Working as a community nurse and seeing people in their own homes is an HUGE insight into the causation of illness and the contribution of different exposures. As much as the health promotion information is out there for people it is always quite generic and doesn’t target key habits that people can recognise in their own lives to make important early changes.

The obvious ones that people are aware of are stopping smoking, improvement in diet and getting more exercise, but there are so many more simple causes of disease that people would never think of and wouldn’t be told until they require medicating.

Many people now know that vitamin d deficiency is quite common especially now as people spend a lot of their lives inside. Humans thousands of years ago spent 99% of their time outside hunting and gathering compared to the modern day with that now at 7%! What a lot of people don’t know is what it can actually lead to many chronic illnesses and diseases including osteoporosis, cancer, type 2 diabetes, muscle weakness, pain, infection and depression to name a few. Sunlight exposure is responsible for so much! It regulates the nervous system, promotes bone growth and supports cardiovascular health by lowering blood pressure. If this information was more accessible the public may be able to make healthier choices before I get to them possibly preventing the development of disease in the first place.

My patients generally are fully housebound, elderly and spend a lot of time sitting indoors. These patients are more susceptible to illness due to their age but just the simple fact that they spend all of their lives indoors puts them at a significant risk of developing further disease and therefore further relying on the health system for care. Think of your elderly relative and the medication they take. They may have arthritis, fatigue, muscle weakness, walk with an aid, possibly have fallen previously or you see them unsteady when walking. Their memory is worsening and their dexterity is beginning to deteriorate. Yes this is all ageing but it is also exacerbated by a sedentary lifestyle with reduced sunlight exposure.

If they were supported to spend time outdoors even just 8-10 minutes in the summer with your face and chest bare it can provide all of your daily vitamin D requirements, however in the winter this goes up to 2 hours. In the UK people are advised to take a vitamin D supplement due to the lower levels of exposure expected during winter. You can also get a small amount of your vitamin D needs from foods, including egg Yolk, fatty fish such as salmon, mackerel and sardines, red meat and liver. This isn’t to rely on but can add up if used in conjunction with each other and direct sunlight.

Unfortunately for a lot of people the cause of the illness becomes so difficult to change as it’s a cycle of cause and effect. If you don’t get enough sunlight it makes you feel unwell which makes you more unlikely to spend time outside. I personally am more responsive and reactive to health promotion that gives me the reasons behind why I should change behaviour. Otherwise it’s less believable and gets forgotten easily. If you would like to know more about how small changes can make a big difference then keep posted.