Public Health Evaluation of Blackpool

1.Summary

The following report looked at South Shore Bloomfield, which is one of twenty-one electoral wards located within the seaside resort of Blackpool. Located on the North West coast of England, Blackpool was once a thriving tourist location visited by families from all over the UK but is now one of the 20% most deprived areas in England. Blackpool suffered a decline in the tourism sector when families chose to travel abroad due to the hot weather, the expansion of cheaper package holidays and cheap flights. Rudgard (2018), indicated that overcrowding was also a problem in Blackpool as individuals began to travel to Blackpool for late-night drinking, hen parties and stag parties for one night only and drug abuse. Due to the tourism decline, many individuals lost work leading to high levels of unemployment with many of Blackpool's residents who began to rely on cheaper, poor quality housing. Education attainment is a major contributing factor to the decline in Blackpool with many individuals leaving school with either no or few qualifications. Education, poor housing and employability all contribute to the deprivation of Blackpool and are linked to other contributing factors that individuals encounter when living in deprived areas. The Dahlgren and Whitehead model have identified a wider range of social determinants of which have a negative impact on the health and well-being of individuals. This indicates that there is a connection between health and environmental factors.

2.Introduction

2.1 Background Information

The World Health Organization (2019) defines health as being a state physical, psychological, social and spiritual wellbeing; not just the absence of disease. This prompts individuals to look beyond disease and focus on all aspects of health. Blaxter (2010), argues that the definition of health varies due to certain influences and the expectancies being within different ranges for each individual, thus making it difficult to create an exact baseline definition of health.

Dahlgren and Whitehead (1991, as cited in chapter 6: social determinants of health”, 2019)

The Marmot Review (2010), shows the social and economic factors that contribute to ill health. Public Health England (2014), states that ‘action on health inequalities requires action across all of the social determinants of health’. The growing disparity between the Blackpool and national averages for males and females can be seen in figure 1.

2.2 Key Objectives

This report will concentrate on three key aspects of Dahlgren and Whitehead model of health and will discuss how education, housing and employment can affect they have of physical and mental health of individuals living in Bloomfield, Blackpool. The report will concentrate on this area due to its ongoing decline and ways in which it could potentially affect the health of individuals.

2.3 Sources

Information used for this report has been recovered from the Joint Strategic Needs Assessment (2017) and The English Indices of Deprivation (2015), for the area of Bloomfield in Blackpool. The Elsevier journal that investigates into Health and Place was also utilized in order to produce an in-depth discussion into how wider contributing factors have an impact on the health of residents living in Bloomfield, Blackpool.

3.Capturing the neighborhood

3.1 Neighborhood Profile

Visit Lancashire (2019), recognise the seaside resort of Blackpool located on the coast of England and is known for its amusements, theme parks and the famous Blackpool Illuminations. Since the middle of the 18th century, Blackpool began to attract visitors from all over the UK. Brodie (2015), stated that Blackpool was visited by individuals so that they could bathe in the sea to improve their health. By the end of the 19th century, Blackpool town was known for the fun it provided to individuals. Lambert (2019), suggests that once the railway which connected Blackpool to the industrial towns within the north, Blackpool then became a substantial town. In accordance with Whitfield (2015), Blackpool began to see a decline within the tourist economy in the late 20th century and as the economy grew, individuals were able to afford holidays abroad. The declining population suffered from high rates of unemployment and ill health. Joint Strategic Needs Assessment ([JSNA], 2017) described Bloomfield to be one of the most deprived areas within the seaside town of Blackpool. Blackpool Council (2015), indicates that Blackpool is divided into 21 electoral wards, with each of these wards having 2 elected ward councilors. Qpzm LocalStats UK (2019), Bloomfield is a ward located within Blackpool of North West England and includes areas of Central Promenade, Central Blackpool and Squires Gate. Brinkhoff (2018), states that in the 2017 census, the population of Bloomfield was 7,044 which is made up of approximately 53% males and 47% females.
 

3.2 Methodology

Data received on unemployment, poor housing and poor education within the area of Bloomfield in Blackpool was taken from Blackpool Council and compared to the Lancashire county council in order to gain a better understanding of the deprivation within these domains. In order to produce an in-depth discussion on how social housing, unemployment and education can have an impact upon the physical and mental health of individuals, a range of academic books and journals have been used within this report.

4.Findings

4.1

Figure 1

Lancashire County Council (2009)

The following graph reveals the growing disparity between the Blackpool and national averages. The life expectancy for females is the highest at 83 years, whereas in such a deprived place like Blackpool, it falls to around 78.8 years. Life expectancy for males is at its highest at around 78.8 years in other parts of England, however, falls to 74 years in Blackpool, this indicates that Blackpool's female value is now lower than the England male value.

