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New figures have shone a spotlight on rising health inequality in one part of Kent - with residents on the start of a bus line living 10 years on average less than those at the end.
The latest data from Medway Council has revealed a worrying variance in life expectancy across the Medway Towns.
These inequalities, according to a doctor who has worked across Medway, broadly correspond to where you live with this factor making a “significant difference”.
For example, the average life expectancy for men who live in the largely rural areas of Cuxton, Halling, and Riverside is 83.5 years.
However, in Chatham Central and Brompton - just under four miles away - it’s 10 years shorter at 73.4.
It means a man riding the 151 bus service from Cuxton to Chatham Central will see his average life expectancy reduce with each bus stop - and not because it’s a long journey.
Still, it’s estimated only 20% of our health is determined by the availability and quality of medical services with the remaining 80% down to the way we live our lives - some of it in our control but much of it not.
The national average life expectancy for men is 79.2 and 83 for women. In Medway the averages are 78.2 and 82.
However, within the Towns there exist huge differences.
Women in Rainham South West have an average life expectancy of 85.9, whereas those living in Watling have a life expectancy of 79.1.
While factors like obesity and smoking are more prevalent in Chatham Central and Watling, these areas also have higher levels of deprivation - which experts say is a significant factor in our health.
People who work in less intensive, better paid, or jobs with more consistent hours, on average, have better health than those in high-intensity, low-paid, and inconsistent work, as well as those who are unemployed.
Dr Julian Spinks, a GP who has worked in many areas of Medway, says environmental factors cannot be overstated.
He told the Local Democracy Reporting Service: “It's been recognized for a long time that deprivation has a very distinct effect on things like life expectancy and also the number of years you have of good health as opposed to poor health.
“Where you live makes a significant difference. It can increase the risk of things like admissions to hospital for conditions like asthma, which could be associated with poor housing, damp and so on.
“If you look at the two areas, and I've worked in both, Cuxton and Halling is a more rural area. It's predominantly owner-occupied. It tends to be people who are relatively better off.
“The amount of deprivation out there is much lower than in Chatham Central and Brompton, which has a much more diverse population, more of them living in rental properties, often short-term rentals.
“If you're looking at deprivation, the most deprived in Cuxton and Halling is equivalent to the least deprived equivalent area in Chatham and Brompton.”
Rainham South West and Cuxton, Halling and Riverside also have above average access to cancer screening services, so although these areas show higher prevalence of cervical, breast, and bowel cancer they are the two lowest wards in terms of cancer deaths, he explained.
Chatham Central and Watling have the lowest figures for recorded cancers, but the highest in terms of cancer deaths - suggesting residents are going under-diagnosed.
Dr Spink added: “We certainly have difficulties getting people to do things like cervical screening, breast screening, bowel screening and so on. And of course, those are the ways in which we pick up cancers early.
“It’s not so much a lack of availability of services to treat cancer, but getting them into those services later which means worse outcomes.”
In March, the Medway and Swale Health and Care Partnership organised a conference which brought together local organisations across housing, education, health care, and employment.
The goal was to work collaboratively to improve the general health of people living in Medway and Swale through improvements to the 80% factors.
“Most people tend to think of health as being almost a random thing, something which happens because of bad luck,” he added.
“And they don't actually realise decisions they're making, often forced into making, are increasing the risk of disease.
“You can't just look at this as a health service problem or a social services development or a housing problem. It all has to be done in the round. We've also got to persuade those people who live in the areas which have lower risk that they may not be able to get all the things they'd love because money has to be prioritised in areas where there is a higher risk of ill health.”
Many residents said they could understand how the health inequalities developed, but were divided on how to solve the problem.
In Cuxton, Jen said: “I can imagine if you don’t get paid very much it means you will buy the cheaper options which probably aren’t good for you.
“I am not sure about taking money away from our services, I worry there are people who need help and if you take stuff it might just be the case that people here get sick more.”
Alan, another Cuxton resident, added: “It makes sense to be honest. I think we get a lot more fresh air out here than in the middle of somewhere like Chatham.
“Something should be done but I don’t know how realistic it is to bulldoze all the houses which aren’t good enough and build new ones and keep them affordable.”
Robin Bourner, a volunteer with Friends of Cuxton Library, believes it’s the greater social support and community cohesion you get in more rural areas that can make a difference.
He said: “Everybody knows each other. And whilst that might be intrusive to some people, I think it’s a great social support because if you haven’t seen Mrs Jones for a while everyone is out there looking for her as you don’t disappear into a vast estate.
“I think that support is vital.”
Meanwhile, Thomas, who lives in Brompton, an area with high levels of deprivation, said: “If you live as healthily as you can you should be alright.
“The thing is you can’t get a doctor these days for love nor money. If you were to do something about that it might help.”
Sarah said: “I know people who have got mould their landlords don’t do anything about and I completely understand people who say they can’t get to a GP.
“You work all day and you don’t have the energy to go sit in a doctor’s office - if they’re even open.”