Newcastle has been ranked as the 12th “least healthy” area of England – and experts have emphasised the situation is likely to have worsened, because the study is based on research predating the worrying impact the Covid-19 pandemic has had on health inequalities.
The ranking is according to the Office for National Statistics’ (ONS) Health Index, which measures a number of factors such as access to health services, living conditions and behavioural risk factors and comes up with a score for each local authority area. The North East as a whole was also the region which ranked worst in the UK.
In response, Newcastle City Council’ s interim Director of Public Health Lorna Smith said the council was doing “as much as we possibly can” but called for “significant investment” from central Government to help tackle the issue. Siobhan O’Neil – chief executive of the Healthwatch Newcastle and Healthwatch Gateshead organisations which work to represent patient voices in the area – also pointed to an “awful lot of factors” influencing poor health in the city and said services must listen to what people using them tell them.
The ONS study maps health indicators from 2015 to 2019 and benchmarks them against the national average at the beginning of that period which is given a score of 100. In 2019, Newcastle scored just 93.6. What this means is that, accounting for the 14 factors identified, health in the city was substantially worse than on average nationally.
The story is similar across the North East, with each local authority in our area ranked in the bottom 50% nationwide. Out of 306 areas, Newcastle is ranked 295th. It’s followed by Sunderland (288th) County Durham (264th), South Tyneside (255th), Gateshead (254th), North Tyneside (198th) and Northumberland (188th).
By contrast the “healthiest” region is the South East which is given a score of 102.1 – compared to just 96.7 in our area. That shows that health improved in the South East just as it was worsening here. However the highest local authority score was for the Ribble Valley (112.9). The lowest rated area was Blackpool, with cities including Manchester, Liverpool and Salford all below Newcastle.
Explaining the data, the ONS said: “The Index aligns with the World Health Organization’s (WHO’s) definition of health, that health “is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”
Across the country mental health and crime are among the factors to worsen considerably, the ONS found – and this is doubly the case in our region. In the year before Covid-19 hit, “access to services” and “access to green spaces” in Newcastle were both areas given strong marks – but “personal well-being”, “crime” and “physiological risk factors” were all areas of serious concern according the ONS analysis.
Reacting to the report, published earlier in March, Newcastle’s interim public health chief Ms Smith said: “Sadly, we know that inequalities are closely linked with higher levels of deprivation, and we can see this in the fact that many other North East areas compare similarly to Newcastle in this index.
“Our health is intrinsically linked to our social circumstances, and it is by improving people’s quality of life that we can improve their health and their outcomes, and we work closely with partners across the city to support our communities as much as we possibly can.”
She explained the way in which local bodies were seeking to address high obesity levels exemplified the council’s approach to improving health outcomes, adding: “Our approach to address local obesity levels is increasingly focussed on our environment and the need for a whole-system approach to ensure we make every day healthy behaviours accessible and achievable for everyone.
“This means looking at everything from our active travel and food infrastructure to looking at the barriers in dealing with chronic illness or caring responsibilities in maintaining healthy weight and wellbeing.”
But she said that, as much as the council was doing with its partners in the city – including through the award-winning Collaborative Newcastle programme – outside support was needed. She added: “By taking a public health approach to these issues, we can address the wider determinants of health, improving health through better housing, raising food standards and addressing economic barriers for instance, though of course this would require significant levels of investment to achieve that are far beyond the budgets of local authorities.”
Ms O’Neil, who has run the city’s Healthwatch organisation since late 2020, added: “We are clearly at the wrong end of the scale to where we want to be on these things for the people of Newcastle. The health of people in the city of Newcastle is influenced by an awful lot of factors. It can be genetics, it can be where we live or how much money we have – they all feed in to the wider determinants of our health.
“Not long after I started this job, during one of the national lockdowns, I went out for a walk that was a big five-mile loop. And in that five miles you pass through an eight year difference in life expectancy, that’s a awful. The data in the ONS study is obviously pre-pandemic, and we know the pandemic has exposed inequalities further.”
She said that Healthwatch’s perspective, and her own mantra, was that it was vital for healthcare organisations to ensure patient voices were heard. She added: “It’s so important to listen to the experiences of people using services. If someone is rocking up at the dental hospital with a serious problem but that’s because they can’t get an appointment at an NHS dentist or can’t afford NHS dentist charges, it’s important to listen to that.
As organisations, we have to recognise that people facing illness are not always going to come to us and tell us what it’s like. It’s our job to ask ourselves if we are really listening to people.” Ms O’Neil also added that, with the impact of the cost-of-living crisis likely to worsen the health of the most vulnerable, it was vital to pay attention to those who might raise issues about their health.
Previously, studies such as the Child of the North report have highlighted how inequality has a “devastating impact” on the future prospects of children in our area – a child born here is likely to be, on average, substantially worse off in terms of their health and wellbeing than if they lived in the South East. ChronicleLive has also been part of a national campaign urging the Government not to “leave behind” children in our area – and to ensure that the “Levelling Up” agenda helps tackle inequality in our region.
Nationally, the Government announced last year the formation of a new Office for Health Improvement and Disparities as part of its efforts to tackle the issue. The Health Secretary Sajid Javid said at the time that OHID would “co-ordinate an ambitious programme” to improve public health – and he has since added to this, saying in a speech setting out plans to reform the NHS that: “We can’t hope to level up unless we level up in health.
“It’s said that ‘demography is destiny’. And while politicians must have some humility in the face of this long impersonal arc, we are not powerless to bend it towards health and prosperity.”