I DON'T much like the term "health inequalities".
It is the shorthand used by many people, including myself, for the gulf which exists between the life expectancy of the most deprived and the rest of society. But it is not an expression anyone would use in a normal conversation about wellbeing - "the trouble with Frank Gallagher and his family is they suffer from unequal health".
Actually, the way illness occurs in any of our lives rarely seems fairer than the way beauty is bestowed. Some people inherit it, some work hard to avoid it, others are deeply unlucky. Who can't name an acquaintance who died tragically young despite a good family background and clean living? We know some behaviours put people at much greater risk, but so much is unexplained. We'll probably never create equal health.
But there is a health gap, or health trap, which goes hand-in-hand with poverty: a greater likelihood of suffering from ill-health or addiction or violence which is entangled with the potentially chaotic lives of people with less money, fewer qualifications, less support and fewer resources to call on than the rest of us. A paper, published by the Scottish NHS last week, argued that whether it is cholera, tuberculosis or drug dependency, the most deprived are the most likely to succumb and therefore it is deprivation and alienation which need to be addressed.
This was the second paper in as many weeks on the subject, the earlier being an investigation into the impact of the current recession on the most deprived in Glagsow. It came out shortly after Chief Medical Officer Sir Harry Burns gave a talk about the demise of the west of Scotland shipyards and the downward spiral this meant for men robbed of their jobs. His speech drew on other studies mapping the uniquely profound "health gap" in Scotland.
Now, I could talk about this subject all day. It is terrible generations of children are conceived, theoretically with the world in front of them, and to know from the circumstances of their parents that they are unlikely to have the same nourishment, encouragement and opportunity as children born a few miles up the road.
But it seems to me we have established this is the issue. What worried me most about the aforementioned NHS Scotland report, apart from it being written in a language exclusive to academics, was its assertion that "further work is required" to describe the trends when new data comes out. Surely not.
You know what I have not seen? A report that draws together the projects under way to tackle elements of this great social divide and says how well they are working. Does this information exist, and, if not, let's start working on it.
Why not take a regenerated family housing scheme and offer intense resources - health visitors, parenting support, addiction specialists, back-to-work opportunities, vegetable boxes, cookery classes, some kind of pride in the community project. Fund it for at least 14 years, replace key staff as soon as posts fall vacant, track the residents annually.
Sure, this could not be replicated everywhere, but at least it would provide consistency in place of instability and tell us if intervention can restore equality where it is absent.
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