In council offices and communities across the country local authorities are at the forefront of efforts to improve public health outcomes and reduce health inequalities. Responding to Sir Michael Marmot’s ground-breaking report and its ten years follow up, councils are striving to improve access to services and break down the factors that lead to poor health outcomes.
From maintaining leisure centres and open spaces, providing housing, ensuring access to employment and training opportunities and working with the NHS on programmes such as social prescribing, it is local authorities that are working to improve services that prevent poor health.
While many of the determinants of poor health are obvious – poor housing, bad diets, alcohol consumption, smoking, sedentary lifestyles and so on, there is an invisible killer in our midst that councils across the country are fighting against. Air pollution has improved hugely in recent decades but there is still far more to be done.
The World Health Organisation estimates that poor air quality results in over seven million premature deaths each year and other estimates put the number even higher. While the majority of those premature deaths occur in developing countries, a significant proportion is still happening in developed countries such as the UK. Within the UK the exposure to polluted air, and therefore the incidence of poor health outcomes, is far greater in areas of deprivation than those with relative prosperity. This leads to poorer people and ethnic minorities being more likely to suffer from the ill effects of air pollution.
The ill effects are numerous – far more varied than most people would realise. Poor air quality is thought to be a contributing factor in 20% of strokes and a cause of numerous forms of cancer and of coronary artery diseases. There is evidence that air pollution raises the risk of dementia and Parkinson’s disease and harms cognitive development. It is also linked to a whole range of conditions including diabetes and obesity as well as miscarriage.
Poor air quality, caused by vehicle emissions, fertilisers, coal and wood burning and incineration is still a huge problem.
Councillors and council officers are putting the same commitment into improving air quality as they have with other areas of public health interventions. But, as with those other actions, so much more could be done if central government gave the necessary funding and powers to local authorities.
Investments in cleaner vehicles including buses and vehicles in the councils’ own fleets, improving infrastructure for cycling and walking, installing electric vehicle charging points and introducing clean air zones are just some of the interventions that councils are taking to improve air quality. Councils are also responsible for monitoring air pollution in their local areas to inform interventions. As the planning authorities they can also design out causes of air pollution including emission free heating systems.
Councils are doing all of this with too little support from central government though. Future funding settlements should recognise the importance of this work, and the savings that can be accrued to the health service and benefits system by improving outcomes because of improving air quality. Per capita reductions in the public health budget have lessened the ability of local authorities to do more to address the matter. Communicating the importance of this issue is also going to be vital. As the invisible killer it is, the need to combat poor air quality is not well understood. This in turn creates resistance to the actions being taken to address the problem such as clean air zones, cycle lanes and phasing out diesel vehicles.
We’ve come a long way on improving air quality but there’s still far more to be done. The government and councils, working together on this agenda will reap the rewards if they can deliver cleaner air in communities across the country.
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