Deprivation causes ill health and early death - Medical Matters with Derry GP Dr Tom Black
In more than 35 years working in my GP practice looking after about 7,000 patients we’ve only ever had one patient who lived to be 100 years old. There are now 100,000 people in Japan more than 100 years and 90% of them are women.
The Better Lives Index just published the best and worse worst places to live in the United Kingdom looking at housing, jobs and health. The best five places are all in the south east of England and London. Derry City and Strabane came in the bottom five of the worst places to live for a better life, ranking 357 out of 359.
People here can expect to live shorter lives (about five years fewer than the best areas), earn lower wages, and stop working at a younger age.
We have much lower levels of economic activity (having a job) and much higher levels of being inactive (42%) between the ages of 50 and 64 years. We also have more pollution and higher levels of childhood poverty. We have high levels of avoidable mortality which means people are dying younger due to inadequate healthcare and we can expect this to get worse as the NHS collapses around us.
Other parts of Northern Ireland that do badly are Tyrone, Fermanagh, North Antrim and the more deprived parts of Belfast.
We have the latest annual Report of Health Inequalities in Northern Ireland from the Department of Health to tell us what is going wrong in healthcare here. The life expectancy for a man in Derry and Strabane local government district is 77.4 years, which is 1.3 years lower than the Northern Ireland average but this is much lower for the most deprived at 72.2 years.
Life expectancy for women here is 81.3 years on average which is 1.2 years lower than the Northern Ireland average and again much lower for deprived populations at 77.6 years. The areas we do very badly in are related to alcohol and drug abuse, mental health, smoking and lung cancer.
This makes for depressing reading, especially for a doctor trying to keep people healthy. The biggest factor in all of this of course is deprivation. Deprivation results in higher levels of alcohol and drug abuse, self-harm, smoking during pregnancy and teenage births.
Deaths from drug misuse are two and a half times higher in the most deprived areas with the worst being in mid and east Antrim where the death rate is treble the average.
These problems aren’t easy to fix despite all the good work being done by the mental health services and alcohol and drug teams.
If you look at the overall picture and ask how can Derry and Strabane can improve things for the Better Lives Index for future generations the key is education and jobs.
If we keep our children at school, get them a decent education and then a worthwhile, well paid job they will have the opportunity to adopt healthy living principles that will avoid the pitfalls that are all too common for people now.
In the meantime the Department of Health needs to focus their investment on those areas with the highest deprivation because at the moment the areas west of the Bann with the greatest need don’t get the help that they deserve.