Health and Well-Being

Levelling up the UK: is the government serious about reducing regional inequalities in health?

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This is my “long read” tip. There is some really interesting stuff to reflect on here, particularly in relation to the issues around levelling up being wider and with more dimensions than just simply north vs south. Try rural vs urban!

The Levelling Up white paper, released in February 2022 after major delay, outlines the UK government’s much anticipated strategy for tackling regional inequality. The centrepiece of the government’s reform agenda, “levelling up” is presented as a solution to the UK’s longstanding and serious geographical inequalities (box 1). Although levelling up is already permeating political and media discourse,10 the white paper is the first attempt to translate this broad idea into specific policy commitments to tackle place based inequalities: white papers set out proposals for future legislation.

Number of inactive adults in England rises by 1.3m since Covid

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This story goes nicely with “And Finally…”. It leads me to reflect that England with its relatively limited access to open countryside is not in its areas a green gym. Indeed in many urban places there are better facilities and opportunities to get active than in rural settings.

About 1.3 million adults have become inactive since the height of Covid, with at least 12 million taking less than an average of 30 minutes’ exercise a week, as activity levels only just begin to recover towards pre-pandemic rates.

The Active Lives Adult Survey, which is the largest study of the matter in England and has 175,000 respondents, tracked adults’ activity for a year from November 2020, with the data taking into account the impact lockdowns had on activity levels.

Just over 60% of adults (28 million) were active, achieving more than 150 minutes of activity a week, while 27%, or 12.4 million adults, were inactive, with less than 30 minutes of activity a week. A further 11.5%, or 5.2 million adults, were fairly active but did not reach an average of 150 minutes a week.

The data also showed that while activity levels dropped during periods of lockdown restriction, since coronavirus became less prevalent and restrictions were eased activity levels had begun to stabilise and were now recovering. In mid-March 2021, 61% of the population were active, compared with 58% 12 months earlier.

‘These salt marshes saved my life’: how nature is helping mental health

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This article is a really interesting insight into the therapeutic qualities of the countryside. In a theme which runs through Hinterland this week it speaks to us about the relationship between coastal places, the sea and its tributaries and people’s sense of well-being. It tells us:

There is already good evidence of nature’s efficacy, such as a 2019 study showing that a two-hour “dose” ofnature a week significantly improved health and wellbeing. The missing link has been connecting health services and nature activities.

“These activities have being going for years, it’s just that they often have not had that connection into the health systems to enable them to receive the people who need the benefits the most, and to deliver precisely what they need,” says Dave Solly, at the National Academy for Social Prescribing (NASP), which was launched in 2019 with funding from the Department of Health.

But things are changing. Seven NHS care groups from the Humber to Surrey received a combined £5m in government funding in December for projects harnessing nature to improve mental health, including tree planting and growing food. There are also now more than 1,000 social prescribing link workers working in GP surgeries and health clinics, helping doctors link patients to nature activities, as well as arts, heritage and exercise groups. A million people could be referred to social prescribing in the next few years.

Among the projects championed by NASP are Wild Being in Reading, an open-water swimming group in Portsmouth, Dorset Nature Buddies, the Green Happy cafe in Northampton, and a Moving in Nature project in Chingford, Essex.

Mental Health Poor for 11 Percent of U.K. Adults During COVID-19

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We’re starting to get a significant handle on the impact of Covid in relation to mental health and this story is very revealing. It’s just a shame it doesn’t apply a rural filter to the analysis.

About 11 percent of U.K. adults experienced deteriorating or consistently poor mental health during the COVID-19 pandemic, according to a study published online May 6 in The Lancet Psychiatry.

Matthias Pierce, Ph.D., from the University of Manchester and colleagues tracked average mental health during the pandemic, characterised distinct mental health trajectories, and identified predictors of deterioration. The 12-item General Health Questionnaire was used to assess mental health in 19,763 adults.

The researchers observed a deterioration in average population mental health with onset of the pandemic, which did not begin improving until July 2020. Five distinct mental health trajectories were identified up to October 2020. Most participants had consistently good or very good mental health (39.3 and 37.5 percent, respectively). 

Twelve percent comprised a recovery group, who initially experienced a decline in mental health followed by improvement to prepandemic levels by October. For 7.0 percent, there was a steady deterioration in mental health during the pandemic, and for 4.1 percent, mental health declined initially and remained very poor throughout. 

The likelihood of having pre-existing mental or physical ill health, living in deprived neighbourhoods, and being non-White was increased for these two groups. Subsequent deterioration in mental health was predicted by severe acute respiratory syndrome coronavirus-2 infection, local lockdown, and financial difficulties.

UK to set up health agency to combat future pandemics

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A case of shutting the gate after the horse has bolted?

A new organisation is being set up with the aim of halting future pandemics. The UK Health Security Agency (UKHSA) will launch on 1 April, the health secretary, Matt Hancock, announced.

He told a briefing hosted by the Local Government Association that the “UKHSA must plan, it must prevent and it must respond. UKHSA must be ready.”

Hancock added: “UKHSA, as it will be known, will be this country’s permanent standing capacity to plan, prevent and respond to external threats to health … UKHSA will work with partners around the world and lead the UK’s global contribution to health security research.

“Next, UKHSA will be tasked to prevent external threats to health, deploying the full might of our analytic and genomic capability on infectious diseases … in all, helping to cast a protective shield over the nation’s health. Even after years without a major public health threat, UKHSA must be ready not just to do the science but to respond at unbelievable pace.”

He said the agency would hire the “very best team possible from around the world” and would be led by Dr Jenny Harries, the deputy chief medical officer for England, who will be its chief executive.

