Fears over health of city women

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THE health of women in Sheffield is “a cause for concern”, according to the annual report on the state of the city’s health.

While life expectancy for men has improved as a result of major efforts to address the causes of premature death, factors such as smoking and drinking that are more traditionally associated with males are now thought to be taking more of a toll on women.

One of the consequences is that health inequality between women in the more deprived and in the more prosperous parts of Sheffield has widened after being narrowed in recent years.

The overall tone of the annual report by the city’s director of public health, Dr Jeremy Wight, reflects the health of Sheffield people being better than ever.

Death rates from major diseases continue to fall steadily and life expectancy for men has improved.

“The less good picture for women is, however, a cause for concern,” says Dr Wight. “Not only has the improvement in life expectancy stalled, but the inequality in female life expectancy across the city is now widening.

“This may well be the consequence of women increasingly adopting lifestyles more traditionally associated with men, such as smoking and drinking alcohol to excess.”

Other possible explanations for the difference between the sexes include occupational patterns and the prevalance of obesity.

Health officials are to undertake further analysis of the widening health gap among women “to enable us to best address the causes”.

According to the latest figures, men in Sheffield can expect to live on average to 77.8 years and women to 81.5 years, both figures being below the national average.

While men in the less affluent parts of the city can still expect to die 8.6 years before those in the more affluent parts, the gap is getting smaller. It was 10.2 four years ago.

For women, the gap has widened from 6.3 years to 8.2 years.

Dr Wight also points out that there are other significant public health problems that do not show up in mortality statistics.

“There is a huge burden of diseases that do not cause death, or else cause ill health and disability for many years before someone dies. Psychiatric diseases and mental ill health are prime examples but there are many chronic physical diseases that also cause much morbidity. Unfortunately we know... that inequality in morbidity across the city is every bit as great as inequality in mortality.”

Despite “dramatic” overall improvements in health, especially in reducing circulatory disorders such as heart attacks and strokes, mental health problems remain “stubbornly persistent”, and the prevalence of diabetes has got worse. Cases of tuberculosis are now higher than in the early 1970s.

Programmes to improve public health in Sheffield are being prepared against a background of a switch in management from the National Health Service to local authorities. After 39 years, it will again primarily be the responsibility of Sheffield City Council from April 2013.

“In many ways, this is taking public health back to its roots, because it was in the big metropolitan authorities of the Victorian era that public health started,” says Dr Wight. “There is a clear rationale, in that local authorities arguably have a greater influence over the things that make populations healthy, or not, than do health services.

“Employment, housing, air quality, the availability of opportunities to be physically active and to eat good food – all are more directly influenced by local authorities than by the NHS.”

At the same time, there is recognition of the need to ensure the best value for money from health budgets when resources are so tight.

Strategies should prioritise prevention and early intervention, with the council, the NHS and the voluntary, community and faith sector working together to improve health and reducing inequalities.

Dr Wight will present his report to the council next Wednesday.