Health: Learning the health lessons of the past

Dr Ian Cameron
Dr Ian Cameron
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A public health chief has revealed his wishes for the city over the next year. Katie Baldwin reports.

On the face of it, Leeds in the 1860s has little in common with the city today.

Then, only 3,221 houses had toilets.

Out of 48,787 children who should be attending school, there were only places for 27,329.

Thankfully, things have changed massively.

But the head of public health in the city now says there is still a vital lesson to be learned from that era – and that is about the importance of health protection.

Dr Ian Cameron, Leeds City Council’s Director of Public Health, said: “Health protection means making a big difference to people’s lives – using some of the technology and scientific knowledge we now have, saving and improving lives. This is why protecting the health of the community remains a priority.

“It is as important now as it was to my predecessors in the 1860s and 1870s.”

In his latest annual report, Dr Cameron has contrasted the city in 1866, when the then-Leeds Council appointed its first Medical Officer of Health, Dr M K Robinson, and 1877, when his successor Dr George Goldie began to see improvements in the health of city residents, with developments over the past year.

For example, today Leeds has the lowest infant mortality rates ever and the number of deaths from communicable diseases is down.

There are still challenges though, Dr Cameron says.

“There are very clear links between wealth and health, and the marked health inequalities in Leeds – a gap we are struggling to reduce.

“Life expectancy in the city varies enormously between areas, and this mirrors the economic situation.

“If we are to really make a difference to health in the city we need to make a difference to the way individuals and families experience the economy, making it easier for people to live healthier lives, in healthier accommodation and with better chances to make the most of the opportunities that are now there to live longer.

“So improving the city’s economy is crucial. But for individuals, there are also simple changes that can make a big difference: don’t smoke, drink sensibly and take some exercise. As it happens, if you don’t smoke, you’ll also be saving money too.”

He said that looking back at Victorian Leeds brought to life the differences with life today.

“My Victorian predecessors faced unbelievable challenges – slums, gross overcrowding, smoke pollution and a lack of sanitation,” Dr Cameron said.

“In 1877 there were 1,978 deaths under the age of one in a population of just under 300,000.

“We now have less than 40 such deaths per year. So we have made progress, however the key lessons for us are that there needs to be strong political leadership, mobilising assets and opinions and sticking at it year on year.”

Working together with other organisations is crucial, he said. Responsibility for public health has now switched to local authorities, but is still strongly linked to the NHS.

“We know people want services which link up, and we understand that the health and care systems can be appear to be very complex,” he added.

“That is why we are working really hard to make our services integrated, so people get a seamless service from GPs, consultants, care workers and others involved in their care.

“We’re making good progress, and this was recognised by the government when we were given pioneer status recently for our integration work. But there’s plenty more to be done, and we hope that we can learn from good practice elsewhere to get even better.”

He said stretched NHS funding could make their aims to narrow the health inequalities gap more difficult, but everyone involved had pledged to do their bit.

“Too many people in Leeds are dying earlier than they should from cardio-vascular disease, respiratory diseases and cancer. We must work together to tackle this,” Dr Cameron said.

“The first two years in life set the pattern for future health and wellbeing.

“Looking to the future it is even more important that we focus on giving the best start in life, if we want a sustainable, healthy Leeds in the future.”

Aims for leeds 2014

Work to better control communicable diseases, including efforts to fight tuberculosis

Emphasise the importance of measles and MMR vaccination, as well as whooping cough vaccination

Reduce air pollution

Reduce infant deaths

Improve health in schools

Dr Cameron said: “The recommendations reflect areas where I am sure we can make a real difference.”

See the report at www.leeds.gov.uk/PHAR or read it in local libraries.

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