac.uk
authors.forename: H
authors.initials: H
authors.lastname: Möller
authors.forename: M
authors.initials: M
authors.lastname: Dherani
authors.forename: C
authors.initials: C
authors.lastname: Harwood
authors.forename: T
authors.initials: T
authors.lastname: Kinsella
authors.forename: D
authors.initials: D
authors.lastname: Pope
mesh_terms: D005260:Female; D015438:Health Behavior; D006285:Health Planning / Q000379:methods*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D009026:Mortality; D011634:Public Health / Q000379:methods*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012309:Risk-Taking; D006113:United Kingdom / Q000453:epidemiology; D014944:World Health Organization