On July 3rd we welcomed Professor Mike Holmes as our speaker. As well as being a partner in the Haxby GP Group, Mike is also Vice-Chair of the Royal College of General Practitioners, chair of Nimbus Care in York, and an Honorary Professor at the University of York. He is well-placed to give us both a local and broader perspective about Health Inequalities, the subject of his talk, and the current impact of COVID-19 on health and social matters.
The local Primary Care Network extends across much of the northern region from Kendal to Hull. The impact of COVID-19 affects all of us, of course, but he made it clear that there is a greatly disproportionate impact on lower-income families and those with less than adequate housing and social support. COVID has brought the health service to a much greater focus on need and risk, and the analysis of these factors, as well as behavioural change in people.
Mike explained that, even before COVID, there were huge differences in health outcomes within even an area as small as York – life expectancy of a male in Wheldrake (which is to age 84) compares vividly with a man in Acomb (79) or Clifton (77). Looking across the county, the differences are even more stark. The life expectancy in the York area (men 81.7, women 84.2) compared with the Hull area (men 59.3, women 73.2) was a shock to many of us listening.
The reasons for such disparities are complex and varied, but many include life habits such as smoking and drinking, obesity factors, diet, exercise, health promotion advice and opportunities, and living conditions. The differences in number of deaths from respiratory diseases was particularly striking across different areas of York, Mike pointed out.
Mike explained that a recent study (the Marmot report), issued just before the COVID lockdown, illustrates that average life expectancy had been increasing by one year during each 5 year period from 1980 to 2010. Since then it has more or less flattened, and Mike felt this was mostly due to the effects of the austerity programme which impacts most on the poorer and less healthy segments of the population.
His fear is that the added impact of COVID, the social and economic impact of lockdown and the subsequent depression/recession that may follow, will only make this situation much worse.
Lest we felt his message was all gloom and doom, Mike did explain a number of positive benefits coming out of the current situation.
The progress of change had been accelerated in areas of NHS technology, co-operation within the NHS and data management. For example, the way doctors interface with their patients has radically changed – for the better for both parties – through video technology and this is bound to change the future of healthcare as we know it. (sounds like a familiar theme!)