What colour would you use to describe the great advances in population health of the last hundred years? Perhaps something bright and cheery? A nice vibrant yellow, or perhaps a warm orange? As appropriate as these might seem I would argue the colour grey possesses a strong case. My reasoning? The massive increase in life expectancy we have witnessed and so the associated increase in grey heads to be seen amongst our populations.
In the 1900’s life expectancy in England and Wales was 46 for men and 50 for women. A century later these had increased to 77 and 81 respectively. Spectacular improvements by any standard. Not all countries have shared the benefits equally, progress is not even across countries or socio-economic groups. It is worth reminding ourselves that Africa saw a fall in life expectancy during the 1990’s due to the AIDS epidemic, which was only reversed when effective responses (political, social and medical) were deployed. Eastern Europe also suffered a drop-in life expectancy in the period of turmoil following the end of the Soviet era. These both serve as reminders that there is nothing inevitable about progress and improvement.
The fact that cities and urban centres can increase stress in individuals is well recognised. There is a correlation between living in a city and a range of mental health problems, although this doesn’t automatically mean urban life has to have a negative impact on our wellbeing. Cities concentrate on a range of factors, both positive and negative. So, a city may suffer from pockets of deprivation, high rates of crime and pollution, but also provide good educational opportunities, access to modern medical care and stimulating public spaces. However, as anyone who commutes through a big city will know there is a lot of stress about.
Now I don’t want to tread on the toes of my friends and colleagues on the Nicotine Science and Policy blog but, as it was National No Smoking Day on 14 March, I am going to reflect a little on smoking in the UK. It was first held in 1984, just after I had started my first job, and I was, I confess, a smoker. 34 years on what stands out most is not the money spent, the clothes damaged, accidental burns endured (smoking with a crash helmet on is not something I would do again) or the other risks associated with smoking tobacco. No, it’s the fact the world was very different.
"Without knowledge action is useless and knowledge without action is futile."
I have now worked in the drugs and alcohol policy field long enough that people have started interviewing me to provide historical context. This prompts deeply ambivalent feelings. I am reminded that I am no longer in the first flush of youth, but the opportunity to reflect on developments over the last twenty years, consider what worked and why, is something to relish. Unlike the frustration at seeing the same failed idea or approach coming around the track again (and again..)