Tag Archives: social determinants of health

Tunnels, traffic and toxic air

Over the last few years I have become increasingly concerned about preventable death and disease from air pollution. As a Respiratory doctor, I worry for my patients living with asthma and COPD, but air pollution affects everyone of every age in London, and every organ of the body. Of course it doesn’t affect us all equally, as the poorest in the city contribute least but are affected most by the toxic air they are forced to breahe. Air pollution is a stark example of the social and health inequalities exacerbated by Climate change. Before the Mayoral elections, I and friends from MedAct made short films, showing the air pollution on our commutes from home to work.

I had hoped that Sadiq Khan, a mayoral candidate at the time, would be a strong advocate for Clean Air, and he has been, at least in words. But actions speak far louder, and disappointingly he has not cancelled the Silvertown Tunnel which will bring more toxic fumes to some of the most polluted communities in London.

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Mutual aid

A view across Greenland Dock, London in teh early morning when is is dark, looking across at a misty view of Canary Wharf.

Joy is elusive this month. I leave home early and return after a long day in darkness. My sleep is broken and unrefreshing. My dreams are invaded by oxygen flow meters, masks, monitors, and breathless patients. I am tired, but that word is inadequate to describe the omnipresent fatigue that seeps into every cell of my body through the day, and which sleep fails to banish.

 

But there is hope. There is always hope. And right now it’s name is mutual aid.

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My health, my choice?

I spent this Christmas, as I’m sure many others did, over-indulging in rich foods and alcohol, and barely moving from the sofa. I made choices that were far from healthy, and take full responsibility for the resulting lethargy, bad skin and headache.

But on a larger scale, to what degree is an individual responsible for their health? It is all too easy to label the smoker with lung cancer, the alcoholic with liver failure or the obese patient with heart disease as culpable and look no further. And of course it is true that no-one held a gun to their head and made them smoke, drink, or eat to excess. But this view is dangerously narrow and simplistic. The actions of individuals and their health-related actions must be viewed within a broader social context. We act as individuals but we do not live in a vacuum.

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