Hancock said the agency must be “vigilant, dynamic and confident”. He added: “This isn’t just an agency. Its job is to provide professional leadership here and around the world.”

UKHSA replaces the National Institute for Health Protection, which was established in August with Dido Harding as its interim chair. She will step down to make way for the new agency.

At the same briefing, Lady Harding, who is head of NHS test and trace, said more Britons downloaded the Zoom app than the test and trace app last year.

She said: “[NHS test and trace] was the second most downloaded app in the country last year, only after Zoom, and slightly ahead of TikTok … 21 million people downloaded the app.”

In a statement, Hancock said: “The UKHSA will be this country’s permanent standing capacity to plan, prevent and respond to external threats to health. It will bring together our capabilities from the scientific excellence embodied by the likes of Dr Susan Hopkins and her amazing colleagues in clinical public health, to the extraordinary capability of NHS test and trace, which Dido Harding has built so effectively over the last nine months, and the Joint Biosecurity Centre (JBC).

High court condemns lack of provisions in UK for suicidal teenager

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A really tragic story and one which I feature because it highlights how very difficult it is to find suitable local accommodation for people with these challenges in rural settings. I know personally of a Nottinghamshire family who have a child based at a Kent facility in this context. This all reminds us that whilst Covid-19 continues to consume all our thinking there are many other pressing challenges a number of which are being exacerbated by the lack of scope to focus on them at the current time. 

Not a single secure bed was available anywhere in the UK last week for a suicidal teenager, according to a high court ruling that highlights the chronic shortage of accommodation to support the country’s most vulnerable children.

Mr Justice MacDonald said the lack of places – partly caused by Covid-19 restrictions – left him facing a “stark choice” either to send the 16-year-old girl to an unregulated placement – meaning she would not inspected – or into the community “where she will almost certainly cause herself possibly fatal harm”.

MacDonald said he had no option but to choose the former in his damning judgment, which began with the Nelson Mandela quote: “There can be no keener revelation of a society’s soul than the way in which it treats its children.”

The lack of secure placements emerged when Lancashire county council sought a place for the girl after she had spent a period on an adult mental health ward where she had threatened to abscond, kill herself and kill staff. A search for a place in an NHS child and adolescent mental health psychiatric intensive care unit was also unsuccessful.

In his written ruling, handed down on Friday in the family division of the high court, the judge said the teenager was “in urgent need of a secure placement” but that “as of this morning, no such placement is available anywhere in the United Kingdom” – putting “anywhere” in italics to highlight his apparent incredulity.

NHS hospital waiting lists could hit 10 million in England this year

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I fear that hotspots of frailty in rural areas, particularly coastal areas, will be particularly impacted by the impact of these waiting lists. This story tells us:

The waiting list for hospital treatment could soar to almost 10 million people by Christmas amid a huge backlog caused by coronavirus disrupting services, NHS leaders are warning.

Hospital bosses say that such a massive increase in England is a realistic prospect, given so many people have been unable to have surgery and crucial diagnostic tests in recent months while the NHS’s main priority has been minimising the damage from Covid-19.

The total number of people waiting to undergo a procedure in a hospital in England such as a hernia repair, cataract removal or hip or knee replacement stood at 4.4 million before the pandemic. It then fell to 4.2 million because in March GPs referred fewer patients for care to help hospitals tackle the pandemic and also because some patients were reluctant to risk getting infected by going into hospital.

However, the NHS Confederation estimates that it is likely to reach 9.8 million by the end of the year as a result of staff shortages and hospitals having to cap the number of patients they can treat at any one time because of strict physical distancing rules that reduce the number of beds available.

In a “pessimistic” scenario – which would result if a second wave of the virus emerges – the waiting list, comprising people who are meant to be treated within 18 weeks, could hit 10.8 million. And even under the confederation’s best-case “optimistic” scenario about 8.1 million people would be waiting.

Housing shortage: Scale of UK’s housing gap revealed

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The lack of affordable housing across England and specifically rural England is having a major impact on people’s health and well-being as this story tells us

In a poll of more than 2,000 people for the Affordable Housing Commission, 13% of adults said their mental health was affected by their housing situation.

Looking just at those in unaffordable housing – costing more than a third of income – produced a greater level of concern.

Twenty-five percent of the sample said their mental health had suffered. That’s potentially millions of people.

The Affordable Housing Commission found that more than half of 18 to 24-year-olds live with family, and 18% are still doing so as 25 to 34-year-olds. 

At the same time, government statistics show that the number of young adults living with parents is on the rise.

Sleaford MP calls for more British fruit and veg to be grown and eaten to boost children’s health and the rural economy

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Really interesting and thoughtful contribution about the future of health from one of my local M.Ps.

Sleaford and North Hykeham’s MP has called for more fruit and vegetables to be grown and consumed in the UK to boost people’s ‘five a day’ intake while supporting British farmers.

A farmer’s wife, Dr Caroline Johnson MP was speaking on Tuesday in the House of Commons in a debate on a continuation of direct payments to farmers for the coming year during the transition period after the UK leaves the EU.

In one of several points she made in the hearing of the Bill, she called for subsidy payments for farmers from the Department for Environment, Food and Rural Affairs to be speedy and also for small farmers to be supported in applying for some of the grants available.

She said: “What has changed is that, 30 years ago, 83 per cent of that fruit and veg was produced in the UK, and now only 54 per cent is grown here. That means that we have a huge capacity to improve the amount of home-grown fruit and veg. In fact, we could grow the sector by 66 per cent overnight if people were to consume their five a day immediately.”

She urged the department to think of the public good of producing extra food as well as producing environmental access improvements linked to grants for farmers and their land. 

“We should think of food production, particularly fruit and veg production, as a great public good for our society, as it would really help to improve the health of our nation.

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