NHS funding must focus on prevention
The UK has faced great challenges over the last 12 months, against a backdrop of an energy crisis, political turmoil and potential recession.
As the country emerged from Covid lockdowns, we are all more switched on to the devastating effects of an ailing national health infrastructure: ask any of the one in seven people waiting for an NHS operation today.
Yet another major health risk is flying under the radar. Air pollution is attributed to almost 12 percent of deaths globally. In the UK, it contributes to 1 in 20 deaths, with 9,400 in premature deaths associated with poor air quality in London alone.
With immense pressure already piling on the NHS, air pollution is provoking a new epidemic of chronic illnesses such as asthma, heart disease and lung cancer. The estimated economic cost of these preventable deaths to society is likely to be more than £20bn every year.
While the public is given stark warnings about other risks to their health, information about air pollution is scant and scattergun, varying wildly around the country.
Nobody would accept it if warnings on cigarette packets or unit counts on alcohol labels varied by which local authority they were sold in, but measurement and mitigation of air pollution is run in a bizarre postcode patchwork, which lets both the health system and the individual down.
It is not just outdoor air pollution from traffic and industry that we have to worry about. Sources of indoor air pollution are springing up everywhere, from the recent news of arsenic particles in London air from the burning of waste wood in wood burners, to gas stove pollution making air inside up to five times dirtier than outdoor air.
England’s Chief Medical Officer, Professor Chris Whitty, has even suggested that indoor air quality should be monitored in public places and argues for a greater understanding of the topic. With air pollution present, no matter whether we are at home or on a busy road, it can be hard to understand what we all can do to protect both our physical and mental health.
Clearly, there are many moving parts in the giant machine that is air pollution prevention. But a key barrier to change is that the data we should use to effectively draw comparisons and inspire behaviour changes exists within siloes. Too many datasets are hidden from public view and impenetrable in nature. Meanwhile, they are published separately without links being drawn from one to the other.
For example, private vehicle road use isn’t tracked alongside the uptake of inhalers in city centres, even though it is clear the two are inherently interlinked as cause and effect. Air pollution is to asthma what unregulated sugary drinks were to Type 2 Diabetes. It is essential that data around it is taken as seriously.
Central government must now redirect data analysts and expert support to local authorities and those regions that are vulnerable in terms of population health to help understand their current situations and what changes can be made to bring about clean air for all.
The Chancellor has just announced £8.8bn in the budget for sustainable transport schemes, but this needs to be directed – based on data – to the areas of acutest pollution not just to the most marginal constituencies in Parliament.
It is also right that the government is seeking to give councils a say in community-based decision making in transport since they are best placed to identify strains on the NHS in their own city than “the man (and it usually is a man) in Whitehall”.
In England, PM2.5 is estimated to cost the NHS £5.1bn by 2035. To halt further air-pollution related deaths, a revolution in data-led prevention is needed, and NHS funding (which, despite pressures, has continued to rise during the last decade or more of ‘austerity’) must be available for this purpose.
A pound spent preventing conditions from asthma heart attacks now saves hundreds, often thousands of pounds, later down the track. It makes financial sense, and it saves lives. But when will the Treasury act?
Kate Barnard is Chief Executive of Enjoy the Air, an organisation working to demonstrate the cause and effect of air pollution to healthcare authorities.
