Editorial: A vivid lesson in the economics of health

Debates about public health have been regularly punctuated by studies confirming the intractability of the link to poverty. This latest is shocking, but no surprise

Share

The variation in early death rates between different parts of the country is “shocking”, according to the Health Secretary. Shocking it may be; but surprising it is not. Ever since the seminal Black Report, published in 1980, set out in stark, evidential terms the link between deprivation and poor health, debates about public health have been regularly punctuated by studies confirming the intractability of the problem.

The latest contribution is a Public Health England website that allows local premature mortality rates to be compared with those of other areas with a similar population and wealth for the first time. A useful tool, no doubt. But it is the national map that is so striking.

Not only is there a two-fold difference in cancer death rates between the top- and bottom-ranking areas (Harrow and Manchester), a three-fold disparity for heart attacks and strokes (Wokingham and Manchester, again), and a near five-fold gap for lung and liver disease (with Blackpool bottom in both). More concerning still is that the vast majority of “worst” and “worse than average” are in the North.

Cue the usual flood of glib remarks about avoiding Manchester (overall worst) and moving to Wokingham (overall best). Of course, there are lessons to be learned. Some relatively affluent places – Thurrock, say, or Bedford – have worse than average premature death rates; meanwhile, deprived Enfield and Brent do better than many, much wealthier counterparts. But such cases are exceptions. In the main, health – or the lack of it – correlates more closely with wealth than anything else.

The latest data is less of a condemnation of individual local health services, then, than a map of British lifestyles. And, to a large extent, that means drinking, smoking and obesity.

Thanks to the recent changes, such matters are now the responsibility of local authorities. Councils certainly do have a part to play. In part, by helping with the revolutionary task of tilting NHS priorities towards prevention as well as cure; but also through community action. Getting rid of fizzy drinks vending machines in schools, an idea backed by the Health Secretary yesterday, would be a start. Proposals to limit the number of fast-food outlets, or curb daytime sales to schoolchildren, also deserve a hearing – albeit with an eye on the practicalities. Education is also of central importance.

For all Jeremy Hunt’s fulminations, however, there is also much that central government might do but is choosing not to. Both of the Coalition’s high-profile public health measures – the imposition of a minimum per-unit price for alcohol, and the introduction of plain packaging for cigarettes – have been kicked into the political long grass. They should be swiftly retrieved.

The sharp rise in obesity also warrants action at a national level. Talks with the food industry over fat and sugar content and clearer labelling have not been pursued with sufficient gusto. Supermarkets’ strategies, such as festooning their check-out aisles with chocolate and holding different stock – often with fewer fresh products – in poorer areas, also raise questions.

Ultimately, of course, individuals are free to make their own choices. But consumers deserve to be both better informed and offered real alternatives. It can only be hoped that the premature death map that has so shocked the Health Secretary will concentrate minds.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Recruitment Genius: Sales Executives - OTE £60,000

£25000 - £60000 per annum: Recruitment Genius: Are you passionate about Custom...

Recruitment Genius: Care Workers Required - The London Borough of Bromley

£15000 per annum: Recruitment Genius: This homecare agency is based in Beckenh...

Recruitment Genius: Sales Executives - OTE £50,000

£25000 - £50000 per annum: Recruitment Genius: Are you passionate about Custom...

Recruitment Genius: Sales Executives - OTE £50,000

£25000 - £50000 per annum: Recruitment Genius: Are you passionate about Custom...

Day In a Page

Read Next
Polish minister Rafal Trazaskowski (second from right)  

Poland is open to dialogue but EU benefits restrictions are illegal and unfair

Rafal Trzaskowski
The report will embarrass the Home Secretary, Theresa May  

Surprise, surprise: tens of thousands of illegal immigrants have 'dropped off' the Home Office’s radar

Nigel Farage
Could cannabis oil reverse the effects of cancer?

Could cannabis oil reverse effects of cancer?

As a film following six patients receiving the controversial treatment is released, Kate Hilpern uncovers a very slippery issue
The Interview movie review: You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here

The Interview movie review

You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here
Rosetta space mission voted most important scientific breakthrough of 2014

A memorable year for science – if not for mice

The most important scientific breakthroughs of 2014
Jeb Bush vs Hillary Clinton: The power dynamics of the two first families

Jeb Bush vs Hillary Clinton

Karen Tumulty explores the power dynamics of the two first families
Stockholm is rivalling Silicon Valley with a hotbed of technology start-ups

Stockholm is rivalling Silicon Valley

The Swedish capital is home to two of the most popular video games in the world, as well as thousands of technology start-ups worth hundreds of millions of pounds – and it's all happened since 2009
Did Japanese workers really get their symbols mixed up and display Santa on a crucifix?

Crucified Santa: Urban myth refuses to die

The story goes that Japanese store workers created a life-size effigy of a smiling "Father Kurisumasu" attached to a facsimile of Our Lord's final instrument of torture
Jennifer Saunders and Kate Moss join David Walliams on set for TV adaptation of The Boy in the Dress

The Boy in the Dress: On set with the stars

Walliams' story about a boy who goes to school in a dress will be shown this Christmas
La Famille Bélier is being touted as this year's Amelie - so why are many in the deaf community outraged by it?

Deaf community outraged by La Famille Bélier

The new film tells the story of a deaf-mute farming family and is being touted as this year's Amelie
10 best high-end laptops

10 best high-end laptops

From lightweight and zippy devices to gaming beasts, we test the latest in top-spec portable computers
Michael Carberry: ‘After such a tough time, I’m not sure I will stay in the game’

Michael Carberry: ‘After such a tough time, I’m not sure I will stay in the game’

The batsman has grown disillusioned after England’s Ashes debacle and allegations linking him to the Pietersen affair
Susie Wolff: A driving force in battle for equality behind the wheel

Susie Wolff: A driving force in battle for equality behind the wheel

The Williams driver has had plenty of doubters, but hopes she will be judged by her ability in the cockpit
Adam Gemili interview: 'No abs Adam' plans to muscle in on Usain Bolt's turf

'No abs Adam' plans to muscle in on Usain Bolt's turf

After a year touched by tragedy, Adam Gemili wants to become the sixth Briton to run a sub-10sec 100m
Calls for a military mental health 'quality mark'

Homeless Veterans campaign

Expert calls for military mental health 'quality mark'
Racton Man: Analysis shows famous skeleton was a 6ft Bronze Age superman

Meet Racton Man

Analysis shows famous skeleton was a 6ft Bronze Age superman
Garden Bridge: St Paul’s adds to £175m project’s troubled waters

Garden Bridge

St Paul’s adds to £175m project’s troubled waters