Figure 2

4.2

Highest qualification achieved by individuals within Blackpool

Blackpool Council (2011a)

The table shows the highest education that has been achieved by residents living in Blackpool in 2011. It shows that residents of Blackpool have either no qualifications or qualifications equal to GCSEs at grade D or below than the national average.

Figure 3

4.3

Housing within Blackpool

Blackpool Council (2011b)

The table shows that Bloomfield, which is located on the south shore of Blackpool has a lower rate of homeownership than the national average, suggesting that Blackpool is an economically deprived area.

Figure 4

4.4

The effects of overcrowding in a family household.

       Reynolds (2005

This graph shows ways in which families are affected by living in overcrowded accommodation and what percentage of individuals agree. Family relationships being the most affected by overcrowding within a family home with 77% of individuals in agreement. Education and Health are also affected by overcrowding with 71% of individuals in agreement with both statements.

Figure 5

4.5

Rooms, Bedroom and Central Heating

The following table demonstrates a high proportion of individuals living within a household containing one room. It also shows a high percentage of individuals living without heating. The size of housing and the number of bedrooms is also smaller than average.

Figure 6

4.6

Estimated percentage of overweight and obese adults in Blackpool compared to England and the North West.

Blackpool Council (2019c)

The following graph presents that there is a higher percentage of individuals living within Blackpool who is either overweight, obese or excessively obese compared to England and the North West.

5. Discussion

5.1 Unemployment

The economy of Blackpool is described by Duggett (2011), as being dominated by public trade and with a decline in trade in hotels and B&B’s resulting in employment rates falling below regional and the national averages. Studies carried out by Gürtzgen al (2016), that employees who have lost their jobs through no fault of their own were twice as likely to develop ailments such as high blood pressure, diabetes and heart disease over one to two years compared to those who were employed throughout that period. Antoniou & Cooper (2005), indicates that unemployment affects both mental and physical health of an individual and is not always the same in men and women. According to Warner (2013), a lack of confidence, low self-esteem and depression are amongst the commonly observed psychological effects of unemployment. This view is supported by Mossakowski (2009) who found that unemployment increases stress levels in individuals resulting in depressive symptoms. Research carried out by Statistics Estonia (2014) found that looking for work becomes harder due to problems like recession, economic problems and for individuals who lack the education or expertise the is required. Unemployment in many cases can lead to a lack of funds, which in turn causes issues for families. Moritsugu, et al (2015), indicates that due to cost constraints, physical health is affected as many individuals may not be able to purchase good quality food which in turn may lead to obesity and nutritional deficiencies. Obesity is a cause for concern in public health in both Blackpool and nationally (see figure 6), this has a negative impact on psychological and physical health. JSNA (2017), have found that obesity increases the risk of developing illnesses at a younger age such as type 2 diabetes and cardiovascular disease. It also causes poor mental health and reduces the quality of life, reducing life expectancy by nine years compared to those who are of a healthy weight.

5.2 Education

A report published by the Office for Standards in Education (2015), found that pupils from disadvantaged backgrounds living in Blackpool are more likely to lose out on high standard education. They also show that only three in ten pupils who are disadvantaged pupils receive five GCSEs at grade C or above including math's and English, this puts Blackpool in the bottom three local authorities in England for attainment. It is recognised by WHO (2010), that those with a higher level of education go on to live healthier lives.  According to Zajacova & Lawrence (2018), individuals with higher education levels have better-paid jobs resulting in greater financial security. A report carried out by the National Center for Health Statistics ([NCHS] 2010), shows how low income and inefficient education underlie many health disparities. Those processing higher and better levels of education have better self-esteem and better life skills leading to better health. Lack of education has been associated with poverty, malnutrition and chronic illness.

