Academics highlight major health challenges facing coastal communities

Professor Sheena Asthana and Dr Alex Gibson wrote a chapter analysing the burden of disease for the Chief Medical Officer’s Annual Report 2021
Torquay panorama

Academics from the University of Plymouth have contributed to a major Government report highlighting the many and varied health challenges facing the UK’s coastal communities.

In the Chief Medical Officer’s Annual Report 2021, Professor Chris Whitty says that – despite the significant efforts of local leaders – these communities continue to have a high burden of health challenges across a range of physical and mental health conditions, often with lower life expectancy and higher rates of many major diseases.

To address this, he has recommended a cross-government national strategy to improve the health and wellbeing of coastal communities.

The report has been developed over the past year and includes a chapter analysing the burden of disease and health service data at a granular level, written by Professor of Health Policy Sheena Asthana and Senior Research Fellow Dr Alex Gibson.

This presents compelling evidence that coastal communities experience a significantly higher burden of disease than their non-coastal counterparts and that this is over and above the level of prevalence that can be explained by socio-economic factors and demography.

There are also particularly worrying trends in public health-related outcomes for children and young people, with the authors saying that policy needs to recognise, understand and respond to the particular circumstances that have resulted in this excess coastal morbidity.

The report is the latest written by Professor Asthana and Dr Gibson, who have spent almost two decades raising concerns about the allocation of funding for the NHS and other English public services.

Professor Asthana, Director of the Plymouth Institute of Health and Care Research (PIHR), said:

"Coastal communities have received little attention in the health literature, perhaps because our mental maps tend to associate socio-economic deprivation and health inequalities with inner cities. Our research shows that coastal communities experience a significantly higher burden of disease than their non-coastal counterparts, with particularly worrying trends in public health-related outcomes for children and young people. We very much hope that these findings help to raise awareness of the challenges facing England’s periphery and that greater priority is given by Government to what should be seen as an important part of the levelling up agenda.”

Sheena Asthana. Plymouth Pioneers
Professor Sheena Asthana

The major points highlighted in the Chief Medical Officer’s Annual Report 2021 include:

  • 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;
  • 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;
  • An oversupply of guest housing has led to Houses of 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;
  • 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.
Speaking about the report, 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.”

Read more information linked to this article

Plymouth Pioneer: Professor Sheena Asthana

Over the last 20 years, Sheena, Professor of Health Policy, has established a large programme of health policy and health services research.

Focusing on health care equity, inequality, evidence-based public health and health service evaluation, Sheena has attracted over £1.6 million in funded research projects as Chief Investigator. 

She leads the Plymouth Institute of Health and Care Research, which brings together world-leading research from across the University to improve the health and care of the South West and beyond. 

Find out more about Professor Sheena Asthana

Plymouth Pioneers. Professor Sheena Asthana

Current projects and research activity

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Coastal Health Outcomes - Contributing to the Chief Medical Officer’s Annual Report 2021
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Resource Allocation Using the Four-Block Model

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