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Improving Health in Canterbury: Current Issues and Future Solutions

This report by Professor Stephen Peckham addresses the current health issues in Canterbury and proposes future solutions. It discusses the main causes of death, such as cancer, respiratory, and cardiovascular diseases, and emphasizes the impact of social determinants of health. The report also highlights the traffic problem and its effects on health, including air pollution and its contribution to illness and mortality. It concludes by emphasizing the importance of integrated planning and public health efforts for creating a healthier city.

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Improving Health in Canterbury: Current Issues and Future Solutions

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  1. Making Canterbury a healthier place to live:  current issues and future solutions Professor Stephen Peckham

  2. Canterbury: a healthy place?

  3. Main underlying cause of death: all ages - Canterbury 2014 Other Cancer Respiratory Cardiovascular England

  4. Mortality from all causesPersons under 75

  5. The Social Determinants of Health

  6. A skewed population profile

  7. And spatial issues -

  8. Excess winter deaths • Canterbury District already has higher excess winter mortality and this is likely to be exacerbated by the proposals in the District Plan. • In the period 2002-2010 Canterbury had the highest excess winter death ratio (22.7) in the County

  9. General Fertility Rate(Live births per 1,000 women aged 15-44): 1998 - 2013

  10. Life expectancy at birth: 2010-2014 data Gap in life expectancy

  11. Traffic and health

  12. The traffic problem Currently approx. 160,000 vehicle trips a day in Canterbury • Transport plan: • Do nothing scenario leads to an 18% increase in traffic flows • Plan is to manage this to an increase of 10% • However, increases will be concentrated in a few specific transport corridors: • A291/A28 • New Dover Road • Shifting people from cars involves substantial investment in alternatives • Problems with traffic modelling: • It was based on fewer than 16,000 houses • Does not take account of other developments • Most schools are in Canterbury city

  13. Canterbury :Average PM10 levels (ug/m3) by day and time in 2015 Maximum

  14. Canterbury: Average and Max ozone levels (ug/m3) by day and time in 2015 Maximum Average In 2015 Canterbury exceeded maximum levels (120ug/m3) on 11 days

  15. Canterbury : Average and maximum NO2 levels by day and time in 2015 Maximum Average

  16. Canterbury St Peters Place site: Average NO2 levels (ug/m3) by day and time in 2015 Maximum Average

  17. Air pollution a leading cause of ill health • In 2014 Public Health England estimated that air pollution in Canterbury contributes to 748 life years lost and an excess mortality of 81 people. Nationally the figure was 28,500 deaths. • In September 2015 it was estimated that there are an additional 29,500 deaths due to diesel emissions. • This would more than double the number of excess deaths in Canterbury and given links of diesel pollution to major health problems substantially more than double the number of life years lost.

  18. Effect of NO2 on children’s lung function Increased air pollution leads to both increased prevalence and severity of asthma – especially in children - placing substantial demands on local health services and poor quality of life for sufferers and their families.

  19. And not just asthma… • Exposure to fine particulate air pollution has adverse effects on cardio-pulmonary health leading to increased morbidity and mortality. • A 10 μg/m3 increase in 24 h NO2 has been associated with increases in all-cause, cardiovascular and respiratory mortality, and with hospital admissions for respiratory and cardiovascular diseases. • The International Agency for Research on Cancer (IARC) has classified outdoor air pollution as a class I carcinogen based on an association between PM2.5in outdoor air and lung cancer incidence or mortality. • There are significant associations between long-term exposure to PM air pollution and lung cancer incidence in over 300,000 European subjects. “Air pollution levels should therefore be taken into account when considering the wider determinants of public health and the impact that changes in air pollution might have on the health of a population.” Bennett O, Kandala N-B, Ji C, et al. Spatial variation of heart failure and air pollution in Warwickshire, UK: an investigation of small scale variation at the ward-level. BMJ Open 2014;4:e006028.doi:10.1136/bmjopen-2014-006028

  20. “… planning needs to be a critical part of our collective responses to the urban health challenge in the twenty-first century. Indeed, more generally, these papers demonstrate how the future of planning is critical to our collective future.” Cath Ranson MRTPI RTPI President 2014-2015 Promoting Healthy Cities Why planning is critical to a healthy urban future

  21. Healthy cities current priorities • Core themes for Health 2020: • Investing in health throughout people’s lives • Tackling the major health challenges of infectious and non-communicable diseases • Strengthening people-centred systems and public health capacity • Creating resilient communities and supportive environments

  22. Development and health • There are strong links between spatial planning decisions and health outcomes. • The need for rapid growth of new housing and associated facilities in the UK offers an opportunity to improve local outcomes through the delivery of high quality urban developments. • The National Planning Policy Framework, Localism Actand Health and Social Care Act all contribute to increasing opportunities or requirements for joint-working between public health and planning. • There is clear evidence that planning decisions can help create urban areas that promote health. Access to green space, high quality housing, safe and active transport and clean air are a few examples where there is strong evidence from research.

  23. Achieving a Healthy Canterbury? • Tackle inequalities – housing, education and poverty • Tackling pollution and road accidents: • Broaden approaches to reduce motor vehicle traffic • Speed restrictions • Diesel restrictions • Improving housing: • Access to affordable housing (estimated need over 490 houses a year) • High standards of sustainability and energy efficiency • Creating open spaces: • Green spaces, tree planting • Place health and the heart of planning and development: • Reduce exposure to pollution • Plan for health – the new healthy towns initiative

  24. Should Canterbury join the Healthy Cities Network? Carlisle Population 75,000

  25. What next? • Establish a healthy city partnership: • Local health organisations • City Council • County Council • Universities • Community and voluntary groups • Local businesses • Call for a Health Impact Assessment of the District Plan: • Work towards sustainable development • Aim for fairness and equality for all • Target disadvantaged and marginalised groups • Encourage the full participation of those to be affected by the plan • Make use of evidence.

  26. Centre for Health Services Studies www.kent.ac.uk/chss

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