5.3 Housing

Of England and Wales authority district, Office of National Statistic [(ONS] 2001) state that Blackpool is the fourth most densely populated outside of London and has a lower rate of homeownership than the national average (see figure 3). The English Indices of Deprivation (2015), measures housing that is in poor condition being it private or social housing. It is recognised that the size of households in Blackpool has decreased from 1971 to 2001. National Health Service Blackpool ([NHS Blackpool] 2009), recognised that an estimated 38% of private housing can be or is classed and a non-decent living environment in comparison to England's percentage of 27.1%. Blackpool Council (2009), suggests that deprived Blackpool Bloomfield properties are mostly associated with the private rent sector and converted flat, which is usually lived in by individuals on the lowest incomes or those receiving benefits. Mcbain (2013), indicates that around two hundred meters from the promenade, what were once guest houses have now been converted into bedsits which cost on an average of £65 a week to rent According to the World Health Organization ([WHO], 2019), the state of housing can have a major impact on the mental and physical health of individuals. JSNA Blackpool (2017), who agree that poor housing has impacts on physical health. Many people are drawn to Blackpool because of cheap housing; however, these types of housing are often overcrowded, damp rotting and have not proper heating, these have shown to be associated with physical illnesses including eczema, hypothermia and heart disease. A report carried out by Reynolds (2005) (see figure 4), shows that living within accommodation which is overcrowded caused harm family relationships and that their sleep is highly disturbed. Thus, having a negative impact on the mental well-being of individuals leading to anxiety and depression. The Mental Health Foundation (2019), found the individuals are twice as likely to take up smoking when dealing with mental conditions such as anxiety and depression. Individuals believe that smoking relaxes the brain and reducing stress, however, this is not the case and causing withdrawal when they try to stop. JNSA (2017), recognises that this, alongside damp and mould, leads to physical conditions such as respiratory issues in both adults and children. Battersby & Bassett (2012), who agree state that poor quality housing is usually in possession of damp and mould. WHO (2009), state that lung function is reduced by the inhalation of mould particles due to prolonged exposure leading to a blockage in the airways ultimately causing coughing and wheezing.

5.4 What can be done by Nurses can to Minimise Ill-Health in Bloomfield, Blackpool

The Marmot review (2010), has highlighted methods in which it aims to reduce ill-health caused by the social determinants of health by using evidence-based strategies to overcome problems. Health care professionals have a duty of care to individuals and should promote health within Bloomfield, Black. The Nursing and Midwifery Council ([NMC] 2019), support this statement as they quote that “nurses must promote wellbeing, prevent ill health and meet the changing needs of individuals throughout their lifespan.”

It has previously been mentioned that ill-health is most prevalent amongst those living in deprived areas. The Royal College of Nursing ([RCN] 2016), found that nurses possess the skills and knowledge in order to tackle social health determinants and should use these skills in providing educational lessons and providing agreed changes to promote better health. Jones and Bartlett (2016), support this by suggesting that health education should be provided and should be individualized to support every individual's needs.

6. Conclusion

The Dahlgren and Whitehead model show that the mental and physical health of individuals living within deprived communities is not only influenced by lifestyle choices but a wider range of social implications. Bloomfield is one of twenty-one electoral wards located in Blackpool and was once a thriving tourist location with many business owners relying on tourists. Once the tourist industry began to decline many individuals lost their jobs due to B&Bs and guest houses being forced to close, which led to many individuals becoming unemployed. This meant individuals had to seek accommodation in B&Bs that had closed and turned into cheap, poor quality flats and bedsits. Social factors have a major impact on the health of individuals and can result in unhealthy lifestyles. Healthcare professionals should show the importance of healthy lifestyles using ducational strategies. Individuals should receive support and have a plan put in place to support their own individual needs.

