Health: Personal, Local & Un-Equal

As well as being the week of International Women’s Day, this is Women’s History Month – a time to reflect on the struggle of women for equality and renew our determination to rise to the challenges ahead.

I’m proud to represent the ward where the Matchgirls Strike of 1888 led to better working conditions and was a founding moment of the New Union Movement. It’s also where the East London Federation of Suffragettes organised and there is a strong tradition of taking local action to achieve social justice.

The health of the women and girls working at the Match Factory was damaged by the terrible conditions so they took action to improve these.  The East London Federation of Suffragettes knew that a healthy and nourishing start to life provided a strong foundation for a thriving future and so set up cost price restaurants with healthy meals for families.  That tradition of grassroots organisation, often working in partnership with Labour local government, is still a core part of delivering services which can transform lives and secure a healthy and brighter future.

The Covid pandemic exposed long standing health inequalities which are holding communities back. Some women in London are living as much as a third of their lives or about 20 years in poor health, ranging from 13 years in Kingston up Thames to 27 years in Tower Hamlets. Each one of those years is time spent at risk of unemployment and often struggling to co-ordinate care for the whole family.

Overcrowded housing is linked to risks to mental and physical health, disproportionately affecting low-income families with children, particularly those from Black, Asian and Minority Ethnic households. Doreen Lawrence’s powerful review into the disproportionate impact of Covid on Black, Asian and Minority Ethnic communities, ‘An Avoidable Crisis’, clearly set out :

“We consistently heard that targeted, culturally appropriate public health strategies to combat chronic conditions such as obesity, heart disease and diabetes, which feed more serious health complications, should be a priority for Government.”

With the recognition that the pandemic disproportionately affects disadvantaged communities; that health and safety in the workplace is a vital part of public health; and that outcomes will be exacerbated by existing intersectional inequalities, now is the time to plan for a future Labour government to tackle health inequalities.

Listening to residents and working side by side with grassroots organisations Tower Hamlets Public Health team have developed culturally competent projects and anti-racist initiatives to tackle health inequalities. At the heart of this approach is building trust in health services which have historically been considered inaccessible. To do this, local authority public health specialists set up teams of volunteer champions to scrutinise data and public health messages and share the most up to date information with their community.

Ambassadors, employed from the local community, set up street stalls and visited local markets to reach out to residents and link them up to community vaccine clinics, set up in local mosques, community centres, on the vaccine bus and in pharmacies. Covid exposes health inequalities and the pandemic has been a time to focus on anti-racist actions to keep communities safe.  Alongside this approach of getting the most accurate information shared by word of mouth, making health communications clear and accessible is vital.

Women across the community have taken on leadership positions to tackle health inequalities. Doctors leading webinars to provide information and reassurance about the vaccine, Directors of local charities setting up food delivery services and linking people into services, volunteers leading befriending support to prevent loneliness which is damaging for physical and mental health. Recognising, celebrating and investing in women’s leadership roles is an important lesson for future public health challenges.

Time and again, I hear from communities about the challenge of joining up ‘local authority’ and ‘health’ services. Many of the services that are vital for supporting people to stay healthy and out of hospital, such as care in the home, day support for vulnerable adults, libraries where people can meet with friends, children’s centres where families can get support and advice are run by local authorities. The pandemic broke down barriers between local authorities, health services and communities working together. We must recognise that ending health inequalities will require local government and health services to work together seamlessly with communities. And we must also highlight that health inequalities cannot all be resolved locally. The Conservative government has not taken the decisions nationally to invest in affordable homes and a decent social security system.

Communities across the country have come together through the pandemic. Now is the time to learn those lessons and renew our commitment to tackling health inequalities. We cannot allow ourselves to accept this injustice and we must apply the same focus to other public health challenges. We must challenge ourselves to get health services into community venues, make sure that all health communications are accessible to the whole community, and engaging with health services is straightforward.

But this work needs continued investment and national recognition of the role of local authorities and health services working hand in hand to connect people to culturally competent services. But more than this, it will require the national government to recognise that behind health inequalities are the condition and cost of housing and the experience of low pay and insecure work. This will take sustained national action and investment which this Conservative government has not done.

For more on the failure of the Conservatives to invest in our communities see yesterday’s blog ‘Medway: Left Behind by Levelling Up’