Health has never been on our minds quite like it has been these past two years. As we enter the third year in which the COVID pandemic overshadows our lives and public discourse the emergence of new variants reminds us that this threat to our health will be with us for some time.
The pandemic has forced us to assess our own physical and mental health and well-being, at a personal level, but also across wider society. It has been a shared experience, locally, nationally, and globally. But that doesn’t mean our experiences have been the same. Far from it.
In fact, the past two years have shone a light on health inequalities across the UK. At an individual level this was immediately noticeable, as those with long-term pre-existing health conditions were more at risk as the pandemic unfolded and asked to shield. At the community and neighbourhood level, some places have been hit harder than others, with certain groups and occupations within society confronted with higher exposure and greater risk.
Now, new research conducted by the Northern Health Science Alliance and Oxford Consultants for Social Inclusion for the APPG for ‘left behind’ neighbourhoods has found that these places are not only more likely to be at greater fatal risk from COVID-19, but also have worse overall health than other places.
The data shows that life expectancy in these places is lower with men and women living 3.7 and 3 fewer years respectively than the national average. Yet, despite living shorter lives, residents of these places are also more likely to spend a greater portion of their lives in poor health than people living in other parts of the country. In addition, as the first wave of infections started to decrease, data showed that people living in 225 ‘left behind’ neighbourhoods in England had been more at risk from COVID-19 due to a higher prevalence of long-term pre-existing health conditions.
Before the pandemic, it was already clear that people living in these neighbourhoods were being ‘left behind’, but the pandemic has put these inequalities into sharp focus. Despite arguably having a greater need, these neighbourhoods were less than half as likely to have a mutual aid group set up in their local area in response to COVID-19 and have also received significantly lower rates of pandemic-related grant funding.
These neighbourhoods fall within the most deprived 10% of areas on the Index of Multiple Deprivation (IMD) and lack social infrastructure, such as places and spaces to meet, and transport and digital connectivity that are essential for an active and engaged community. They are predominantly located in coastal areas and on the outskirts of post-industrial towns and cities in the North and Midlands, have higher rates of people out of work due to sickness than the England average, above average deaths from respiratory diseases, and a greater proportion of people not in employment due to mental health conditions. At the same time, data shows these areas have lower access to public transport provision, with residents living further away from key health services such as hospitals and GPs than other deprived areas.
As members of the APPG for ‘left behind’ neighbourhoods we are committed to dramatically improving health outcomes for the 2.4 million people living in these communities. A long and healthy life should never be determined by location or the lottery of birth. It is simply not right that people living in neighbourhoods such as these are more at risk from public health crises than people living just 10 miles away from them.
What this data shows is that health inequalities can have a dramatic impact at the hyper-local level. But so too can some of the solutions if people and places are given the right support and investment. We have seen this demonstrated time and again through community case studies and large-scale data sets in our APPG’s work over the past 18 months.
For example, in Bedfordshire, a resident-led group supported by the National Lottery Funded Big Local programme (which gives £1.1m each to 150 areas across England) are revolutionising the way local people engage with their GP and health services. They have employed a Community Health Champion, based in the local GP surgery, who offers support with non-medical issues affecting a patient’s health such as a poor support network, bad housing, or an inactive lifestyle. This approach allows residents to explore the root causes of health inequalities in a trusted and supportive environment.
Across just a sample of 10 people who sought help from the service, the health and social care savings from this approach amounted to £39,667 across an 18-month period. Imagine what this could do if expanded to more neighbourhoods.
These grassroots, resident-led initiatives demonstrate how social capital can form the basis of a preventative approach that recognises that our health is dependent on more than just access to care and medicine – vital though these are. These sorts of networks and connections are crucial to our well-being and are formed in informal places and spaces where you can have a conversation about what’s going on in your life and how it impacts upon your health.
Of course, ongoing investment in hospitals, GP surgeries and medical research will always be crucial to good healthcare. But investing in social infrastructure: community hubs, halls, and spaces for people to develop this social capital, has a vital role as well. For people to live happy, healthy lives we need a more holistic approach that extends beyond individuals and families into the neighbourhoods and communities that are so vital for all our well-being.