We all know there can be huge gaps in life expectancy experienced between different stops on the tube or an equivalent bus route, in Bath or Blackpool, Plymouth, Coventry, Nottingham or Sheffield. Familiarity with these gaps can dim their power to shock.
At the start of the summer the ONS published the latest figures showing how long we can expect to live in very good or good health. The language is dry but telling: ‘those living in the southern regions not only enjoy longer life expectancies but also greater proportions of their longer lives in a favourable health state compared with their counterparts living in the North.’
If you live in the north east, get ready to spend the last quarter of your life with some kind of health problem.
A quarter of your life. An entire quarter.
There are better ways to spend that time. Matching spare socks, hoovering behind the sofa, wondering if Barnsley will ever retain the services of a decent holding midfielder. Or alternatively and more fruitfully, enjoying time playing with your grandchildren, meeting up with friends and family, volunteering, learning new skills that will help you keep in touch and interested and engaged with people and the community around you. We can apply the five ways to wellbeing whatever our age.
But while we all can and should help ourselves, between 50-60%(estimates vary) of this is down not to our behaviour or our genes but to the circumstances in which we live. By and large, the causes of health inequalities are the same across the country: the twin issues of poverty and prosperity, power and control of resources for good health, exposures to damaging environments both physical and psychological. But it is the severity and scale of these causes that is greater in the north, resulting in our poorer health.
Of course that also marks out the north as a good place to start when inquiring into what can be done about social inequalities in health in this country.
I have blogged about this before and about the work we had commissioned from the Manchester-based charity the Centre for Local Economic Strategies, to see if there might be some new insights that might help to bring about real change.
An independent panel have been looking at the evidence in the light of the changes in public health responsibilities, the current economic context and public service reform, from a northern perspective, considering what could be done differently to impact on health inequalities.
The panel has been chaired by Professor Margaret Whitehead, from the University of Liverpool, with members drawn from local government, academics and the voluntary sector based in the north.
Their report, called ‘Due North’ will be published this month and I know it will be challenging – how can it not be, given the deep-seated issues.
And the timing couldn’t be better. For a start the Deputy Prime Minister and other ministers are asking northern councils to start planning together on a new economic strategy - to build a hub on par with that of London. Having a decent job is one of the strongest determinants of health and such a development is hugely welcome. But we also need to underpin this with a strong health component – we will not realise this ambition without tackling high levels of chronic ill health.
New arrangements such as combined authorities and local enterprise partnerships, with new responsibilities and greater potential for collaboration could open up opportunities for real change. But we need to see this spread to local communities and see actions that build on assets - in contrast to previous failed regeneration attempts which ignored local communities.
Marmot clearly laid out the evidence that good quality early years are essential for a generation of health and the Due North report will further underline its significance, against the backdrop of child poverty on the rise, and difficult choices for children’s services.
And finally Due North will include recommendations on the role of the health sector including ourselves in PHE and the NHS. It will support PHE’s National Conversation on health inequalities and will link with other initiatives such as the London Health Commission - as tacking the inequalities in the north will benefit the whole country.
Health inequalities have persisted over decades and long term problems need long term solutions. I hope you will read the report and join this lively and topical debate that is ‘Health Equity North’.
Featured image: Angel of the North, Anthony Grist. Used under Creative Commons