Iain Scott | May 21st 2012 | @Healthcare
There's a London saying that for every Tube stop you travel eastwards from Westminster, there is a one-year drop in local citizens' life expectancy. But that's obviously not true. In actual fact, the difference in life expectancy between two or three Tube stops may be more like nine years.
That is certainly the case in the north London borough of Haringey, where I live. In the west of the borough, male life expectancy is about 81.5 years. Just a few miles to the east it is less than 72.5. (The average for the whole of England is about 78.) The same applies with other benchmark data, too, such as those for cardiovascular conditions or obesity. One in every three kids in Haringey aged 10-11 is obese or overweight, and there is a big difference between the figures for the west of the borough and those for the east.
One of the liveliest and most diverse neighbourhoods in Europe, let alone London, Haringey also offers a unique snapshot into the great inequities that can divide Europe's citizens. Those of us who live here are used to outsiders referring only to negative aspects of Haringey, such as its role as the flashpoint for last summer's riots. So it's not without pride that I learned this week that Haringey policymakers are embarking on a pioneering public health initiative.
Haringey's public health director, Jeanelle de Gruchy, makes it plain that she feels the higher rate of obesity in poorer parts of the borough is a key contributor to health inequality between the east and west. To tackle the problem, she hopes to go beyond the typical public information campaign, and make use of a lever that is all too rarely associated with health – planning.
In parallel with the increase in obesity in the west of Haringey has been a growth in the number of fast food outlets. For de Gruchy, this is not merely coincidence. According to a report in the Sunday Times, she has drawn up maps to illustrate the proliferation of takeaways in the areas in which obesity levels and shorter life expectancy are most pronounced. These data will provide ammunition for a proposed new planning policy, by which Haringey council will consider the adverse effects of any proposed new fast-food outlets when deciding whether they should be allowed to set up shop. And the policy goes even further – taking a lead from neighbouring Waltham Forest, Haringey will not permit takeaway food outlets within 400m of schools, parks or youth clubs.
The council's move has prompted a predictable chorus of critics calling "nanny state". It is true that when it comes to obesity, it can be incredibly difficult to determine cause and effect. Does the real fault lie with food manufacturers who do not do enough to make sure their products are healthier? But that is not a fight that can be won at the local level. And despite all the free will in the world, where cheap takeaway food is more prevalent than healthier alternatives there is bound to be an effect on local citizens' overall health.
As a local, I hope that the Haringey plan is successful. Its lead will almost certainly be followed by others. As Oswin Baker, of social policy think tank Rockpool, recently pointed out, public health is moving back into the remit of local government. "Many public health tools and levers are already in local government's hands," he says. "It's just a question of building on what they already know."
No borough wants to be known as the home of Europe's least healthy citizens. As local governments take on more responsibility for citizens' health, they will look for clever solutions, involving other departments where appropriate, in order to meet health targets while balancing tight budgets.
And anyway, in the wise words of one Haringey local quoted by the Sunday Times at the weekend, "You will not generate a community with chicken shops."