New health data out this month lay bare the impact of Covid-19 on Londoners – increased death rates across all age groups, a dip in life expectancy for men and women, and widening health inequalities, particularly for people in ethnic minority groups and from deprived areas.
The Health Profile for London 2021, published by the government’s Office for Health Improvement and Disparities (OHID), presents the first detailed summary of health in the capital since the pandemic struck in early 2020.
It presents a stark picture of direct and indirect effects of the disease, with almost two million cases of Covid confirmed in the city and some 22,000 Covid deaths by the end of 2021 – a higher death rate than in any other region of England.
Case rates varied dramatically across the Greater London area, from 16,000 per 100,000 population in Westminster to 24,000 in Havering. Death rates in the most deprived areas were double those in the least deprived, and significantly higher for black and Asian Londoners.
High Covid mortality saw London experience the largest fall in life expectancy of all the regions to 79 for men and 83.5 for women, again with the most deprived areas most badly affected. Two dose Covid vaccination rates were the lowest in the country, dipping to only just over 50 per cent for people of black Caribbean heritage.
The city also ranked bottom of the league both for low birth weight and for overweight children in Year 6, with more than one in six children categorised as obese. More than a quarter of five-year-olds showed visible tooth decay, again higher than the figure for England as a whole.
Cancer screening rates and childhood vaccination rates are low and anxiety levels up, while reduced access to health care during the pandemic is expected to result in an increase in long-term health problems.
The proportion of children in London showing good levels of development at the end of their Reception year remained higher than the England average, although children on free school meals did less well,
There were other more encouraging figures, with life expectancy, while stalled, still higher than in England overall, and the capital’s rates of teenage pregnancy are below the England average, except in Lewisham and Enfield. Deaths from drug misuse are the lowest in the country too, except in Hammersmith & Fulham.
Fewer Londoners smoke than elsewhere, and adult obesity levels are the lowest in the country, albeit with more than half of Londoners still ranked as overweight or obese.
Possible indirect effects of the pandemic could be storing up problems for the future, the report says. Impacts, including the consequences for young children of missing school, mental health concerns, unemployment and the disruption of general health services, will continue to be monitored, it says.
Inequality and poverty levels in London represent both “historic and emerging challenges” for the government’s levelling up programmes, according to the report. The capital has the highest rates of homelessness in the country and above average rates of low income, with a third of Londoners living on income below the minimum required for a “socially acceptable standard on living.
The report highlights how the pandemic “directly, disproportionately affected some populations, including people from ethnic minority groups, those living in deprived areas, older people and those with pre-existing health conditions,” said Professor Kevin Fenton, OHID public health director for London and statutory public health adviser to Sadiq Khan.
“We are emerging from the pandemic with widening inequalities, and many people are living with poorer health. Action on health inequalities must urgently seek to address this,” he added, announcing the setting up of a new public health unit working across the city particularly on the “social, economic and environmental conditions” affecting health.
The unit will be headed by Fenton’s deputy Vicky Hobart. “Nobody’s health should suffer because of who they are or where they live,” Hobart said. “But right now, people in London are living with preventable disease and disability, and sometimes dying far earlier than they should because they don’t have the things they need for good health.”
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