Two areas of one town, two miles apart. So how can there be a difference in life expectancy of 20 YEARS?
SARAH RAINEY investigates. Her conclusions speak volumes about modern Britain
MID-afternoon in Stocktonon-tees and a man is slugging from a bottle of cider as he staggers into a betting shop, one of six that line the town’s High Street.
at the takeaway next door, young women with buggies are chatting on their phones as they wait in line for £1 cartons of chips. the Clock tower pub — boasting £2 pints and double vodkas for £2.49 — is doing a roaring trade, as is the casino, where regulars have been on slot machines since 9am.
In nearby Hartburn, meanwhile, lunchtime is a very different affair. tables outside the Village Deli, serving £6.95 antipasti boards and bottles of organic pinot grigio for £19.95, are packed, as is the garden at the gastropub where customers sip craft beer in the sun.
the leafy streets are lined with dog-walkers and children chase each other around the playground in the park.
fewer than two miles separate Stockton town centre and Hartburn, an affluent suburb to its south, but the areas are worlds apart.
Life expectancy is the starkest dividing factor, a reflection of the vast health inequality carving this once-booming industrial town in two.
While residents of Hartburn, a predominantly middle-class enclave boasting green spaces and high ofsted-rated schools, can expect to live to the age of 84, those in the town centre have a life expectancy of 64.
to put this into context, the average life expectancy in the UK is 82. In starvation-stricken ethiopia, it’s 65.
Cancer, lung disease and conditions caused by lifelong drug and alcohol abuse are rife in central Stockton, with more than a quarter of people suffering from long-term health problems or disabilities. But in Hartburn, just 4 per cent of people are in long-term bad health.
this extraordinary division within a single British town is brought to light in a Panorama documentary, Get rich or Die Young, due to be shown on BBC1 on Monday night.
Stockton-on-tees, it reports, has the biggest health inequality in the country — and while the good parts of town appear to be on the up, conditions in the most disadvantaged areas are only getting worse.
It’s not the first time the spotlight has fallen on this deprived pocket of the north east. the 2015 series of Benefits Street was filmed here, on the tilery estate in the town centre.
the show, dubbed ‘poverty porn’ by its critics, painted a picture of high unemployment, poor health and an entrenched welfare culture, with many locals unable — or unwilling — to improve their lives. W Hen producers knocked on doors to find participants for the series, residents reportedly chased them from the street and pelted them with eggs.
emotions aren’t running quite so high in Stockton this week. town centre locals are alarmed — but unsurprised — by the bleak health statistics.
Grandmother Carol Instone, 56, a self-employed cleaner, blames unhealthy eating habits for contributing to high levels of obesity and heart disease, even among the very young.
More than one in five children in the area are classed as obese by the time they leave primary school, and a third of adults are overweight.
‘We never used to have takeaways every night but now it’s normal,’ she says. ‘If you go down the High Street there are eight or nine fast-food places in a row. Where else do you find a town that has that?
‘People around here don’t cook dinners any more. on a low income, it’s hard to be healthy — fresh vegetables are expensive.’
though it sounds unlikely, such sentiments aren’t far from the truth. a single bag of supermarket salad costs £2 — the same as a cheeseburger, chips and a fizzy drink.
Paul thomas, 67, a resident of the tilery estate who’s volunteered at the nearby Willows community centre for 20 years, has seen the same pattern.
‘People’s health is definitely getting worse,’ he says. ‘I know families who get a Chinese for dinner one night, an Indian the next, fish and chips after that and then pizzas. they’re too lazy to go to the supermarket — and it costs more.
‘there’s a lot more drink and drugs around. and most people smoke — myself included. I’ve smoked since I was 14 years old and I’m not going to stop now. If I was going to get sick, it would have happened already.’
But not everyone shares his outlook — or his good fortune.
rob Hill, who’s 46 and lives on the nearby Hardwick estate, has myriad health problems, including type 2 diabetes, the lung disease emphysema, and lymphedema (swelling caused by excess fluid collecting in the tissues). all of his conditions have been exacerbated by years of poor lifestyle choices.
two years ago, doctors gave rob, a taxi driver and fatherof-eight, six months to live. aware that he is living on borrowed time, he has planned his funeral and says goodbye to his children every night before bed.
‘It’s devastating,’ he says. ‘Inevitably I’ll get a collapse in my airway and that will be it. I will die. I could go to sleep tonight and it’s lights out.
‘My diet used to be reasonable until I started [driving] the taxis. then it was burger vans, McDonalds, KfC, anywhere I could just pull in. I’d have a bargain bucket on the seat next to me, driving down the motorway, chicken wing in my mouth.
‘It’s hard as that’s the last thing I want my kids to see.’
rob is far from the only Stockton town centre resident facing a premature death. the headstones in Durham road cemetery of 30, 40 and 50year-olds outnumber those of pensioners.
the rate of lung cancer and coronary heart disease here is two-and-a-half times the UK average. Cancer deaths in under-75s occur at nearly three times the national rate.
In neighbouring Hartburn, however, incidences of these conditions are well below average. So what’s driving the widening gap? Professor Clare Bambra, professor of public health at newcastle University, led a five-year study into health inequalities in Stockton-on-tees. She says poverty is at the root of the vast difference in life expectancy.
‘In the town centre, people simply don’t have the money to buy things that would be good for their lives,’ she explains. ‘they don’t have the option of buying healthier food, or joining gyms, or going on nice holidays. they’re too worried about feeding and clothing their kids, and whether they can afford to pay the rent and stave off eviction.
