The Chief Medical Officer’s 2021 annual report has highlighted the substantially higher burden of physical and mental health conditions in coastal communities.
Professor Chris Whitty recommended a cross-Government national strategy to tackle the challenges, which include lower life expectancy and higher rates of many major diseases. Major points from his 2021 annual report included:
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Older, retired citizens – who have more and increasing health problems – often settle in coastal regions but without the same access to healthcare as urban inland areas. In smaller seaside towns, 31% of the resident population was aged 65 years or over in 2019, compared to just 22% in smaller non-coastal towns.
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Difficulties in attracting NHS and social care staff to peripheral areas is a common issue. The report found coastal communities have 14.6% fewer postgraduate medical trainees, 15% fewer consultants and 7.4% fewer nurses per patient than the national average, despite higher healthcare needs.
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An oversupply of guest housing has led to houses in multiple occupation (HMOs) which lead to concentrations of deprivation and ill health. Directors of public health and local government leaders raise concerns about the challenges of poor quality but cheap HMOs, encouraging the migration of vulnerable people from elsewhere in the UK, often with multiple and complex health needs, into coastal towns.
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The sea is a benefit but also a barrier: attracting NHS and social care staff to peripheral areas is harder, catchment areas for health services are artificially foreshortened and transport is often limited, in turn limiting job opportunities. The least wealthy often have the worst health outcomes.
Another important theme was that the underlying factors in coastal communities with poor health outcomes share more similarities with other coastal areas than their nearest inland neighbours. For example, in terms of health characteristics, a resort town like Blackpool has more in common with Hastings, Skegness or Torbay than with Preston, just 18 miles inland.
The report highlights the paradox that coastal areas are generally intrinsically healthier than their inland counterparts due to the physical and mental health benefits to living near the coast, including better access to outdoor spaces for exercise, social contact and lower air pollution.
The CMO made three key recommendations:
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There should be a cross-Government national strategy to improve the health and wellbeing of coastal communities, incorporating key drivers such as housing, environment, education, employment and transport.
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The current mismatch between health and social care worker deployment and disease in coastal areas needs to be addressed. This should be actioned by Health Education England (HEE) and NHS England and Improvement (NHSE/I).
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There needs to be a substantial improvement on the lack of granular data and actionable research into the health needs of coastal communities and research funders need to provide incentives for research aimed specifically at improving coastal community health.
Chief Medical Officer Professor Chris Whitty said: "Coastal areas are some the most beautiful, vibrant and historic places in the country. They also have some of the worst health outcomes with low life expectancy and high rates of many major diseases.
"These communities have often been overlooked by governments and the ill-health hidden because their outcomes are merged with wealthier inland areas. A national strategy informed by local leaders and experts will help reduce inequalities and preventable ill health. If we do not tackle the health problems of coastal communities vigorously and systematically there will be a long tail of preventable ill health which will get worse as current populations age."
