Two Islingtons: Understanding the Problem - Islington Council

6. Reducing Health Inequalities
6.1. Health inequalities mirror other income and other inequalities in the borough. There is a
high prevalence of smoking amongst certain groups including Bangladeshi, Irish, Turkish,
Somali and Pakistani men. BME backgrounds are significantly over-represented in
specialist mental health services, in particular Black African, Black Caribbean and Irish
communities as well as a high level of mental health issues and disability amongst refuges
& asylum seekers. Child obesity in Islington is worse than national average – 25% of
children are obese and 40% are overweight by the age of 11-12 and children & young
people in Islington are 36% more likely than counterparts in London / England to
experience mental health problems.
6.2. There is a national target to reduce health inequalities by 2010, as measured by infant
mortality and life expectancy at birth. Life expectancy in Islington is lower than the national
average. Men in Islington have the lowest life expectancy in London at around 75 years,
and women have the fourth lowest life expectancy, at 81 years. Although life expectancy in
Islington is increasing, the gap between Islington and the rest of London and England is
widening, as life expectancy is increasing elsewhere at a faster rate.
6.3. The diffuse nature of health inequalities in Islington presents challenges when designing
interventions that target high risk groups, as well as interventions that address the health
needs across the whole population. Recommendations from the recently published
Marmot review and the Mayor of London health inequalities strategy recommend that all
interventions must address the whole population across the social gradient. This means
that small scale interventions targeting small numbers or groups are not effective to
improve overall health status in Islington over the long term. This approach, to address
health inequalities across the social gradient, requires universal action and interventions
where the whole population have the opportunity to benefit as well as targeted
interventions with particular high risk groups.
6.4. A programme of work over the short, medium and long term is in place to tackle existing
inequalities as identified in the Islington Health Inequalities Strategy, “Closing the Gap,
Tackling Health Inequalities in Islington”. Short term actions to improve life expectancy
focus on reducing early deaths across the borough. Diseases responsible for early
deaths include cardiovascular disease (CVD), cancer, infant deaths, and seasonal excess
deaths such as winter deaths. Projects and activities in place include the development of
the Seasonal Health and Affordable Warmth Strategy which will target individuals at
high risk of early death particularly winter deaths e.g. vulnerable elderly (particularly those
living alone or in care homes), those in poverty and fuel poverty and those unable to adapt
to adverse weather conditions – e.g. learning and physical disabilities.
6.5. Medium term actions aim to improve lifestyle behaviours which contribute to poor health
such as smoking, healthy eating, physical activity, alcohol and drug misuse, mental health,
sexual health and teenage pregnancy. Progress on three of the lifestyle areas are
identified in this paper; mental health, health eating and smoking cessation.
6.6. Projects and activities in place include implementation of the Islington Mental Health
Promotion Strategy with universal action to address stigma and discrimination and
promote early identification of mental heath problems. Targeted actions address
vulnerable communities and those in the criminal justice system, carers, and clients with
existing mental health problems. Long term actions aim to address social determinants
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