I have been concerned with the health of the population throughout my working life, starting as a junior nurse through to being CEO of University Hospitals Birmingham and now working with health care technologies and in other health related areas.
While most of my career has been in acute hospitals, I have always recognised that acute health care is the end of a long chain of events and factors affecting health. Acute health services are there to treat or cure problems, rather than prevent them. Reducing health inequalities has been on the agenda as long as I’ve been in health service management, and yet it is still nowhere near being achieved. Why is that? It is because health depends on far more factors than what the National Health Service can deliver.
As a child growing up, my grandmother used to tell me that life span was three score years and ten i.e., 70. In fact she lived to the age of 74 which she thought was a good innings. My mother will be 89 this year, and throughout my lifetime we have seen life expectancy rise, at least until recently.
In 2020, Sir Michael Marmot published his second report which noted that life expectancy had risen continuously from the beginning of the 20th century but from 2011 the improvements slowed and almost came to a halt. Life expectancy actually fell in the decade 2010 to 2020 for women in the most deprived communities outside London and for men in some regions too.
Why is this so? The health of an individual depends on many factors including their economic circumstances, lifestyle and nutrition, and social situation. Poverty is highly correlated with poor health, both physical and mental. The physical environment also impacts health – for better or for worse.
Birmingham and the West Midlands have some areas of significant deprivation and the Covid pandemic highlighted and exacerbated these inequalities. The localities with the poorest health also have higher levels of poverty, unemployment, low wages and low educational attainment. If we wish to address health inequalities, then two of the areas we must deal with are reducing poverty and minimising those environmental factors that contribute to ill health.
Fortunately, we do have some advantages in the West Midlands region; the West Midlands is in the forefront of innovative technology, IT, clean energy and transport. We have some world class universities on our patch, and researchers and academics are working to address some of these issues. For example, at Warwick University, where I am based, I am fortunate enough to be able to have amazing conversations with engineers and researchers who are developing the next generation of clean energy and transport. Their ingenuity and inventiveness never cease to amaze me. These carbon neutral technologies will enable clean power and transport for the next century, reducing our emissions and pollution and improving air quality.
These technologies can also contribute to the economic prosperity of the area. The expertise of these researchers and engineers, together with support of local government, is a key factor in attracting major investment in these technologies which will provide high value employment opportunities. A great example of this is the proposed Giga site for car battery production which would create 6,000 new jobs in Coventry. The West Midlands has a proud history of car manufacturing, so it is fitting that the next generation of cars and public transport (including trams) which use clean electric technology, are being developed and manufactured here.
Medical and clinical research is likewise providing answers to some long-standing clinical issues, not only Covid, which should also provide further commercial opportunities and employment in the life sciences industries. The West Midlands has one of the highest concentrations of life sciences SMEs (small to medium enterprises) in the country.
Finally, not everyone is aware that the West Midlands is also a centre for the gaming industry. Gaming is not just about Dungeons and Dragons but can impact many areas of life such as healthcare, education, and assistive technologies. The technological advances in gaming which are being developed here have applications far beyond their original purposes in augmented and virtual reality. For example, such systems are now being used in nursing homes and healthcare settings to enhance the lives of residents.
Underpinning many of these developments is the roll out of 5G technology in the West Midlands, one of the first in the country. This firmly cements the region as being in the forefront of technological advances. These developments together with many more, have the potential to provide significant numbers of high value jobs. These sorts of jobs will help to improve the local economy and reduce poverty which is one of the main determinants of health.
The use of clean technology for transport will help in reducing the pollution and particulate matter in our air thus improving the environment. Recent reports have shown that the air in the Birmingham on the West Midlands was causing ill health and premature death. The introduction of a clean air zone by Birmingham City Council is helpful for this, but in my view, we have to go much further to promote clean transport, both private and public.
Lifestyle is of course a major determinant of an individual’s health, and we all know that exercise is good for us, but sometimes it takes an added incentive to get us up and going. I am extremely proud to be part of the organising committee for the Commonwealth Games. We want to use the Commonwealth Games to promote the value of exercise for all, not just for future generations of athletes.
I would like to see our parks and public spaces better utilised with the public, private and charitable sectors working together to provide more opportunities for all ages to take part in a whole range of sports, physical and creative activities. This will not benefit just individuals of all ages, but provide opportunities for socialising, reducing loneliness and promoting inclusive communities.
Poor mental health impacts negatively on many aspects of home, work, social life and relationships as well as our physical health. I was delighted therefore to be asked to chair a pilot study (www.MHPP.me) led by Coventry University funded by the Midlands Engine looking at mental health and productivity in the workplace. This study is looking at the effects of caring for the mental health of employees, and the impact this has on productivity, as well as on the individual. This is clearly the right thing to do, but what is heartening is the hundreds of Midlands firms which have signed up to take part in this programme, showing that they really are committed to improving the mental health and wellbeing of their employees.
There are of course many other factors involved in promoting great health and wellbeing such as good housing, personal safety and crime reduction, reduction in loneliness, and diet and nutrition. Too many to explore here, these are rightly the focus of government at both local and national levels.
My vision for the next ten years is of an increasingly prosperous and healthy West Midlands, where everyone can enjoy equal opportunities, good health and wellbeing, safety and security. Achieving this goal will require coordination across many areas of the public sector, alongside support and investment in our knowledge sectors which are developing future technologies, which together can make all our lives healthier and happier.
By working on solutions to reducing fossil fuel energy and transport, by investing in the life sciences and high-tech industries, not only can we improve the environment, but this has the potential to improve the socioeconomic status of people in the West Midlands thereby further contributing to an improvement in health and wellbeing.