Foreword: Alice Wiseman, Gateshead Director of Public Health
It's raining, it's pouring In 2017, my report as Director of Public Health in Gateshead was called 'It never rains but it pours'. It focussed on inequalities and described how disadvantage can cluster and accumulate across the life-course.
In this year, 2019/20, the question is 'how are we doing'?
We know that poverty and social inequality are sources of enormous stress for local families.
We know that when parents are overwhelmed by stress, they can struggle to meet the basic emotional and physical needs of their children and this can adversely affect their physical, emotional and social development. This may have life-long implications, impacting a child's developing brain and immune system, leading to susceptibility to mental health problems and chronic disease later in life.
We know that, in our borough, rates of mental health problems and diseases such as high blood pressure, heart problems, inflammatory conditions and diabetes are disproportionately high in both people who experience adversity in childhood and for people living in poverty.
We have already agreed that, for Gateshead, this pattern of disadvantage is not acceptable.
This report will examine the work we have been doing over the last three years, to understand the progress we have made and the challenges which remain. I will also touch briefly on the COVID-19 pandemic which is so much a part of our lives at this time.
COVID-19 has created a position which has not only highlighted again the inequalities we knew about but has exacerbated them and created new pressures. We are not just dealing with a COVID-19 pandemic, but we are dealing with a syndemic (a combination of epidemics which interact, cluster and exacerbate the burden of disease).
COVID-19 has reminded us (as if we needed reminding) that we must do more to understand and mitigate the impact of the interaction between the biological and social causes of ill-health.
For COVID-19, we know that people in our deprived communities are more likely to be working in occupations where social distancing is more difficult to observe (for example: manual occupations and key workers) and consequently they have a greater risk of exposure to COVID-19 infection. We also know that, during the restrictions, they were more likely to be furloughed, and despite Government support, 80% of minimum wage is not enough to live on. Once infected with COVID-19, they are more likely to experience a severe form of the virus due to the interaction between the virus, other diseases and poverty. We have seen this disproportionate risk evidenced in the deaths of key workers across all settings; the very people who kept our country running at the hardest of times. Our most disadvantaged communities are living with those experiences and that knowledge.
Our COVID-19 response has also demonstrated that it is impossible to untangle our community's health from the economy - they are two sides of the same coin. The long-term impact of COVID-19 on our population and economy remains unknown but the reality is that many people in Gateshead have been impacted and lost loved ones. Countries across the world that have demonstrated the best control of the virus are also the countries that have reported the lowest economic impact. I am immensely proud of our local response to COVID-19 and incredibly grateful to be working in a place that has strived tirelessly to do the right thing regardless of how hard it felt. I've been overwhelmed by amazing colleagues across all organisations; the local authority, health, police, fire, local business, schools, our amazing community and voluntary sector, and not forgetting our fabulous residents, that have stepped up to the challenges COVID has brought us. If there is one silver lining from COVID-19 it is this. I know that Gateshead has the capacity to move forward into recovery with the same resilience and strength that I have observed over the past few months.
We must focus our economic recovery on creating well-being for all our residents. We will need to take bold decisions so our resources (time, money and people) are focussed towards creating a fairer Gateshead.
We must listen to those in Gateshead who experience disadvantage and involve communities in the solutions. We must stand up for those who have the greatest level of need ensuring their voices are heard above the noise of those people in more powerful positions.
Finally I want to finish by making a commitment to everyone that I will continue to do everything that I can to protect and promote health and wellbeing and tackle inequalities with a focus on supporting Gateshead residents to overcome the hardships that COVID-19 has brought us.