When I am talking about the ways in which deprivation affects the health and wellbeing of the people of Merthyr Tydfil, I am careful to comment that Glasgow has statistics that are even worse than ours. A recently published study from Glasgow reports findings from a project comparing people from the poorest parts of the city with a sample from the wealthiest communities and the likelihood that they had carotid plaques (furring of the major artery in the neck, an indicator of heart attack and stroke risk). The research team found that many of the known and suspected risk factors for heart disease were more prevalent in the poorer people.
Interestingly, they found that even when all these risk factors were accounted for, individuals from the most deprived areas had around a 1.5-fold to 2-fold higher risk of plaque presence than those from least deprived areas.
The authors concluded: Health status is a reflection not only of features of the individual but also of wider social and economic influences, health and social services, early life experiences, and environmental factors. These findings fit in with the work of Marmot and Wilkinson who have been studying these issues for more than twenty years. Blaxter, reported in the Health and Lifestyle Survey, a large research study published in 1990, that only wealthy people could improve their health by changing their lifestyles. Indeed, she also showed that poor women who smoked enjoyed better health than poor women who did not smoke; a message that the Health Promotion industry has chosen to ignore.
I came to Merthyr as a general practitioner inspired by Julian Tudor Hart to “walk one mile up the river” in order to help people not to fall into the rivers of disease, disability and death. There are many changes that I can help individuals to make to reduce the risks of bad things happening to them, but the real health and well being dangers that my patients face have much more to do with inequality and inequity.
Will the new leader of Welsh Labour have the ideas and the policies to tackle these challenges and make a real difference to our health statistics?