Fair Society Healthy Air

In 2010, the Marmot Review highlighted the increasing evidence that environmental factors exacerbate health inequalities. The three year inquiry found that, in England, the lower a person’s social position, the worse his or her health. In 2016, the UK’s controversial breach of European air quality standards provides us with a very clear example of the ongoing health inequalities identified in the powerful 2010 report.

Poor air quality, which is principally caused by emissions from vehicle engines and degrading tires, has accounted for between 40 and 50 thousand premature deaths in the past year. PM10 and PM2.5 particulates penetrate deep into the lungs and the cardiovascular system causing hundreds of thousands of citizens to need treatment from the NHS for heart disease, lung cancer and stroke. The nitrates and sulphites which are exhaled from diesel exhausts exacerbate asthma, cause lung disease and increase susceptibility to infections.

A recent report from the World Health Organisation found that as much as 80 percent of the UK’s population has been exposed to harmful levels of noxious air, with 39 urban areas, including London, Glasgow, Leeds, Nottingham, Southampton and Oxford found to have breached safety levels.

Within these cities it is the most deprived communities that are generally located in close proximity to high risk pollution hotspots – major transport axes such as railway stations or depots, main roads, busy junctions, airports and flight paths. The situation is made worse because the most vulnerable members of those communities are also the worst affected by poor environmental health: the young; the elderly and those who already suffer physical or mental health problems.

And inequalities extend beyond the home to the work place where it is those in lower paid jobs and often working on the roadside, such as street cleaners, refuse workers and parking staff that are most at risk.

In the longer term Government must comply with EU regulations and give local authorities the powers and resources needed to remove polluting vehicles from areas of high population, in particular schools, hospitals and GP surgeries. These powers would also allow local authorities to invoke licensing and procurement powers to drive more efficient technology standards in public transport, in particular buses.

But whilst the politics of Westminster sorts itself out, the health sector has an important role to play in improving, as far as possible, local environmental conditions (the air we breathe) and workplace safety.

Working with local authorities, through their Health and Welbeing Board, GPs and hospital managers can invest in programmes that raise awareness of the risks associated with air pollution. They can invest in better local monitoring of pollution levels and require contractors, such as street cleaning or refuse collection companies, not to put their workers at risk in the areas with the highest levels of pollutants. And they can support programmes, such as those delivered with Barts Health NHS Trust to provide the most vulnerable individuals with the information and stimulus needed to change their travel patterns and reduce their personal or family exposure. Results from this programme will be launched on 21st June.

Action taken to reduce health inequalities will benefit society in many ways. It will have economic benefits in reducing losses from illness associated with health inequalities, which currently account for productivity losses, reduced tax revenue, higher welfare payments and increased treatment costs. It is also the basis of a fair society. But if we are to give every child the best start in life, create good work places for all and ensure a universally healthy standard of living, the health sector must play its part in delivering clean air right now.

Hugh Goulbourne is a Director at environmental charity, Global Action Plan, and a policy adviser to Deputy Leader of the Labour Party, Tom Watson MP