The reality of living in a deprived area

Wealth and health correlate - the more money you have, the better health you are likely to experience.
I happen to live in a deprived area, in the red on this handy deprivation index map. So, what's it actually like? How does it impact on our ability to make healthy choices?

First up, diet. Everyone knows poor diet is linked to numerous long term health conditions and obesity. There is a lot in the media about choosing to be fat, but how much choice do you actually get in deprived areas? All distances are courtesy of Walkit.com, and are fastest route, so mostly along dual carriageways.

CLOSEST SHOP: Cornershop and Nisa. 0.2km
CLOSEST SUPERMARKET: Morrisons, 1.1km
ALSO AVAILABLE: Marks and Spencer 1.1km, Farmfoods 1.1km, small Tesco 1.7km.

The food choices are varied. The cornershop sells mostly sweets and newspapers, with a small amount of essential daily purchases, like milk.
The Nisa sells a very poor selection of 'fresh' fruit and vegetables, at slightly increased prices. I have never had an unmouldy onion from there, but it will suffice at a push. There is no fresh meat, just sausages, bacon and ham, and no fresh fish at all. There are four whole aisles dedicated to sweets, crisps and cake. There's also a large frozen food section. One whole side of the shop is full of alcohol. There is also a large variety of cigarettes. The deals offered by Nisa are usually focused on cheap multibuys of packs of sweets, alcohol and fizzy drinks.
I'm sure you're acquainted with the produce sold by Tesco, Morrisons, M+S and Farmfoods.
Cost wise, it is cheapest to get a full shop, including fresh produce, from Morrisons or Tesco However, this requires transport, on which more later. The nearest greengrocer is approximately 4km away. There are food banks all over the city, with supermarkets regularly collecting for them. The nearest one is about 2km away and open once a week, accessible by voucher.

Now, exercise. The opportunities for exercise here are limited to walking/jogging, children's karate and gym membership.
BANNATYNES: Costs more than £600 a year, 2km away
COUNCIL FUNDED GYM: £8 a session, 1.7km away
PERSONAL TRAINER: £25 an hour

There are three parks within walking distance. One has lots of broken equipment, countless enormous rabbit holes, and is a popular haunt for drunks. One is much bigger, with better equipment, but is sited right next to the nastiest pub in the area. The last one is a proper landscaped town park, but last time we visited the park, it was full of dust and fumes from the housing estate being built behind it. The general area is well provided with pavements and trees, at least on the main thoroughfares. Once you get into the residential areas, it's less of a concern.

Education is a key determinant for health. The better your education, the better your job prospects, the better your later income, the better your health. The schools here are not great. There is only one primary school here, which received a good rating at its last Ofsted inspection. There are two secondary schools with catchment here. The closest is inadequate according to Ofsted. The other requires improvement, and is 1.7km away. Thankfully, the nearest preschool has an outstanding rating, but is oversubscribed by the entire city, as it has excellent special needs provision.

Transport is not amazing. In fact, my city is apparently the worst in the country for public transport, a particularly damning statistic for a 'new town'. There is a bus service every ten minutes into the city centre, which costs around £4 for a dayrider. Theoretically, this allows travel across the services in the city all day, but it's usually cheaper to get a dayrider than a straightforward return (it's £2.10 for a single to town). A taxi is between £5 and £7 each way, depending on where you're going - it's £5 to go the almost 5km into the city from my house, and £5 to go to the next suburb along. The bus is a five minute walk from my house. My husband is out of the house working from 10 to 12 hours a day. We can only afford one car, and all the families round here are the same. This means doing the grocery shopping has to be done either on foot, or at the weekend. Thankfully, we do the majority of our shopping online, as we can both afford both the technology, and the delivery charge. Access to the internet cannot be taken for granted.
It also means going to the doctors (which is 4km away) relies on public transport or friends. This is great fun when you've got a sick child on the bus.
One nice thing for the city in general is that it does have comprehensive cycle lanes and footpaths. The only problem, as a lone female, is that some of them seem designed to make you fear attack. There is one underpass here that goes under one road and over another. It terrifies me every time I go through it, even when it's the middle of the day, because it is totally invisible from the roads and surrounded pathways. Subways and leafy, murder-alley type paths are de rigeur. Good lighting, and CCTV are less popular.

Employment opportunities are slim to none here. You have to travel either into the city, or to the outskirts where the factories are. Unless you want to work in retail, but retail never paid anyone's living costs by itself. Or you could be a dinnerlady, or a cleaner. Which...same. If you work outside the area, you better hope you earn enough to run a car, or face the awful buses, or be healthy enough to cycle.

