Transition Town South Liverpool – An Initiative for Health and Wellbeing within Transition Town South Liverpool
Aims; -Provide access to alternative and to low carbon strategies for health
-Identify the critical importance of food for health and the consequent importance of localized food strategies
-Support the local authority’s movement strategy ‘Liverpool Active City’
-Work for an understanding of the wider determinants of health, particularly stress and the availability of social support
Justification; The launch of a Transition Towns Initiative in a major city like Liverpool offers a unique opportunity to advance health and wellbeing both for participants and for the wider community. Most if not all the elements in a successful Transition Towns initiative will impact upon health and upon wellbeing.
- Nutrition. Poor nutrition is a massive cause of ill health according to the World Health Organization (WHO) and to the World Cancer Research Fund. Some researchers believe that we should eat 8 or 9 items a day not 5 as suggested by the UK Government. It is suggested that 80% of our food should be vegetables or fruit.
- Transport and Movement. Lack of regular patterns of movement or exercise is again a major cause of ill health according to WHO and the World Cancer Research Fund. A transitional initiative should provide a focus on healthier patterns of transport and movement
- Social Support and networking, Social support and networking, which will be better in a successful transitional initiative is also highly beneficial to health according to WHO and to academic researchers.
- Stress, Stress, when it is experienced long term or is unavoidable is also highly dangerous according to WHO. Stress is likely to be reduced when we can control our own lives better as we can in a transitional environment
These are just four of a series of Social Determinants of Health, which has been described by WHO sponsored reseachers and which are partly susceptible to local action.
Health and sustainable living are linked according to the WHO and to the United Nations.
Recognising links is likely to be particularly beneficial for the poorest and most deprived, northern cities like Glasgow, Liverpool and Manchester include populations, which experience massive inequalities. In Liverpool and Merseyside people get ill earlier, stay ill longer and die sooner than in almost any comparable area in Western Europe (excepting Greater Manchester and the Clyde Valley). According to the recent WHO Commission on the Social determinants of Health Glasgow contains a 30 year difference in life expectancy, the poorest in Glasgow have worst health experiences than many in India. Patterns of health in Glasgow reflect those found in Liverpool, Manchester and other British towns and cities. These can be tracked according to the Multiple Deprivation Indicators, which are published by the Government for every Census Super Output Area (Census areas which are parts of wards) as well as by health profiles, which are published for wards and for local authority areas.
Climate change and Peak Oil will reduce the resources available to our expensive health services. These are drug dependent and very dependent on a high wage bill as well as being capital intensive. Much of the burden of illness is avoidable and results from the failure to implement public health and risk avoidance strategies, which have been well documented by WHO and by health researchers. We need to act now to reduce the burden of avoidable illness and lead the more limited resources to those who are unavoidably ill, particularly in view of a likely reduction in carbon emissions and carbon intensive economic activity of at least 80%. Such a reduction must impact upon traditional patterns of health care.
If transitional initiatives are worthwhile and good for us anyway do we need to know about these links with health?
-Understanding these links will strengthen our priorities to take transition forward.
-The WHO has developed an optimum policy framework for Health Improvement it is called the Health for All Initiative it includes a recommended pattern for a Healthy City, which is supported by comprehensive research and resources.
If we take this research and these resources into account it will ensure that our decision making and our use of information and resources is as good as it can be at time when Government systems will come under pressure and may fail , due to Climate Change, Peak Oil and the increased pressure of competition from the developing world. (Alan Cunningham 6.10.2008)
The notes below describe a presentation made by Alan Cunningham to the Transition Cities Conference at Nottingham on 27.11.08. This is a temporary edit, these notes will subsequently be transferred to the Conference section
Is a Transition City a Healthy City?
