Dr Tony Hill's annual report on Public Health in North East Lincs can be downloaded here. It includes a study of health in the East Marsh Ward - of how many different factors such as housing, crime, environment, education, and the local economy, all come together to affect the health of not just individuals but the whole community of individuals.

We summarise here some of the issues described.

Housing - Something like a quarter of the houses are not up to the standard required nowadays (they are tecnichally classed as 'non decent'). Cold or damp homes may cause heart problems in older people and respiratory diseases in children. Uneven or slippery surfaces can lead to falls and other accidents. Much of the property is rented from private landlords, and action is sometimes required by the council to ensure they are in good repair.

Security - The report commented " North East Lincs ranks worst of 15 other local authority areas with similar socio economic characteristics". The number of people feeling insecure and anxious is relatively high, and the added stress, even if it does not lead to depression, can add to other health problems.

Environment - Clean air and green open spaces are important. For the residents, improvements in street appearance (especially pavements), greater security with alley-gates, traffic noise and polution came first.

Education and Economy - Educational qualifications of residents in the East Marsh Neighbourhood Renewal Area are on average low and this contributes to the high level of unemployment there. Not long ago 16% were on incapacity benefit. For those who do work much of it is local.

There is an element of deprivation that is self perpetuating, since those who are skilled or get a good job tend to leave the area and be replaced with others with low incomes looking for cheap housing.

The report does point the way forward. Several of the suggestions are already in operation.