‘these inequalities based on location can be traced back to Victorian times, when there was a big difference between labourers and the professional gentry. then, there was a 30 to 40-year gap in life expectancy — and that’s carried on.
‘for those in deprived areas, there’s a sense that it’s always been like this: their parents had the same struggles, so it’s part of who they are.’
C ERTAINLY, poverty is stamped on every corner of the town centre’s estates. a three-bedroom house here is worth just £50,000, and only 22per cent of residents own their homes. the majority (53per cent) live in social housing, and overcrowding is almost double the national average.
Boarded-up shops, rubbish, furniture dumped in the street — it’s not hard to see why this was picked as a Benefits Street filming location.
More than a quarter of the potential workforce in central Stockton are unemployed and 10per cent get out-of-work benefits. Many more juggle multiple part-time jobs, surviving on as little as £45 a week.
Compare this to Hartburn, where 92 per cent of locals own a home (and the average value is £219,000), unemployment is 5 per cent and just 1 per cent are on benefits.
Margaret Middleton, 62, works at Hardwick in Partnership, a community organisation helping residents of the Stockton estates find work.
She says being unable to get a job has a ‘huge impact’ on life expectancy. She’s seen this worsen in the past decade as businesses have closed, depriving locals of opportunities and much-needed self-esteem.
In Hartburn, by contrast, expensive eateries and boutique shops, such as florists and dog groomers, pop up weekly.
Simply being from central Stockton is enough to taint a job applicant, Margaret says. ‘Postcodes have a great deal of impact on employers, which a
People don’t cook dinners any more. On a low income, it’s hard to be healthy — vegetables are so expensive
lot of people in this area struggle with,’ she explains. ‘Historically this has always been a council estate, and that affects people’s perceptions.’
That said, few believe locals are entirely blameless in their health troubles. It is they who spend the money they have on cigarettes, alcohol and fast food, and they who have contributed to spiralling drug problems. Drug-related deaths here have trebled since 2001.
This is very much the feeling among residents of Hartburn, where a ‘them’ versus ‘us’ attitude seems deep-rooted. Many would never dream of venturing into central Stockton’s estates. ‘People here care about their health,’ says Sharon Yawson, 52, a nurse practitioner. ‘They are two very different places.’
Carolyn Brewster, 57, a carer, says: ‘I don’t think it matters where you’re born. It’s learned behaviour from your parents and peers. Everybody can get themselves out of a council estate if they want to.’
Professor Bambra says things aren’t so simple. ‘Ultimately it’s a coping mechanism,’ she explains. ‘People in deprived areas often don’t have a sense of the future. Their lack of income leads to social isolation and hopelessness. They don’t feel they have control over where their lives are going. When the payoff is several years down the line, it’s hard to make long-term changes to your life. It all ties in to a lack of hope.’
Mental health problems, she says, are pervasive here — further driving life expectancy down. Hospital stays for self-harm in Stockton town centre are three-and-a-half times the national average. Suicides are scarily commonplace.
Local residents, like roofer Shaun Hunnam, 35, feel there is a lack of incentive to seek help. ‘It’s hard to get out of the cycle. I don’t think it can be stopped. There is no community spirit — there used to be a lot of that. People don’t want to work. They don’t want help.’
Dr David Hodges, who lives in Hartburn but has a surgery in central Stockton, says residents are proud. They are often reluctant to acknowledge there may be something wrong with their way of life.
‘I get very angry with the health inequality as so much of what is in my waiting room doesn’t need to be there,’ he says. ‘It is preventable. I will accept chronic illnesses in your 60s, but I don’t accept that we should be expecting people to be ill in their 40s. It’s a disgrace.’
Dr Paul Williams, MP for Stockton South, used to be a GP in the town and knows only too well the cycle many locals end up in.
‘From the moment some children are conceived, they are exposed to a less than ideal environment,’ he explains. ‘If babies are in homes where there is conflict or they’re exposed to experiences such as domestic violence or drug or alcohol abuse, then their disadvantage becomes even more entrenched.
‘They start school unable to read or write, get behind their peers and are often on a trajectory that leads them to finishing school without enough qualifications. Then they get trapped in poverty.’
Targeting the young seems to be the key to reversing this appalling trend. And measures — such as a new service offering dietary advice, mental health intervention and family support to children aged up to 19 — are being taken by the borough council.
But is it enough? And as money is seemingly poured into other parts of town — Stockton’s pedestrianised centre recently had a £38million makeover, and the council is funding the construction of a Hilton hotel — is help reaching those who need it most?
LoCAL councillors insist it is. But Bernadette RizziAllan, the headteacher of St Bede’s primary school in one of Stockton’s most deprived areas, isn’t so sure.
‘People’s health should not be defined by their social class,’ she says. ‘our children have just as much innate ability, potential and talent. I don’t believe for one second their life path is fixed.’
She’s introduced programmes tailored to the needs of the most vulnerable pupils, from counselling to exercise sessions. The results speak for themselves — the school now outperforms those in some of Stockton’s wealthiest areas.
At the Willows community centre, Paul Thomas and other volunteers are also taking matters into their own hands.
‘We give the kids juice and fruit at youth club nights,’ he says. ‘They’re not getting it at home, so at least we know they’re getting some goodness in their diet. And we’ve started helping with their CVs, so they can get into work.
‘I keep plugging away. But when you see the same people with the same problems again and again, there does come a time when you think: “Is there any point to it? Will things here ever change?” ’
He shakes his head. Wherever you live in this town, it’s the question on everyone’s lips.
Get rich Or Die Young: Panorama is on BBC1 at 8.30pm on Monday.