IN SICKNESS AND IN HEALTH
IT’S STAGGERING to think that at least one in three babies born in the country today will reach the age of 100. So, too, is the fact that the number of centenarians has quadrupled over the last two decades.
But while life expectancy has risen steadily since the middle of the last century, there are growing concerns about the quality of life. Science and technology is keeping us alive for longer, but are we able to enjoy it?
It’s a question that is worrying health experts like Dr Andrew Furber, who this month took over as Centre Director for Public Health England in Yorkshire and the Humber. “One of the things I’m continually shocked by is the gap between the healthy life expectancy and the full life expectancy,” he says.
The figures are, indeed, alarming. Even though a boy born today in Yorkshire will, on average, have a life expectancy of 79 years, only 61 of these will actually be healthy. “As a population we’re ageing, which is a good thing, but the problem is that for men, on average, 18 years of these are spent living with ill health.”
For women it’s even higher – almost 20 years – and closing that gap is a Herculean task. “I think the biggest challenge is how we focus less on treating illness and seeing the NHS as a sort of care and repair service, and more on stopping people getting ill in the first place.”
Not only is this gap widening, there have even been mutterings that life expectancy could soon start to fall in some places.
However, Dr Furber says it’s too early to say if this is the case. “There’s been a lot of debate about the data coming out and it’s quite a complicated picture to unpick. We’ve got used to seeing life expectancy rising year on year and this has been slowing down and understanding what’s behind that is something that’s being looked at.”
What isn’t in doubt is the shocking regional disparities that exist. “For a man in the ten per cent most deprived parts of Yorkshire and Humber healthy life expectancy is only 52 years, compared to the top ten most advantaged areas where it’s 70 years.
“So places like Hull would have lowest life expectancies and places like Harrogate would have the highest based on what we know about the socio-economic circumstances in those areas.”
On top of this there’s also a significant North-South divide when it comes to public health statistics. As Dr Furber puts it: “The further north you get the worse the figures become.”
Well known risks, such as smoking, are still an issue despite all the warnings about the impact it has on our health. “One in six adults in Yorkshire and the Humber continues to smoke even though the numbers are coming down. That’s the average, but if you look at somewhere like Wakefield among routine and manual workers you’re talking about one in three people.”
Obesity is another problem that isn’t going away. “There’s been a lot of emphasis on childhood obesity but it’s a factor among adults too with the increasing rates of diabetes we’re seeing.”
However, given the well-documented travails of the NHS and a healthcare system buckling under pressure, it’s been suggested from some quarters that heavy smokers and drinkers should pay for treatment of ‘selfinflicted’ illnesses.
It’s not something Dr Furber supports. “I don’t think that’s the route to go down because where do you draw the line? A couple of years ago I broke my ankle playing football, was that my fault for being a 50-year-old guy still thinking he could play football? I think we should be proud as a nation that we have a healthcare system that’s free at the point of need and I don’t think anyone wants that to change.”
Inroads are being made into both with fewer people, especially youngsters, smoking and more adults doing exercise. There are also schemes in place aimed at making exercise part of children’s daily routine. “In Barnsley there’s some great work being done around what’s called ‘the daily mile’ which encourages all primary school children to run or walk a mile each day. This not only makes them more alert, it helps them function better while they’re in school.”
There are other health challenges that need addressing. In his previous job as Director of Public Health in Wakefield, Dr Furber was at the forefront of tackling mental health in all its many forms.
campaign around loneliness is absolutely on the money because if we can identify and support people who are socially isolated, lonely and a bit vulnerable it can prevent problems further down the line.”
Mental health provision has come under increasing scrutiny and last year the Care Quality Commission said unequal access to mental health services could be “putting young people’s lives at risk”. It’s something Dr Furber says can, and must, improve. “I think the waiting times for some of these services are unacceptable and have to improve; we need to be more creative about how we provide support. In Wakefield we commissioned an online service where children could log on to a website and discuss issues they might have with counsellors there and then without having to wait.”
The big unknown factor in all this is the impact of Brexit. “There are some really important public health connections with Europe. For example, there are systems in place that track communicable diseases across Europe and it’s really important that these, along with the networks of scientists who help generate the evidence of what works and track patterns of disease, are maintained after we leave the EU.”
He says the falling number of EU workers in the region is likely to have an impact, too. “We know that recruitment of nurses is proving increasingly difficult and it will be even harder if nurses from Europe are thinking twice about whether they want work in the UK, which means we have to upskill our local population.”
His chief concern, though, is trying to help improve the health statistics across the whole region. “There are inequalities in Yorkshire that are quite shocking and doing something about that has to be pretty much at the top of the list of priorities – we have to make sure we narrow that gap.
“It’s going to be difficult because it’s not just a health issue, it’s a societal issue. It’s about how do you get high-paying jobs into places like Castleford rather than somewhere like Harrogate?”
It’s a big job, as is ensuring that towns and cities can cope should a health emergency arise. “There’s a lot of work we do that people don’t know about. We respond on a daily basis to outbreaks of infectious disease, so flu’s a big thing at the moment but we’ve had outbreaks of measles in Leeds recently and we get cases of TB from time to time.
“There’s a lot going on behind the scenes that if we didn’t deal with would be a much bigger problem.”
Chris Bond