WHAT might a healthier Gwent look like in 2030? And what roles do government, councils, the NHS, and we as members of communities and as individuals, have to play in creating and maintaining it?
These are key questions at the heart of Building A Healthier Gwent, a report that shines a stark light on the gaping inequalities in people's health in Gwent, which mean that those in its least deprived areas can expect to have 18 years more of healthy life than those in its most deprived.
They are question that health bosses hope people in the area can help to answer, bringing together expertise and local perspectives in a Gwent-wide conversation about improving health for everyone.
Building A Healthier Gwent is the annual report of Dr Sarah Aitken, Aneurin Bevan University Health Board's director of public health, and it comes armed with ambition, as well as uncomfortable fact.
One overarching ambition, to be more precise - for a healthier Gwent by 2030, envisioned as including the following developments:
- All partners - be they government, the health board, councils, communities and individuals - focusing collectively on things that create greater equity, and starting to see greater equity in determinants of health, such as lifestyle, social and community networks, and the physical, social and economic environments around us;
- Places where we live, work, learn and play that make it easier for people and communities to live healthy, fulfilled lives;
- More children and young people living in an environment that supports being a healthy weight;
- All children and young people living in smoke free environments and viewing not smoking as the norm;
- Vibrant, connected communities with people preferring to walk and cycle for local journeys;
- Families and children being active in shared open spaces and getting the most out of an abundant, natural environment;
- People living, learning and working in strong and mutually supportive, resilient communities, real and virtual;
- Concerted action to improve mental wellbeing, based on a strong understanding that there is no health without good mental health.
Dr Aitken's report is intended to build on last year's, entitled A Healthier Future for Gwent, in which a key theme was cancer, its risk factors, and the things we can do to reduce those risks.
Dr Sarah Aitken
"This year's report reiterates the point that the NHS has achieved great things, but 70 years later we still have people in some communities living 18 years longer in good health than in others in Gwent," said Dr Aitken.
Men in Gwent's least deprived areas live an average 88 per cent of their lives in good health, against 76 per cent for men in the most deprived areas. For women the difference is broadly the same, being 86 per cent and 74 per cent respectively.
"Health outcomes are at their poorest in the middle of Newport, and in Valleys areas," said Dr Aitken.
"In practical terms, that translates as people in the most deprived communities getting, for instance, heart disease or lung cancer in their 50s, living with it for 20 years, and dying in their early 70s.
"And in the least deprived areas it would be living into their 70s in good health, living with disease for 10 years, and dying in their 80s.
"This has a huge impact on people's lives, as individuals and for families, and also for communities and the economy.
"The reason for the difference is disease, and the fundamental message is that the major diseases that cause people to be in ill health - heart disease, cancer, respiratory disease - are preventable.
"The Valleys in particular have a history of heavy industry, and poor health was associated with heavy industry. It is not there anymore, and the fact the that poor health outcomes continue means they are a result of lifestyles."
The report stresses that lifestyle risk factors are a key measure, that of the people who live approaching 90 per cent of their lives in good health, very few smoke or are overweight, and they are more likely to be physically active, and eating healthily.
By 2030 in Gwent the ambition is for children to grow up seeing smoking as not the norm. Picture - PA/PA Wire
"Things could be different by 2030 if we do the things that work, such as focusing on smoke free environments so not smoking is the norm," said Dr Aitken.
"Things do not have to be the way they always were. Beginning to narrow the gap in health inequality by then is ambitious, but there's no reason why it cannot be done, and possibly more quickly.
"It is about making lots of small things happen, and building enough momentum to start to narrow that 18-year gap.
"It is not coming down at the moment, and in some areas, for instance inequalities in cancer, it is getting worse.
"This is about people in all our communities living their lives in good health."
Dr Aitken is keen to start a conversation involving individuals, communities and organisations, about ways in which health inequalities can begin to be tackled, to start the task of building a healthier Gwent.
A series of engagement events are taking place across Gwent which people are invited to contribute ideas. Two have been held - in Torfaen (Pontypool) and Caerphilly (Markham), and three more are planned:
- Thursday October 3 - Llanhilleth Institute, 9.15am-12.15pm;
- Friday October 11 - Usk Memorial Hall, 9.15am-12.15pm;
- Tuesday October 15 - Newport Centre, 9.15am-12.15pm.
There is also a short online survey for those who are unable to attend. The link to this - closing date Sunday October 20 - can be found at www.wales.nhs.uk/HealthierGwent
The findings from the engagement events and the survey will be presented at a Building a Healthier Gwent Conference in Newport in November.
"We need as many people as possible to take part, to put forward ideas about narrowing the health inequalities gap, and I hope we will have themes emerging about where we should start," said Dr Aitken.
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