When we think of health we tend to think of doctors, nurses and hospitals, whilst these are very important if we are ill they are not the major agents in determining whether we get ill in the first instance. The causes of health and of illness are actually spread very wide. This is shown by the World Health Organisation (WHO) Policy Framework and it’s supporting research as well as by the more recent Report of the WHO Commission on Social Determinants of Health (Appendix 1)
The WHO Policy Framework ‘Health for All’ is a framework for healthy and sustainable living; it suggests that health is a product of the way society is organized and that there is a close interrelationship between a sustainable lifestyle and a healthy lifestyle. ‘Health for All is not just designed for policymakers; it is designed for anyone who seeks to maximize their health potential and that of their family and community. (‘Sound development is not possible without a healthy population…. the health sector cannot meet basic needs and objectives on its own; it is dependent on social, economic and spiritual development,’WHO)
The Policy Framework has led to the establishment of a ‘Healthy Cities Model and Template which is supported by comprehensive research and resources.’ –this has not found favor with the political parties in England and Wales but is important internationally.
The UK Government has drawn attention to health factors such as obesity, smoking, drug and alcohol abuse however health researchers have identified underlying causes of causes which seem to be rooted in patterns of personal relationships, social support and stress. Our hunter gatherer ancestors had to be in the clan or tribe to survive, short term stress responses could be essential for survival, however long term stress or social exclusion can cause effects which can be very damaging to our health.
Whilst the Transition model is an excellent one, there is a need to take account of interrelationships between health and sustainability, which are well recognized by WHO, UN and by health researchers. There is a need to have regard to the complexity of conditions that exist within major cities, these typically include extreme inequalities, with prosperity and deprivation coexisting close together, health inequalities, which find expression in differences in life expectancy also cultural and ethnic diversity. If the Transition model disregards these conditions when it is applied in cities, it will be seen as marginal or just the preserve of a privileged few.
The launch of a Transition Towns Initiative in major cities like Liverpool, or Manchester offer unique opportunities to advance health and wellbeing both for participants and for the wider community.
Most if not all the elements in a successful Transition Towns initiative will impact upon health and wellbeing for instance;
- Nutrition. Poor nutrition is a massive cause of ill health according to the World Health Organisation and the World Cancer Research Fund. Some researchers believe that we should eat 8 or 9 items a day not 5 as suggested by the UK Government. It has been suggested that 80% of our food should be vegetables or fruit.
- Transport and Movement. Lack of regular patterns of movement or exercise is again a massive cause of ill health according to WHO and to the World Cancer Research Fund. A transitional initiative should provide a focus on patterns of transport and movement
- Social Support and networking, which is obviously going to be better in a successful transitional initiative is also highly beneficial to health according to WHO and academic researchers.
- Stress, when it is long term or unavoidable is also highly dangerous. Stress is likely to be reduced when we can control our own lives better as in a transitional environment
These are just four of a whole series of Social Determinant of Health, which has been described by WHO and which are partly susceptible to local action and which would benefit from a localisation strategy. (Other determinants include; poverty, unemployment, conditions of employment, conditions for mothers and children, conditions for life transitions including ageing, addiction)
Recognising and supporting such links is likely to be particularly beneficial for the poorest and most deprived. Northern cities like Glasgow, Liverpool and Manchester contain massive inequalities. In Liverpool and Merseyside people get ill earlier, stay ill longer and die sooner than in almost any comparable area in Western Europe (Excepting Greater Manchester and the Clyde Valley) According to the recent WHO Commission on the Social determinants of Health Glasgow contains a 28 year difference in life expectancy, the poorest in Glasgow have worst health experiences than many in India. Patterns of health in Glasgow reflect those found in Liverpool, Manchester and other British towns and cities. These can be tracked according to the Multiple Deprivation Indicators, which are published by the Government for every Census Super Output Area (parts of wards) as well as by health profiles, which are published for wards and local authority areas.