7.References

• Antoniou, A., & Cooper, C. (2005). Research Companion to Organizational Health Psychology (1st ed., pp. 283-284). Cheltenham: Edward Elgar Publishing.
• Battersby, S., & Bassett, W. (2012). Clay's Handbook of Environmental Health (18th ed., pp. 379-380). Abingdon-on-Thames: Routledge.
• Blackpool Council. (2015). Elections. Available at: https://www.blackpool.gov.uk/Your-Council/Voting-and-elections/Elections/Elections.aspx
• Blaxter, M. (2010). Health. 1st ed. Cambridge: Polity, pp.9-10.
• Brinkhoff, T. (2018). Bloomfield (Ward, United Kingdom) - Population Statistics, Charts, Map and Location. Available at: https://www.citypopulation.de/php/uk-wards-northwestengland.php?adm2id=E05001645
• Chapter 6: social determinants of health. (2019). Available at: https://www.gov.uk/government/publications/health-profile-for-england/chapter-6-soal-determinents-of-health
• Constitution of WHO: principles. (2019). Available at: https://www.who.int?about/mission/en/
• Joint Strategic Needs Assessment Blackpool. (2017). Adult obesity. Retrieved from http://www.blackpooljsna.org.uk/Living-and-Working-Well/Healthy-Lifestyles/Adult-obesity.aspx
• Joint Strategic Needs Assessment Blackpool (2017). Deprivation. [online] Available at: http://www.blackpooljsna.org.uk/People-and-Places/Wider-determinants-of-health/Deprivation.aspx [Accessed 31 May 2019].
• Joint Strategic Needs Assessment Blackpool. (2019). Housing and Homelessness. Retrieved from http://www.blackpooljsna.org.uk/People-and-Places/Wider-determinants-of-health/Housing.aspx#Theeffectsofhousinguponhealth
• Marmot, M. (2010). Fair Society, Healthy Lives. England. Retrieved from
• http://www.instituteofhealthequit.org/resources-reports/fair-society-healthy-lives-
• the-marmot-review/fair-society-healthy-lives-full-report-pdf.pdf
• Marquez, E., Dodge Francis, C., & Gerstenberger, S. (2019). Where I live: A qualitative analysis of renters living in poor housing. Health & Place, 58, 102143. doi: 10.1016/j.healthplace.2019.05.021
• Mcbain, S. (2013). How Blackpool became a “dumping ground” for the socially excluded (pp. 2-4). Blackpool: New Statesman. Retrieved from https://www.newstatesman.com/politics/2013/12/when-lights-go-out
• Mental Health Foundation. (2019). Smoking and mental health. Retrieved from https://www.mentalhealth.org.uk/a-to-z/s/smoking-and-mental-health
• Moritsugu, J., Vera, E., Wong, F., & Duffy, K. (2015). Community Psychology (5th ed., p. 169). London: Psychology Press.
• Mossakowski, K. (2009). The Influence of Past Unemployment Duration on Symptoms of Depression Among Young Women and Men in the United States. American Journal Of Public Health, 99(10), 1826-1832.
• NHS Blackpool and Blackpool Council. (2009). The Annual Public Health Report for Blackpool (p. 12). Blackpool: Unknown. Retrieved from http://www2.blackpool.gov.uk/democracy//members/admin/files/45185e22-3307-40dd-ab8c-b0915926f306/Appendix%207a.doc
• NMC. (2019). Standards for competence for registered nurses [pdf] (p. 17). London: NMC. Retrieved from https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-competence-for-registered-nurses.pdf
• ONS. (2001). 2001 Census data - Office for National Statistics. Retrieved from https://www.ons.gov.uk/census/2011census/2011censusdata/2001censusdata
• Pfeiffer, F., Gürtzgen, N., & Fitzenberger, B. (2016). Determinants and Economic Consequences of Youth Unemployment at the Beginning of the 21st Century (1st ed., pp. 392-393). Berlin: Walter de Gruyter GmbH & Co.
• Public Health England (2014). Chapter 6: social determinants of health. [online] Available at: https://www.gov.uk/government/publications/health-profile-for-england/chapter-6-social-determinants-of-health [Accessed 31 May 2019].  ‘action on health inequalities requires action across all of the social determinants of health’
• Qpzm LocalStats UK. (2019). Bloomfield Demographics (Blackpool, England). Available at: http://bloomfield.localstats.co.uk/census-demographics/england/north-west/blackpool/bloomfield
• Raingruber. (2016). Contemporary Health Promotion In Nursing Practice (2nd ed., pp. 4-6). Massachusetts: Jones & Bartlett Publishers.
• Reynolds, L. (2005). Full house? How overcrowded housing affects families [Ebook] (1st ed., pp. 2-5). Unknown: Nicola Robinson. Retrieved from http://file:///home/chronos/u-3b2b28a34242548f3e88f91855f986e4a9b087d8/MyFiles/Downloads/Full_house_overcrowding_effects.pdf
• RCN. (2016). Promoting health | RCN. Retrieved from https://rcni.com/hosted-content/rcn/first-steps/promoting-health
• Statistics Estonia. (2014). Statistical Yearbook of Estonia (11th ed., pp. 32-34). California: Statistical Yearbook of Estonia.
• Visit Lancashire. (2019). Blackpool - Visit Lancashire. Available at: https://www.visitlancashire.com/explore/blackpool
• Whitfield, M. and Brodie, A. (2015). Blackpool's Seaside Heritage. 1st ed. England: Historic England, pp.1-10.
• Warner, R. (2013). Recovery from Schizophrenia: Psychiatry and Political Economy(2nd ed., pp. 46-47). Abingdon-on-Thames: Routledge.
• World Health Organisation.  (2009). WHO Guidelines for Indoor Air Quality: Dampness and Mould (1st ed., pp. 7-11). Europe: WHO Regional Office.
• World Health Organisation. (2010). WHO | Education and health go hand in hand. Retrieved from https://www.who.int/dg/speeches/2010/educationandhealth_20100920/en/
• World Health Organisation. (2019). Housing and Health. Retrieved from https://www.who.int/hia/housing/en/
• Zajacova, A., & Lawrence, E. (2018). The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach. Annual Review Of Public Health, 39(1), 273-289.