A healthy London requires a holistic approach to health

5 June 2019

By Tom Coffey

Joining our series of guest blogs, Tom Coffey, Senior Health Advisor to the Mayor of London, draws on his experience working at the Greater London Authority, to show how social inequalities impact health outcomes. This final guest blog, supports the findings of our latest report and shows there is a great need to think of health more holistically.

One of the most pressing challenges our capital faces is the stark health inequalities that prevent Londoners from fulfilling their potential.

Shockingly Londoners are still suffering ill health because of avoidable social, economic and environmental influences – their health is being shaped by the circumstances of who they are and where they live.

This inequality affects how long Londoners live, and how long they live in good health. A girl born in Tower Hamlets today can expect to live 27 years – a third of her life – in poor health. The upcoming report, Beyond the NHS: Addressing the root causes of poor health, by the Centre for Progressive Policy highlights the need to tackle socio-economic factors in order to address health inequalities.

This is unacceptable, and that is why the Mayor launched his Health Inequalities Strategy – a strategy that focuses on tackling the determinants of health, with a particular focus on reaching the youngest Londoners to make sure they have the best start in life.

It is also why Sadiq has weaved health policies throughout his other areas of responsibility – from planning to transport – in order to have a real impact on our city. Just this month we’ve seen the Mayor launch the toughest global emissions standard with the world’s first Ultra Low Emission Zone. This bold policy is reducing toxic air pollution to protect the health of all Londoners, but also helping to tackle health inequality in our city as we know that the most deprived Londoners are exposed to the worst pollution, and that children are the most vulnerable to its effects.

Giving children the best start in life is the most effective way to address health inequalities in the long-term, so bold measures are needed if we are to make London a healthier, fairer city. The Mayor’s Healthy Early Years London programme works with schools, nurseries, children’s centres, playgroups and childminders, supporting them to help infants and pre-school children learn about healthy habits like healthy eating, physical activity and looking after their teeth, as well as a range of social and emotional care and support.

This kind of intervention at an early stage in a child’s life can have real impact – early years settings can lay the foundations for lifelong health and wellbeing. Lots of families in London will use these early years settings, making them a perfect environment through which to provide advice and support for families and vulnerable groups.

Physical activity and a balanced diet are an important part of healthy living, and developing healthy habits at a young age can help set them up for life. Sadiq has shown his commitment to this through his support for all schools to sign up to the Daily Mile programme and his efforts to reduce children’s exposure to junk food advertising. It’s clear that advertising plays a huge part in the choices we make, particularly in communities with more limited options, and Londoners have shown overwhelming support for the Mayor’s ban on adverts for junk food and drink on our transport network.

Health inequalities are also evident when we look at mental health, as people in low income households remain more likely to develop mental health problems than those in the highest income households. The Mayor wants Londoners to feel comfortable talking about mental health, reducing stigma and encouraging people across the city to work together to prevent suicide. This includes ensuring every state school in the city has access to a trained mental health first aider, and Sadiq’s Healthy Schools London programme which helps schools support the health and wellbeing of their pupils, recognising the importance of timely signposting and referral of children to relevant mental health support.

However, the success of innovative approaches in the Mayor’s Healthy Inequalities Strategy depends upon public health services having the capacity and resources to deliver effective interventions – from social care for vulnerable children, to help to quit smoking or sexual health services.

The enormous pressures facing the NHS and cuts to local government funding threaten to undermine the success of our programmes in London, putting people’s health at risk, and potentially letting health inequalities widen. Schools and early years settings are also under increasing financial pressure, and it is vital that they are properly funded so that we can ensure no one is left behind. The truth is that without the Government stepping up to the plate and providing the funding that communities in our city need, tackling London’s health inequalities is going to be much harder.

Working with the Mayor, I will continue to make the health of all Londoners a priority. From creating healthy public spaces and streets to equipping teachers with the tools they need to help children develop skills for healthy living – creating a healthy city is reflected throughout the Mayor’s policies at City Hall. If London is to continue to prosper in the decades ahead, we must value the health of all Londoners and ensure that the whole city can look forward to healthy, happy and fulfilling lives.

Tom Coffey OBE is Senior Health Advisor to the Mayor of London. He is also a GP, Clinical Lead for Mental Health and Children’s Services at Wandsworth CCG and the Joint-Clinical Lead for Emergency Care NHS England (London). He also works in A&E in Charing Cross Hospital and is a GP advisor to the Battersea Healthcare social enterprise.