The growing gap between life expectancies in different parts of Oxford has once again been under the spotlight. The Bureau of Investigative Journalists, in conjunction with the Oxford Mail, has been investigating the underlying causes of the 15-year life expectancy ‘gap’ in Oxford, which was first reported in the Oxfordshire Joint Strategic Needs Assessment 2018.
Gill Oliver and Anna Wagstaff’s report focuses on industrial-related ill health. For example, they note the proportion of Northfield Brook workers in ‘white collar’ jobs is 28 per cent, compared to 78 per cent in North ward. Oliver and Wagstaff also discuss the higher rates of obesity, heart disease, diabetes and depression in the less advantaged areas of East Oxford. They rightly highlight the connection between poverty and poor health, from the unaffordability of fresh fruit and vegetables to the high levels of stress associated with living with limited means.
However, the article scratches at the surface of what is a deep and complex problem. In particular, there is little explanation of why the life expectancy gap should have quadrupled over just eight years.
There are other important questions that we can and should be asking of the current data. What is the impact of insecure and low-paid work on physical and mental health, and how has this changed over time? Has East Oxford seen a significant increase in the proportion of low-paid and insecure employment compared to other areas of the city?
The anecdotal evidence I collect on the doorstep, and in my constituency surgeries, would suggest exactly so. Jobs like scouting which were previously relatively reliable and could provide enough to live on, now can’t. Several Oxford colleges continue to pay their scouts below the Oxford Living Wage (a rate set, and paid, by Oxford City Council). Many are also employed through an agency rather than directly by the college they work in. The explosion in casual employment through app-based delivery companies, and the decline in local building and construction companies, have also distorted the job market in Oxford. With social security no longer making up the difference, many people are just scraping by – with implications for their physical and mental health.
Another important factor in life expectancy is quality of living conditions. Poor housing is not mentioned in the article, but evidence shows a clear link with ill-health. According to the housing charity Shelter, cold, damp and overcrowded housing conditions increase the risk of severe ill-health or disability by up to 25 per cent during childhood and early adulthood. Over time, Oxford’s housing market has got increasingly challenging for low-income people.
We should also not forget that there have been major changes to healthcare between 2007 and 2015. Some procedures are no longer available on the NHS; funding for mental health has failed to keep pace with rising demand; and public health has been massively cut back. I would encourage the new Director of Public Health to probe further into these intra-city discrepancies. Without understanding gaps in health care provision, it is impossible to understand the health of the overall population.
In conclusion, it is wonderful that men in north Oxford are, on average, living to the age of 90. But these statistics show that improvements to the health of the city’s richest people are just not trickling down to others, for a range of social, economic, environmental and health reasons.