THE poorest people in Oxford are more likely than ever to suffer life-limiting conditions such as diabetes, heart failure and obesity, doctors have warned.
Rates of emergency hospital admissions in the city's most deprived areas are now up to five times higher for respiratory conditions, stroke and heart disease.
It has long been known that poor people die younger than rich people across England and Wales, but an investigation by The Bureau of Investigative Journalism has highlighted the life expectancy gap locally – and the health problems that go with this disparity.
The difference in life expectancy between men living in the most and least deprived areas of England was nine-and-a-half years from 2015 to 17; for women it was seven-and-a-half years.
In Oxford, average life expectancy for both men and women is higher than the national average, but inequality between the city's poorest and richest areas is stark.
Men in Northfield Brook next to Blackbird Leys – one of the poorest wards in the city – die on average at 75 – 15 years younger than their counterparts living in North ward, just north of St Giles, which is one of the city’s most affluent areas.
The life expectancy gap recorded between 2011and 2015 was almost four times wider than it was between 2003 and 2007, and there are no signs it is set to improve.
Carol Richards. Pic: Alex Sturrock/TBIJ
Carol Richards is a community worker at the Dovecote Centre, an afterschool club and play scheme for young children in Northfield Brook, part of the Leys Estates.
She recalls a seven-year-old girl being dropped off at a school holiday scheme with no lunch. When her mother was called, she had to borrow money to buy food, and told Ms Richards she was facing eviction.
“It’s been horrendous,” she said. “We had one child we had to de-louse.
"She had months and months of [having] lice in her hair... If you’ve got no money to even buy food, how have you got that to treat for head lice?”
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Before her retirement, Halina Simm spent decades working as a community children’s nurse and health visitor, covering Blackbird Leys and Rose Hill. She also volunteers at a local emergency food bank.
“There are fewer shops with fresh fruit and vegetables [in the area, compared to more affluent areas],” she said. “And sometimes families struggle to think about meals that are nutritionally satisfactory, so they will go for fast food and easy food to eat.”
This city has one of the highest average salaries in the UK and a world-renowned university that has £6.1bn in total funds and endowments as of 2018.
But a few miles down the road from the colleges are those who find it hard to get by every day, and have radically different health prospects.
Volunteers at the Communi-tea cafe. Pic: Alex Sturrock/TBIJ
Dr Dougal Hargreaves, the clinical advisor for the State of Child Health 2017 study by the Royal College of Paediatrics and Child Health, said obesity has a huge impact on life expectancy, raising the risks of disability, poor mobility, heart attacks, stroke, cancer and mental health problems.
Doctors at Leys Health Centre, which serves Northfield Brook, say they see twice as many cases of some chronic conditions – including diabetes, heart failure and adult obesity – as those working at the Observatory Medical Practice which serves North ward.
Northfield Brook residents are also more likely to need emergency care: the prevalence of serious respiratory problems is three times higher in Northfield Brook, but the rate of emergency hospital admission for these conditions is five times higher. The statistics for stroke and heart disease tell a similar story.
Joe Richards lives on the boundary between Northfield Brook and Blackbird Leys.
Like many on the estate, he spent most of his working life – 40 years – at the car plant, much of it as a crane operator.
Joe Richards. Pic: Alex Sturrock/TBIJ
The proportion of Northfield Brook workers in white collar jobs is just 28 per cent, compared to 78 per cent in the wealthier North ward.
Now in his 70s, Mr Richards has several health problems and cannot walk unaided.
Whenever he sees a doctor, Mr Richards says, the first thing they ask is if he used to smoke. "And I say you are asking the wrong question – why didn’t you ask me about the environment I worked in for 40 years?
"Those overhead cranes, and all the welding down below. All of that used to go up to the ceiling."
Mr Richards says he now finds it hard to get to the kitchen and cook using his walking frame, leaving him living on a diet of Weetabix, tinned soup, boiled eggs and ready meals.
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He is heavily reliant on carers. The modest savings he built up while working mean he has to pay his own care bills.
He was assessed as needing 14 hours of care a week but at almost £20 an hour, he says it is unaffordable.
“I’ve had to reduce the amount of care to five hours a week because I couldn’t afford more. My savings are going down,” he says.
Health problems in his area are not just physical: at Leys Health Centre doctors report rates of depression that are 74 per cent higher than those recorded by the Observatory Medical Practice.
Living in poverty raises the risk of developing mental health problems such as depression, stress and anxiety, which can cut life expectancy by as much as twenty years, according to some studies.
Shops in Blackbird Leys. Pic: Alex Sturrock/TBIJ
The divide between rich and poor can start early, Dr Hargreaves said: "Once you are born, the house you go back to has an ongoing effect on your life chances.
"If you are living in a house where someone smokes, if it is damp or overcrowded, with parents who have mental health problems, then that affects all sorts of things.
"It can affect your health – whether you get the right vaccinations, whether you get developmental checks and how much you go to hospital – but also it has a huge effect on cognitive development, which affects whether you are ready for school, how well you do in exams. The trajectory that you go on to in life.”
Steve Harrod, Conservative county councillor responsible for children and family services, says he recognises the issue, but says the council is constrained in what it can provide: “We are acutely aware of the growing problems with child poverty and poverty in general,” he says. “We’re in the process of redesigning the way our services are delivered but it’s going to take time. There’s no quick fix.”
The Bureau of Investigative Journalism is a not-for-profit organisation that aims to 'hold power to account'.
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