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Why your wealth can damage your health

A new survey for Barnet establishes a clear link between social deprivation and health. But as IAN LLOYD finds out it also throws up some anomalies which has got health chiefs racking their brains.

It's official your wealth can seriously damage your health.

A statistical snapshot of the borough reveals that 'Garden Suburb man or woman' living in the most affluent areas is significantly more likely to go onto higher education and nearly four times more likely to find work than their counterparts in Burnt Oak the borough's most deprived area. And factors like these will have a significant impact on their health.

But while people in Garden Suburb, Hadley and Mill Hill are likely to live longer and healthier lives than those in areas such as Burnt Oak, Colindale and West Hendon, they don't have it all their own way. Richer women, for example, are more likely to die from breast cancer probably because they have children later in life while affluent Hadley curiously has the third highest breast cancer death rates in the borough behind Woodhouse and Arkley wards.

"There are no specific diseases which are exclusively to do with deprivation," said Andrew Burnett, director for health improvement and medical director at Barnet Primary Care Trust (PCT).

"Affluent people and deprived people die of the same diseases but people who are more deprived tend to die at a younger age. People in Garden Suburb still die of heart attacks but you tend to get your heart attack which will kill you at a later stage in Garden Suburb."

Barnet's Health Improvement Programme is due to be released at the end of March and helps inform the PCT how its £276million budget is distributed next year. The good news for all of us is that Barnet has 105 fewer deaths per 100,000 people compared to England and Wales as a whole. In fact men in the borough have a life expectancy of more than 76 and women more than 79.

However, Mr Burnett sounded a warning: "Although Barnet is healthy compared to the rest of the country you have still got this relationship between deprivation and health."

Key factors determining your health include poverty, employment, air quality, housing, water quality, diet, exercise, physical behaviour, alcohol, drugs and education. But one area to which Mr Burnett wants to pay particular attention is smoking.

"There is a strong association with deprivation and smoking. Smoking is commoner in people who have a lower income and have left school with fewer or no qualifications, have experienced or are experiencing unemployment and live in poor housing," he explained.

"There is an association between lower rates of smoking and greater success in giving up amongst people who have higher income, have left school with qualifications and possibly gone to university.

"They are more likely to end up in a job that has got a high salary, more likely to be able to afford a larger house and therefore you may say you don't need to smoke because you have other things that give me pleasure in life. You cannot say this is definitely the case but there are these associations."

Anomalies thrown up by the programme include high death rates for lung cancer and respiratory disease in Hadley, Friern Barnet and Totteridge.

"At the moment we don't know why that is but we are looking into it," said Mr Burnett. "There are pockets of deprivation in affluent areas and there are pockets of affluence in deprived areas. If you have got a particularly affluent area which has got a housing estate that has got a lot of deprived people on it that can drag the score down."

One phenomenon that can be explained is the high rate of breast cancer in prosperous areas.

"There appears to be a correlative protective effect of having babies at a moderately early age, of having more than one pregnancy and of being able to successfully breast feed. Women in more affluent areas tend to have fewer children and have them later. But although it is commoner in affluent women, survival rates are better."

The programme should be launched at the Barnet Community Fair on 23 to 24 March at the RAF Museum, in Grahame Park Way, Hendon. Mr Burnett said the aim was to build healthier and happier communities.

"It is about helping people to understand, giving them the tools and showing them how eating a healthier diet, taking some exercise each day, stopping smoking, practising safe sex and not taking illicit drugs, are all ways of improving your health. That is something the PCT can directly influence."

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