We focus on four complex health issues more prevalent in urban areas
With the Social Progress Imperative, we've developed the first neighbourhood level, health-focused social progress index of its kind.
With Wellcome Trust
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Multiple long-term conditions
Addressing the social determinants of health that can slow progression from one to many long-term health conditions
Few places are as diverse as ours. While this vibrancy is an asset, it also involves a deeply unjust distribution of opportunity.
The stark differences in the length and quality of people’s lives in urban areas are not inevitable and so can be improved. We know inequalities in income, employment and housing contribute to health inequity in our place – those who live in more affluent areas can enjoy up to 19 more years of healthy living compared to those in more deprived areas.
Three years on from publishing ‘From one to many‘, the picture for people with health conditions remains the same. People are developing long-term conditions at an early age and underlying inequalities speed up people’s journeys to multiple conditions. On average, people first become ill at the age of 35, five years before the NHS begins offering routine health checks. And, nearly one in three Black adults in Lambeth and Southwark already live with more than one long-term condition; no other ethnicity is so disproportionately affected.
Health conditions related to the pressures of twenty-first century urban living dominate the picture. Chronic pain, hypertension, depression, diabetes and anxiety are common. Of all people developing a second long-term condition, more than half will struggle with their mental health. This is because of the complex and mutually reinforcing ways in which the social, economic and emotional pressures of living with ill health interact – the pressures of life make us sicker and being sick adds to the pressure of our lives.
Yet, none of this is inevitable. Research reinforces what people living in Lambeth and Southwark tell us: that intervening when people are younger would make a significant difference.
Four areas are particularly important: financial health, good work, decent housing and healthy neighbourhoods hold the power to slowing the progression from one long-term health condition to many.
We're focusing on four main areas to slow progression to multiple health conditions
We commissioned research, undertaken by researchers from King’s College London, to analyse healthcare data from interactions between GPs and patients in Lambeth in 2020, as part of a broader study examining 15 years of data. The insights from this research have helped shape our response to this major urban health challenge.
It highlights the true scale and impact of health inequality in our place, observed through the lens of people’s journeys from one to multiple long-term conditions.
Insights from our research with King's College London
The more we learn about the risks that turn one long-term health condition into many, the better we can seize opportunities to guard against them with precision.
Combatting precarity and spotting for moments in people’s lives that trigger a deterioration in health are vital. Common threads that run through all of our work are the need to:
With that in mind, there are three examples of change we want to see in cities:
Explore how work, money and homes can make our cities healthier and fairer
Exploring the impact of finances on our health
Exploring the impact of housing on our health
Exploring the impact of employment on our health
Exploring how the places where we live impact our health