Weighing up health inequalities in Cambridgeshire
Brexit, climate change and cyber security have all been causing fierce debate in recent months. There is one concern which continues to receive little attention: health inequality.
Living, working and studying in Cambridge, with its extensive biomedical research facilities and thriving academic population, it could be easy to assume that Cambridgeshire does not suffer the same health inequalities faced by much of the UK. Cambridgeshire as a region does have relatively good health outcomes – yet those who venture outside of the historic Cambridge city centre will find a different story. Over 30% of people in Cambridgeshire, equating to more than 200,000 individuals, have a long-term health condition, many of whom live in the most-deprived districts in the county.
According to Public Health England (PHE), people living in areas such as these can expect to die at an age eight years younger than those in the least-deprived areas. This means that many people in the poorest regions of England won’t even reach their 75th birthday, while those in richer regions can enjoy life well into their 80s. Avoidable deaths, those which are preventable and treatable, are also four times higher in the most-deprived regions of the UK, where people can spend nearly a third of their lives in ill health.
The World Health Organisation defined the right to health as a fundamental human right in 1946. This was further recognised in the 1948 Universal Declaration of Human Rights and the 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR), of which the UK is a signatory. The UK is therefore bound by international law to protect the right to health. Despite this, a major discordance in health outcomes between the rich and the poor can still be observed across the UK.
One of these districts is the Northernmost region of Cambridgeshire, Fenland. Multiple measures of ill health are significantly worse in Fenland than both Cambridgeshire and England as a whole. There are approximately 130 avoidable deaths per 100,000 people per year in Fenland compared to 90 per 100,000 in Cambridge city. Many of these deaths are due to chronic diseases such as diabetes and cardiovascular disease, but alcohol misuse and smoking are also shortening the lives of people in Fenland where life expectancy is significantly lower than the national average. Levels of obesity are particularly high at 17% of the population, compared to the estimated 10% for England as a whole. Emotional wellbeing is also a concern, with people in Fenland reported to be the most unhappy in the UK receiving an average happiness score of 6.7 compared to the UK average of 7.52, as based on a survey by the Office for National Statistics.
Health and deprivation are inextricably linked. It is, therefore, unsurprising that Fenland is the most deprived district in Cambridgeshire, with overall levels of deprivation higher even than the UK average. This is reflected by the fact that 20% of children live in poverty and only 50% of pupils achieve 5 A*-C GCSEs. Poor education is intertwined with poor health, and this is exemplified in the increased levels of child obesity and mental health disorders in Fenland. Considering the wealth of knowledge and expertise in Cambridge, it is shocking to think that just 25 miles north of the city, children are struggling to achieve a basic level of education and health.
So, what, if anything, is being done to improve health outcomes in Fenland? Three years ago, Cambridgeshire County Council and Care Network Cambridge implemented the Healthy Fenland Fund. This initiative consists of a small grants fund, with a total of £825,000 over five years, and a community development team working to enable small community groups to develop projects and activities aimed at improving physical and mental health in Fenland.
More than 100 groups have been supported thus far, with over 1,500 people reporting improvements in physical, mental and emotional wellbeing since participating in a community group. The Healthy Fenland Fund has also strengthened community confidence with 74% of the groups going on to be self-sufficient after receiving initial support. These figures demonstrate that, when it comes to improving health and wellbeing for all, short-term investment leads to long-term benefit. In this way, small-scale local schemes should be supported and promoted by local councils and the government if we are to improve health and tackle health inequality across the UK.
A myriad of social, cultural and economic factors influence health outcomes, all of which need to be acknowledged and tackled to reduce inequalities in health. With such a highly developed economy and one of the best healthcare systems in the world, it is appalling that disparities in health should exist based on socioeconomic status in the UK. In Cambridge, perhaps it is time we recognised these inequalities across Cambridgeshire, and support councils, charities and local people to ensure everyone has the opportunity for a long and healthy life.
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