Vital 5

The Vital 5 initiative advocates for people, communities and organisations to make improvements in/to five factors that have a major impact on health at an individual and population level.


We believe that reducing obesity and harmful drinking, stopping smoking, controlling blood pressure, and identifying and improving poor mental health will help prevent ill health, promote good health, and improve detection, management and treatment of existing conditions.

Dr Rachna Chowla interviews Prof John Moxham about the Vital 5

Why the Vital 5 

We know that focusing on prevention and early detection are the most effective ways of improving outcomes for a population.   

For many diseases, including most of the long-term conditions threatening to overwhelm the NHS/health systems, the initiation and development of those diseases is a consequence of a relatively small number of behaviours and conditions.

Of particular importance are high blood pressure, obesity, smoking, alcohol and common mental health conditions.

Patients with poor mental health often also have physical health problems and many patients with chronically poor physical health frequently also have mental health conditions. Few diseases can be properly managed without consideration of both mind and body

Long-term conditions and diseases that are associated with the Vital 5 include: 

  • Blood pressure – hypertension 
  • Mental health – anxiety and depression 
  • Obesity – diabetes, heart disease and cancer 
  • Smoking – heart disease, respiratory disease and cancer 
  • Alcohol – liver disease, mental health conditions and cancer. 

By focusing on these five key metrics, we believe we can support prevention, detection, health promotion, management and treatment wherever there is an opportunity to do so.  

The evidence behind the Vital 5

Focusing on outcomes and value is more important than ever as life expectancy is stalling, wide and persisting health inequalities still exist and our populations continue to experience increasing ill-health. 

In 2017, The Lancet published one of the most comprehensive assessments of global population health ever undertaken called The Global Burden of Disease. This report reinforced the evidence that diseases and conditions such as cancer, diabetes and heart disease are the leading cause of illness, disability and early death in England. 

Improving health by addressing these known major causes of death is a massive value proposition. 

The benefits

Identifying, recording, and sharing the Vital 5 data between all health partners and our patients, and acting on the results across our population, would substantially improve outcomes and make our health and care system more sustainable. 

So, working with our partners across south east London, we are focusing our energies on the Vital 5 as we believe this approach has the potential to make the biggest difference to people’s health and to the sustainability of health and social care.

Mini-series with Prof John Moxham introducing the Vital 5

Our vision 

Our broad ambition is for organisations and communities to support all individuals to know and be able to act on and improve their Vital 5, however, we want to take a population health approach so that we can target different people in the most effective way.  

This includes: 

  • Children: To ensure all children get the best start to life possible and intervening early before health chances are damaged by life circumstances– as we are witnessing more poor health and increased risk factors in child health already
  • Working-age adults: To ensure there is active monitoring of risk factors during the years when the majority of people have limited interactions with the health service. In this life stage usage of health services for many people can be more episodic and infrequent, and some people, often men, can fall out of contact with health services for years. However, during these years people’s life circumstances and lifestyles may be starting to have an impact on their health, but it is easy to overlook, not know about or miss early indicators
  • Older adults: To reduce the risks around frailty and ensure people enjoy ageing well and stay independent and in their own homes for as long as possible 
  • Learning Disabilities: Working with colleagues across King's Health Partners, we are developing a Vital 5 for learning disabilities, recognising that more than 1.2 million people in England have a learning disability and face significant health inequalities compared with the rest of the population.