Housing conditions are poor. My house, which is a little older than average, is a terraced Edwardian villa. It features original windows in the kitchen and bathroom, which means no double glazing. All three exterior doors are originally, and not weatherproof. They also let in an unseemly number of slugs. The heating is inadequate for the size of the house, and the gas costs approx £1 an hour to run. The walls are lime plaster and keep falling down when you put nails in them, and there's no cavity wall to insulate. The damp gets really bad in the bathroom. My landlord's attitude is that it's an old house, it's not worth the work. Many landlords and rental agencies will not countenance your application if you are on benefits, because as ANY FULE KNO, people on benefits are going to ruin their house, and never pay their rent. I do not know how this is legal. How does it MATTER how you pay your rent, as long as it is paid? We claim minimal benefits now, but would still have trouble getting a new rent because of this ridiculous ruling by most agencies.

There aren't many opportunities for socialising. The primary school have craft mornings for parents (which aren't advertised, so how you're supposed to know it exists is beyond me). There's a large immigrant population here, which has no apparent provision from anyone. There are no language classes in the area, and no advertised groups for those who have recently arrived. The nearest Surestart centre was closed as part of budget cuts (to make way for the £120 million city centre redevelopment, which has so far pissed off everyone who lives here, and attracted very new visitors) but the preschool who occupy half the site has managed to open a few groups for families, as so far the plans to turn it into a disability outreach centre have not been implemented. The nearest fully operational Surestart centre is a little over 2km away, and includes a KS4 pupil referral centre that may put off some parents from attending. There are two pubs locally, and plenty of outdoor drinking spaces, as well as a Costa, but as far as making friends go, opportunities are somewhat limited if you don't already know people here. You can travel out to other areas, if you can bear to navigate the awful bus system. But that's a big if. Being part of strong social networks is one of the best ways to protect your health.

Health services need to be easy to access. I speak as someone who feels rubbish at the moment, but cannot face the bus journey, and then half mile walk to the doctors' when struggling with sickness and pelvic pain. The nearest doctor's surgery is actually in the next suburb along, and would take me 25 minutes to walk, or I could get off the bus in front of it. The reason I joined my actual doctor's surgery is because they have a branch surgery at the top of my road. Alas, this has been out of use for six months, although they claimed it would reopen after Christmas. I have personally never had a problem with getting appointments because I have inside knowledge on how the system works, and thus don't object to detailing my health woes in great detail to a receptionist. Dentists are also a problem. I have a very good dentist, who I love, who is only about 2km away, but who will only see me as long as I have a prescription exemption certificate. Thankfully, I've had one almost constantly for the last five years. However, when I lose my exemption, as I will around a year after my baby's born, I will either have to pay astronomical private dentist fees, or re-register with an NHS dentist miles away. Bad teeth is an image of poverty, because many people either cannot reach, or cannot afford, a decent dentist.
The local hospital is an originally PFI funded, highly modern, highly in debt, new build about 10 minutes away by car. I have to say, I've used them regularly since it opened, and I have never been less than impressed with their care and service. However, to try and get there by bus is a nightmare. You have to catch the local bus into town, going PAST the hospital as you do so, then transfer to a DIFFERENT bus which will eventually drop you off right outside. The local link community bus service that linked up directly from the north of the city to the hospital was dropped as part of the council cuts over a year ago.
My son is autistic, and is still waiting for his assessment, one year after initial referral. Thankfully, the council-run educational psychology team is a lot more efficient than the NHS-run neurodevelopment team. I imagine other disabilities and services are similarly hit and miss, though thankfully we don't need to access them.
On a slightly different note, midwifery services are also taxed, and I have been warned that if I have a homebirth (this is the plan, I'm sure I'll blog about it at some point), the midwife on call may be coming from up to 64km away. However, homebirths are being encouraged to reduce the load on the maternity unit.

Now, a lot of these problems are things that could be (in fact, can ONLY be) solved by a forward-thinking government, or some well informed local councillors. The local councillors here are mostly concerned about things like parking on grass verges, and tree trimming. I know this because they send me the most unintentionally hilarious newsletter every now and then. They do nothing about improving the general local services, aside from repeatedly shutting down attempts to open YET MORE takeaways on the main drag into town. I imagine actually fixing the structure of the area takes considerably more red tape than people in a four year term of government can be arsed to go through.
And some of these problems are circumvented by moving away (if you can afford it), owning a car (ditto), or taking on the 'Big Society' initiative and trying to set things up yourself. Again, this is not easy.

In a few months, I've got to propose an improvement to my community as part of my dissertation. And just writing this has given me so much to think about how much this community COULD be improved. But where do you START?