Yesterday I celebrated a really exciting new project – Health for Life in Schools – that aims to provide Primary School children in South Birmingham with the skills to lead a healthy and active lifestyle for life. It was an excellent event – Forestdale and St John Fisher schools from my Northfield constituency were there, showcasing the work of staff and pupils to grow vegetables, encourage healthy eating and promote physical activity.
Health for Life was also a timely event, but one with a sobering context, coming just a week after new data confirmed that where you live in the UK still determines long you live.
The figures did not make for easy reading in Birmingham. Out of 150 local authorities, we rank 120th in terms of “premature mortality rates.” In simple terms, that means the amount of people dying early in Birmingham is the 30th highest in the country. And it means that 321 out of every 100,000 people in Birmingham die before the age of 75, largely of cancers, heart attacks and strokes. These are not inevitable deaths. A staggering 80% of heart attacks and strokes are preventable through diet, physical activity and not smoking.
In response to the figures, the Health Secretary expressed himself as “shocked”. But why? This issue has been on the agenda for years now – the former Labour Health Secretary Alan Johnson requested Sir Michael Marmot to hold an inquiry into the matter in 2008. It gave clear recommendations. Sir Michael said that ending this national inequality is a matter of social justice, that will take action at all levels – from the NHS, to central and local governments, and of course at community level. The latest figures just underline again that social inequality creates health inequality. Poverty, inadequate housing and restricted opportunity in education all continue to shape people’s life chances in a major way. They increase the likelihood poor diet, of smoking and exposure to smoke, and of excessive alcohol consumption.
Of course, none of this is inevitable. As far as diet is concerned, the reality is that it is often possible to grow some fresh food on a budget and without a big garden at home. I saw that demonstrated by the schools involved in Health for Life and it’s something being actively promoted locally through projects like Northfield EcoCentre’s community garden. And even if you can’t or don’t grow your own vegetables, the idea that convenience foods or fast foods are always more affordable than their fresh alternatives is often a myth too. Ever seen the price of pre-packed frozen baked potatoes where all you have to do is – wait for it – bake them?
But despite all this the fact remains that it is much more difficult to put together a healthy and varied diet if you are short of money. Just look at the different “choices” people have available in the food shops they can go to, or in the amount of fast food outlets they have on their doorstep depending on the predominant income level in an area. Locally for example, just compare the range of shops around in, say, Northfield to those in, say, Harborne. This is not all about free “lifestyle choices.”
It’s a similar story when it comes to physical activity. It’s true you don’t have to have access to expensive gym equipment to exercise easily, but the reality is it is hard to exercise more if there are no affordable and quality leisure facilities nearby. That’s a real and present danger for any areas of Birmingham, particularly as the impact of the previous Tory-Lib Dem Council administration’s cuts to leisure funding filtering through to the front line.
The current Government has passed responsibility for public health from the NHS to Councils like Birmingham. Nothing necessarily wrong with that. In the right environment, It could foster better integration of services. But when local authorities are already stretched to breaking point from cuts to essential services, what then? The Government has ring fenced local spending on public health until 2015, but what about after that? Over the past month I have received over 100 letters from constituents calling for much needed improvements to social care – another important responsibility of local authorities. Where does public health rank against those needs?
It’s the Government’s job to make difficult choices, both locally and nationally. Difficult choices won’t go away if and when there is a change of Government. But the fact is that the scale of the present government’s “austerity” policy is so great that difficult choices are becoming impossible choices for local authorities. And those who will end up suffering worst will be those least able to pay with money will pay in different ways. And if we don’t tackle the health inequalities that disfigure our towns and cities, that will mean that that too many people in poorer communities will continue to die early.
Projects such as Health for Life are excellent, but for them to achieve their potential we need more. We need national economic policies that will cut the deficit in people’s life chances, not only the economic deficit. It requires a new emphasis on growth, jobs and opportunities to tackle inequality and poverty, and give everyone the best start in life. Will the Conservative-led Government rise to the task by changing course? Judging by their response to last week’s early death statistics, somehow I doubt it.
