Closing the health gap in Sheffield
Public meeting held with Dr Jeremy Wight, Director of Public Health in Sheffield; and, Danny Dorling, professor of Human Geography at the University of Sheffield
Presentations and discussion
The presentations used in the talk, and an audio recording of the talk and discussion, are now available. For a fully interactive presentation with sound and slides, go to:
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Inequalities in Public Health in Sheffield
Jeremy Wight noted that the gap in life expectancy and health across the city, linked to wealth, has been around for some time, at least a hundred years. Danny Dorling also noted that whilst health across the city had improved since the 1980s, the health gap had also widened.
Jeremy covered the main causes of illness:
- Lack of physical activity
- Poor diet
He then covered a range of reasons why these causes are so ingrained in our unequal society. This included:
- Traffiking and pushing of tobacco in poorer areas;
- lack of money, work and/or education;
- relative poverty;
- poor housing;
- lacking hope for the future.
There have previously been successful initiatives in Sheffield for tackling public health, particularly around reducing heart attacks. The “Fairer Sheffield Health Lives” strategy aims to build on this, largely based on the conclusions of the Marmot Report. The Public Health Report 2010 aims to encourage the new GP Collaboratives to tackle health in a similar manner. Jeremy finished the talk with a suggestion of what a really radical approach to improving public health would focus on improving the health of disadvantaged communities:
- Encouraging the shuffling of populations to reduce area based differences;
- Equalising incomes, such that absolute and relative poverty is reduced;
- De-normalising tobacco smoking in all parts of society;
- De-criminalising currently illegal drugs, as drug deaths and other issues are directly related to their being illegal.
In the discussion it was questioned whether a Director of Public Health had the power to address the root causes of inequality. Jeremy argued that the work did have an impact, and there had been real positive advances. The shift of public health to local government did offer a good opportunity for more joined up work, although it was important links with GPs were not lost.
The spending review and public health
Danny Dorling outlined possible impacts of the spending review, suggesting that reforms to housing, disability, and other benefits would produce a more divided city as poorer families are forced out of wealthier areas; and increase poverty due to cutting of the education maintenance allowance, disability benefits, etc. He believed that the current Government was, like previous policy makers, simply naive in their beliefs; and that policy makers had to be asked why sixteen European countries have higher life expectancy than the UK.
Several comments and questions from the audience covered the potential of the spending review. Questions covered how rises in inequality could be measured, for example, through increasing rates of attempted suicide. It was noted that the transfer of the Census to a private company and scrapping of a survey of school children’s health would make it more difficult to measure inequalities.