West Cumbria Opportunities & Challenges 2025 52 53 Health and Wellbeing The conditions in which people are born, grow, live, work and age, as well as their access to financial resources and social networks are important determinants of health and wellbeing.1 When individuals live in poverty and are unable to access employment, educational opportunities and quality housing, health inequalities are commonly observed, especially when compounded by unhealthy behaviours, such as smoking, poor eating habits, physical inactivity and excessive alcohol and drug misuse.2 It is often those from the most disadvantaged backgrounds that face the greatest health and wellbeing challenges, a feature starkly exposed by the Covid-19 pandemic. Many observers both during, and after the pandemic, have acknowledged that existing inequalities based on factors such as race, gender and geography, significantly increase the risk of becoming ill with diseases such as coronavirus.3 Moreover, measures put in place to contain the spread of coronavirus, have exacerbated existing health and wellbeing challenges particularly for people with long term medical conditions such as heart disease, cancers and respiratory illnesses with observed delays in both diagnosis and treatment. Restrictions on community interactions during the pandemic have also resulted in growing concerns about poor mental health, with issues such as depression and anxiety affecting a broader spectrum of people in West Cumbria, not just those facing economic and social disadvantage. The cost-of-living crisis has further contributed to poor physical and mental health outcomes. Practically, reduced spending power can result in some people, particularly those in rural areas, being unable to afford transportation to medical appointments. Similarly, behaviour changes as a result of reduced spending power can result in changes in food buying patterns, home heating arrangements, and lower physical activity levels.4 The VCSE, alongside public sector colleagues within West Cumbria, are doing their very best to address these challenges. Strategically, partners are working hard to ensure that people are receiving the right support and at the right time. More locally, new initiatives, such as a new community hub in Whitehaven5 offering roundthe-clock mental health support, are responding to local need, in accessible locations. 1 There are multiple sources defining the wider (or social) determinants of public health including from national and international organisations. For example, https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1; or https://www.health.org.uk/topics/wider-determinants-of-health 2 Fair Society, Healthy Lives: The Marmot Review, 2010. Although published in 2010 this is a key document in understanding the connections between health and inequality. 3 See for example: https://www.local.gov.uk/perfect-storm-health-inequalities-and-impact-Covid-19#:~:text=The%20COVID%2D19%20pandemic%20has,England%20and%20 Wales%3A%202%20March; or https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/what-are-healthcare-inequalities/actionrequired-to-tackle-health-inequalities-in-latest-phase-of-Covid-19-response-and-recovery/ 4 https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-17940-0 5 The hub is being funded by NHS England as part of a pilot to provide more mental health support in local communities. The hub has been developed by a partnership of organisations including Cumbria Health; Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW); Everyturn Mental Health; Home Group; iCan Wellbeing Group CIO; and The WELL Communities CIC. • New health structures are promoting collective partnership working to deliver health and care services for local communities in West Cumbria.6 • VCSE organisations are working with environmental, cultural and sporting organisations to deliver place-based interventions that promote the health and wellbeing for residents. • Through its designation as a Marmot Place,7 Cumbria is leading the way in addressing health inequalities and improving health. • Anchor organisations including the NHS and Cumberland Council are actively improving their operations to promote health and wellbeing.8 • Schemes such as Watchtree Wheelers and Growing Well are promoting access to green spaces, gardening and active travel options, encouraging residents to see the ‘great outdoors’ as a place to improve physical and mental wellbeing. • West Cumbria continues to demonstrate significantly high levels of chronic illnesses such as heart disease, respiratory illness and some cancers. • Rates of recorded drug use related death, self-harm and suicide are exceptionally high, with Cumberland identified as having some of the highest rates of suicide for both women and men in England. • The Covid-19 pandemic and the cost-ofliving crisis have combined to adversely affect many factors that influence positive physical health and mental wellbeing, including rises in incidences of domestic violence, growing levels of loneliness and isolation, and poor diet and nutrition. • West Cumbria’s super-ageing population is presenting current and future public health challenges, including increased demand on health and care services. • VCSE organisations are committed to supporting public health colleagues, but are facing unprecedented demand, leading to their own internal health and wellbeing concerns for both staff and volunteers. • Several measures of disability for West Cumbria are above national averages. OPPORTUNITIES CHALLENGES 6 The North East and North Cumbria Integrated Care System (ICS) is a partnership of organisations that provide health and care across the region. ICSs have two parts: Integrated Care Boards (ICBs) and Integrated Care Partnerships (ICPs). ICBs replaced clinical commissioning groups (CCGs) in the NHS in England from 1 July 2022. The relevant ICB for West Cumbria is the NHS North East North Cumbria which works collectively, joining up resources and expertise to provide the best health and care for local communities. In addition, The Integrated Care Partnership (ICP) is a committee of the ICB and the 14 local authorities from across the North East and North Cumbria. ICs can also include representatives from public health, social care, housing services, and VCSE organisations. ICPs focus on wider public and social care issues. See https://northeastnorthcumbria.nhs.uk; and https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/integrated-care-systems-health-and-care-act 7 Alongside Lancashire, Cumbria has been identified as a Marmot Place. This designation recognises that health and health inequalities are mostly shaped by the social determinants of health defined as the conditions in which people are born, grow, live, work and age. UCL’s Institute of Health Equity works with identified places to improve health and reduce health inequalities. https://www.instituteofhealthequity.org/taking-action/marmot-places 8 See https://www.kingsfund.org.uk/insight-and-analysis/long-reads/anchor-institutions-and-peoples-health or https://www.health.org.uk/newsletter-feature/the-nhs-as-an-anchor 9 Public Health Profiles: Office for Health Improvement and Disparities, https://fingertips.phe.org.uk/search/life%20expectancy 10 Data via Local Insight https://localinsight.org/ 11 Data via Local Insight https://localinsight.org/ 12 Fingertips Data: Office for Health Improvement and Disparities, https://fingertips.phe.org.uk/ (Please note there are quality concerns with this data) 13 Fingertips Data: Office for Health Improvement and Disparities, https://fingertips.phe.org.uk/search/asthma 14 Public Health Profiles: Office for Health Improvement and Disparities, https://fingertips.phe.org.uk/health-profiles#page/1/gid/1938132696/ati/501/iid/90366/age/1/sex/1/cat/-1/ ctp/-1/yrr/3/cid/4/tbm/1 15 https://fingertips.phe.org.uk/search/DIABETES#page/1/gid/1/ati/15/iid/241/age/187/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1 16 Public Health Profiles: Office for Health Improvement and Disparities, https://fingertips.phe.org.uk/search/cancer 17 Public Health Profiles: Office for Health Improvement and Disparities, https://fingertips.phe.org.uk/search/cancer 18 2021 Census data, via Local Insight https://localinsight.org/ Through its designation as a Marmot Place,7 Cumbria is leading the way in addressing health inequalities and improving health. It is often those from the most disadvantaged backgrounds that face the greatest health and wellbeing challenges, a feature starkly exposed by the Covid-19 pandemic.
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