Health inequalities: Steps we can take to create health

Dr Mark Spencer, co-chair of the New NHS Alliance, explains how a new initiative in Fleetwood, Lancashire is aiming to improve health across the whole community.

‘Healthier Fleetwood’ is about making Fleetwood a healthier place to live for current residents and generations to come. It will focus on ‘what makes me well’ rather than ‘what’s made you ill’. 

Nationally, the gap in life expectancy between the richest and poorest in society is widening. It’s clear that the traditional public health messages around stopping smoking, drinking less alcohol, losing excess weight and taking more exercise just aren’t being listened to in deprived communities.

Fleetwood is an area of high deprivation with high prevalence rates for all long-term conditions. Life expectancy in its most deprived areas is 10 years below the national average and is significantly below the most affluent part of the Fylde Coast, just six miles away.

I’ve been a GP in Fleetwood for over 25 years. Have I had a positive influence on people’s health? Well, hopefully yes, but only on an individual one-to-one basis. Detecting early cancer, recognising the early symptoms of heart disease and helping people with depression certainly improve their health, but this is more about managing illness rather than keeping people well.

My view is that over these past 25 years the overall health of Fleetwood hasn’t really improved much at all. Modern sedentary, high calorific life styles are certainly bad for your health.

How can we create health?

When I suggest to patients that stopping smoking, knocking the vodka on the head and eating more healthily would help them, a fairly common response is: ‘Why should I? What’s the point? My life is rubbish. Getting through today is hard enough so why bother about tomorrow? Just give me some pills and I’ll be out of your way’.

However people don’t need a pill for wellness. They need hope. They need to be able to look forward to tomorrow. They need to choose to be healthier today so that they can enjoy tomorrow, with their children and their grandchildren.

Hope, a sense of purpose and control over your own life and your environment will bring major health benefits for individuals and the whole community. This is Health Creation.

Fleetwood will be trying to put this into practice over the next 12 months. There is hope and local inspiration already out there and we plan to draw on that.

Green spaces

The Willow Garden Project is one such example. We aim to use this as our inspiration for creating more green spaces across the town and then encourage volunteers to look after them.

As a GP I can prescribe exercise through the Y-Active Project run by our local YMCA. Some people really enjoy gym-based exercise but lots don’t. I’d like to be able to prescribe gardening as an alternative. This not only increases activity rates but also increases social interaction and has a positive effect on the local environment.

One of the green spaces would be a dedicated dementia garden featuring health promoting herbs and vegetation, as well as reminiscence spaces. Along with looking after public green spaces our volunteer gardeners would also tend to the gardens of the elderly who are no longer able to look them themselves.

Again this will not only have positive physical benefits but it will also reduce the degree of social isolation experienced by the elderly and housebound.

Healthy eating

Another area  we aim to look at is food. I believe that we have lost basic cookery skills. Younger people don’t cook because their parents never taught them. Ready meals and high calorie processed food is the order of the day. So, we are aiming to teach Fleetwood how to cook again. Specifically, as a fishing community, we are going to look at cooking fish.

Moreover, parents and their children have lost the social interaction of cooking together and eating together. So, we plan to bring a food teacher into our primary schools and, using the facilities of Fleetwood Town Football Club, another local inspiration, they will cook for their parents and then sit and enjoy the meal together.

This is the start of our journey. We’ll be exploring health creation in more detail at the NHS Alliance’s annual summit this year, and we welcome you to join us. For more information please get in touch here:   

  • Dr Mark Spencer is a GP in Fleetwood, Lancashire, medical director of FCMS and co-chair, New NHS Alliance

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