icWales - 'You are' where you are born, say doctors:
"'You are' where you are born, say doctors Mar 31 2006
Madeleine Brindley, Western Mail
THE community in which people are born will shape their lifelong health, a leading expert says today.
Generations living in some of Wales' most deprived communities will be condemned to lives dominated by poor health, unless they or society can pull them out.
And as more evidence emerges about the links between ill health and social factors such as housing, employment, and education, experts have called for a new wider focus for health promotion and prevention.
Dr David Salter, acting chief medical officer for Wales, said health professionals must work in tandem with employers, education and housing chiefs to improve the inherently poor health of certain parts of the country.
And Professor Mansel Aylward, professor of psychosocial and disability research at Cardiff University, added, "The time has come to stop messing about and to look at the broader landscape to make significant change.
Health is not just about public health or healthcare delivery, it's about what housing people live in, the culture, criminality.
"Unless we address these factors, then we won't get any change.
"In simple terms, we can treat disease with pills but we don't yet have any pills for psychosocial ills."
New community profiles, which map ill health by local authority boundaries, reveal that the South Wales Valleys remain blighted by ill health.
Life expectancy is at its lowest in Merthyr Tydfil and Blaenau Gwent; deaths from all types of diseases are highest across the South Wales coalfield, and people living in the Valleys are more likely to binge drink and to smoke and less likely to meet government guidelines on fruit and vegetable consumption and exercise.
This is in sharp contrast to the rural and relatively affluent area of Ceredigion, which constantly has low levels of some of the most lethal diseases in Wales.
The community profiles, were developed by the Chief Medical Officer and the Wales Centre for Health.
They also reveal a correlation between poor health, poor housing, unemployment and low educational achievement.
Prof Aylward said, "There is little doubt that the community in which you are born really sets the tone for the rest of your life, unless you or society makes efforts to move you up.
"Our physiology, pre-disposition to disease, and the diseases we get, are all part of our social background.
"We know that people who are in the less well-off areas are more likely to be out of work or working in industries that are much more rigid, less well-paid and more hazardous than people in the upper brackets.
"We know that housing is likely to be poorer - more damp, fewer facilities.
"These social determinants of ill health are there all the way through people's lives."
Dr Salter said, "Addressing social, economic and environmental circumstances of individuals and communities is central to improving health across Wales.
"Health Challenge Wales, the national focus and driver for efforts to improve health, is making connections between a broad range of services not only from the health sector but also from the employment sector, schools, colleges, workplaces, local government and the voluntary sector.
"The Welsh Assembly Government along with many other organisations and individuals have all been taking up the challenge to do more to help people improve their health and reduce health inequalities.
"This is a very good start but if we are to change the geography of ill health and unhealthy lifestyles in Wales, we are going to require a sustained commitment to health improvement from even more organisations and individuals - we all need to be part of the challenge."
Overall mortality - Deaths from all causes, including respiratory and heart conditions, are likely to be higher in deprived areas - an indication of poorer overall health and poor lifestyles, including higher rates of smoking.
High rates: South Wales Valleys areas of Blaenau Gwent, Merthyr Tydfil, Rhondda Cynon Taf, Caerphilly and Neath Port Talbot.
Low rates: Ceredigion, Monmouthshire, Powys, Gwynedd and Anglesey.
Life expectancy (men and women) - Poor life expectancy rates in the South Wales valleys mirrors the increased death rates.
Best: Ceredigion, Monmouthshire, Powys and Anglesey.
Worst: Merthyr Tydfil, Blaenau Gwent, Rhondda Cynon Taf and Caerphilly.
Long-term limiting illness - The 2001 Census identified high rates of long-term limiting illnesses in Merthyr Tydfil, which is reflected in the large numbers of people claiming sickness benefits.
Hot spots: Merthyr Tydfil, Blaenau Gwent, Neath Port Talbot, Rhondda Cynon Taf and Caerphilly.
Not spots: Monmouthshire, Cardiff, Vale of Glamorgan, Flintshire and Powys.
Cancer (men and women) - Cancer does not appear to follow deprivation, with all sectors of society at risk. But higher rates of smoking and drinking and poorer lifestyles in some communities could increase the risk of certain types of the disease.
Higher levels: Denbighshire, Anglesey, Conwy and Swansea
Lower levels: Monmouthshire and Ceredigion
High blood pressure, mental illness (including anxiety and depression), arthritis, back pain and diabetes - All of these conditions are closely linked to lifestyle - diet and exercise.
Difficulties accessing food shops, fresh produce and lack of money all influence how healthy, or not, an individual's lifestyle is.
High rates: Merthyr Tydfil and Blaenau Gwent had
Lower rates: Powys, Gwynedd, Monmouthshire and Conwy
Lifestyles (including smoking, binge drinking, exercise and fruit and vegetable consumption) - Despite the almost prohibitive price of tobacco, people in deprived communities are more likely to smoke.
Less healthy lifestyles: Rhondda Cynon Taf, Blaenau Gwent and Merthyr Tydfil
Healthiest lifestyle: Ceredigion and Conwy
