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The Olympics and health in East London

by Clive Furness

The Olympic Games are coming to London.  The stadium, the pool, the velodrome and the combat sports will all be in Newham.  Newham is in east London.  Historically part of Essex it is now firmly part of London’s East End.  For followers of popular soap operas, the Walford postal code, E20, will be the code for the new housing that will abut the Olympic park.

It is by any measure one of the poorest parts of the UK.  Every ward features in the poorest 20% and eight (out of 20) were in the poorest 5%.  Using the Index of Multiple Deprivation, Newham is the second ‘most deprived’ borough in England.

As far as the Office of National Statistics (ONS) is concerned there are 239,000 people living here, this is important as it determines the level of central government funding received.  Independent analysis commissioned by the borough suggests 299,000 and there are 357,000 people registered with local GPs.

Whilst we don’t know the exact population, we do know that roughly 27% of households change during the course of a year.  This is often the same people moving between properties in the borough, but includes people moving into the borough for the first time.

We also have the youngest population in the country and, arguably, the most ethnically diverse.  The average life expectancy is roughly 10 years less for Newham residents than the national average.

There is a trend in public health towards education and encouragement to change individual lifestyles. However, there is a clear correlation between poverty and poor general health, even though the causative connection may be complex and vary for different conditions.  Research that the borough has recently commissioned allows us to look at the health of our population down to ward level and this will become a tool that informs our decision making as the public health function returns to local authorities. We have clustered our wards into community forums and these show that the two with the highest health needs are Canning Town and Manor Park.  Broadly speaking, Canning Town remains older and white, Manor Park is largely Asian; two very different places and populations and with markedly different health problems.

The Black Report, published in 1979 and promptly shelved by the incoming government of Mrs Thatcher, suggested that as much as 80% of health determinants were matters outside the scope of the NHS.   Thus the value of work to mental health and to the aspirations and achievements of children is not a matter for healthcare, though of enormous importance to the health of the public.  Poor housing is a matter peripheral to the NHS.  The NHS may deal with the chronic problems associated with obesity, (e.g. diabetes, cardio-vascular diseases), but their prevention is not an issue for your local hospital.

It is tempting to suggest that the Olympics have given us a new vitality and sense of direction.  They haven’t.  We welcome them and the once-in-a-lifetime excitement and opportunities they offer.  But they will not make any difference to the long term health of our population.  For us they form part of an ongoing struggle to improve the health and the wellbeing of a population that traditionally comes in poor and moves out as residents become richer.

In the mid-1970’s the churches played an important part in slowing that drift.  Men such as David Sheppard (at the Mayflower) and Colin Marchant (at West Ham Central Mission – now MCC) encouraged Christians to put down roots in the East End and build communities as well as families.  The local authority also is now trying to find ways to encourage people to stay.

Thus in housing, where roughly one third of the housing in the borough is privately rented, we have begun a registration scheme for private landlords to drive up the standards and eliminate over-occupancy; the largest number of people living in the same property so far has been 37.  We propose to buy houses in the private sector which will be offered to people on regular but low incomes who wish to get a step onto the housing ladder.  Unlike previous shared ownership schemes this will start with a contribution as little as 25% and perhaps lower, and instead of paying rent on the remainder the householder will be responsible for the upkeep and maintenance of the property.

We have driven up the education achievement levels consistently over the past 10 years, with very few children leaving without any GCSEs.  The correlation is not so crass as to suggest that five GCSEs will overcome a package of disadvantage.  But for most young people it will help them to get a step up to make their own way in the world.

Newham has some of the highest levels of benefit claims in the capital.  A political decision was made to encourage work as the primary way out of poverty.  We have some 18,000 adults who have never worked (or at least never paid income tax) and they and their families are clustered in social housing.  We opened Workplace, which has found work for several thousand Newham residents.  This was developed on the back of an ambitious regeneration programme, the most recent part being the new Westfield shopping centre in Stratford, close to the Olympic Park.  In an exemplar of public and private sector co-operation some 1500 of the 4000 new jobs went to Newham residents.  The council and Westfield have set up a retail academy to provide training at the pre-recruitment stage and o ensure career development of workers at Westfield.

If the criticism of the welfare state has been to encourage a cycle of dependency, we have sought to develop a ‘virtuous circle’ in which effort is rewarded.  When the local authority seeks to help an individual or family there is a cost, as we do so as representatives of the wider community.  We have begun to ask explicitly for some payback to that community in a voluntary capacity. This may range from sitting as a school governor to running a children’s football club.  What is reciprocated is not the most important thing.  But the recognition that if my community helps me, I should help my community in some way, is.  It is all part of an approach that is explicitly seeking to increase the personal, community and economic resilience of our borough and its people.

You may reasonably ask what this tour of a local authority’s political initiatives has to do with health and I go back to the Black Report.  The public health challenge for the twenty-first century is to stop some of the problems of relative affluence, ‘downstream’.  The NHS will continue to treat people’s illnesses.  The job for public health is to reduce the incidence of diseases that are avoidable, but which have so far proved impossible to eradicate.  In part people have a responsibility for the decisions that they make, sometimes they also need the tools and the support of the community around them to do it.  f

 

Clive Furness has been councillor for Canning Town in Newham, since 1997. He holds the Health and Wellbeing portfolio for Newham as the Executive Member for Health.  He is a Baptist and is secretary of the Memorial Community Church.

Clive Furness