Climate change and Peak Oil will reduce the resources available to our expensive health services. These are drug dependent and very dependent on a high wage bill as well as capital intensive. Much of the burden of illness is avoidable and results from the failure to implement public health and risk avoidance strategies, which have been well documented by WHO and by health researchers. We need to act now to reduce the burden of avoidable illness, within an ageing population and leave the more limited resources to those who are unavoidably ill, particularly in view of a likely reduction in carbon emissions and carbon intensive economic activity of at least 80%. Such a reduction must impact upon traditional patterns of health care.
Do we need to know about these links with health? I believe that we do.
-It will strengthen our priorities to take Transition forward.
- people cannot achieve their fullest health potential unless they are able to take control of those things which determine their health’ – The Ottawa Charter on Health Promotion – The Transition Movement is an important vehicle for this.
If we take this work and these resources into account it will ensure that our decision making and our use of information and resources is as good as it can be at time when Government systems will come under pressure and may fail due to Climate Change, Peak Oil and the increased pressure of competition from the developing world.
I am not arguing for any change in the core model of transition communities merely that in organizing for transition, communities should be encouraged to make the widest possible use of information and resources, including the WHO Health for All Approach.
I hope that in considering this conference on Transition Initiatives the Transition Network will give proper weight to the large volume of important work done by the WHO and by health researchers on urban and community health
Alan Cunningham 21.11.08
Ref: WHO Commission for the Social Determinants of Health. http://www.who.int/social_determinants/en/ Multiple Deprivation Indicators 2007 http://www.communities.gov.uk/communities/neighbourhoodrenewal/deprivation/deprivation07/
Local Area Profiles http://www.apho.org.uk/default.aspx?QN=P_HEALTH_PROFILES
Appendix 1(Selected from IUHPE Report by Alan Cunningham) (italics AC)
WHO Commission on Social Determinants of Health
The final report of the WHO Commission on Social Determinants of Health "Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health" was published in August 2008.
The Final Report of the Commission sets out key areas of daily living conditions, which impact upon health and the underlying causes that influence them in which action is needed. ‘It suggests that the high burden of illness responsible for appalling premature loss of life arises in part because of the conditions in which people are born, grow, live, work and age’
The report concludes that Social factors - rather than genetics - are to blame for huge variations in ill health and life expectancy around the world. The report found that in almost all countries, poor socioeconomic circumstances equated to poor health. The differences were so marked that genetics and biology could not begin to explain them. The authors write in the report that the combination of bad policies, economics, and politics is, in large measure responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible. The report calls for governments to consider how all their policies impact on health. It says that it is entirely possible to reduce health inequality within a relatively short period of time. But it warns that, without action, injustice and inequality will only increase. (web site: http://www.who.int/social_determinants/final_report/en/index.html )
Comment by AC. Just about everything impacts on health, so decisions taken by all government departments, local government, employers, ngos, churches, trade unions and community groups all have positive or negative effects on health. Unless ordinary people have a better understanding these agencies will take poor decisions, which will affect health without accountability.
Ordinary people can do more: 1) Don’t accept advice from existing institutions uncritically look at alternatives such as World Cancer Research Fund, WHO websites.
2) Recognise that sustainable choices are also healthy choices i.e. food choices, patterns of transport and movement, organizing for sustainable living is likely to lead to better social support and less stress, both these factors are very important for our health.
3) Build better social relationships and communities, whether within our locality, our church, our trade union.
4) Work to ‘build communities and neighbourhoods that ensure access to basic goods, that are socially cohesive and that are designed for good physical & psychological wellbeing and that protect the natural environment’ Appendix 2
Male life expectancy, between and within-country inequities, selected countries Table 2.1 p32 (Report of the WHO Commisssion on Social Determinants of Health)
UK Scotland, Glasgow (Calton) 54 India 62 US Washington DC (black) 63 Philippines 64 Lithuania 65 Poland 71 Mexico 72 US 75 Cuba 75 UK 77 Japan 79 Iceland 79 US Montgomery County (white) 80 UK Scotland, Glasgow (Lenzie N.) 82