Working out how to vote: Establishing my priorities

It is now less than three weeks to the general election and I find myself increasingly exercised over how to vote.

It seems to me that we face a stark choice as a nation:

On the one hand the prospect of many more years of a Conservative government, with the danger that this will prolong the damage caused to our public services, further increase the widening inequalities in our country, and fail to tackle the issues of housing, poverty and the environment; and all this under the leadership of Boris Johnson – a prime minister who has shown himself to be dishonest, and disrespectful to women, ethnic minorities, disabled people and those of different sexualities; a leader who will push through his personal vision of Brexit, ignoring the concerns raised by politicians and specialists of all parties and persuasions, and refusing to take it back to the people.
On the other hand we could see a Labour government, with a manifesto which (while I don’t agree with all that is in it) offers hope for promoting environmental care, building up our public services, reversing the growing inequalities, and lifting people out of poverty; under the leadership of Jeremy Corbyn who seems to me to be a man of principle and integrity, who has consistently stood up for justice, equity and human rights, who respects and listens to people, and who, by taking a neutral stance and offering a second referendum with a clear deal on the table, is showing that he is genuinely listening to and respecting the will of the people of this country.

I recognise that many will have a very different (and no doubt equally valid) view of those two options; also that whichever of those two comes to pass, a lot will depend on the role of the other political parties in forming a coalition, or in supporting, opposing or moderating the policies of the ruling party. For me, the main choice seems to be between voting Green with the long view in mind or voting Labour to counter the immediate risk of a Johnson-led Tory government or – worse still – a Johnson-Farage coalition.

I read a rather disturbing editorial in the Times last week which basically suggested that most people vote, not on the principles they believe in, or on the basis of any manifestos, but rather in line with what they perceive their social circle will vote.

That troubles me, and just because most of my friends, most of my colleagues, and most of the people I spend my time with voted remain and are firmly left of centre on the political spectrum[1], I want to be able to listen to all sides, to think critically about what the different parties are promising, and to base my vote on the values and priorities I truly believe in.

So what are my priorities?

Lois and I have been giving this some thought over the past weeks, and here is our starter:

Addressing the deep social and economic inequalities in our society, and reversing the widening gap between rich and poor;
Caring for our environment and taking meaningful steps towards reversing the damage we are doing to our planet;
Providing affordable, suitable housing for all and taking immediate steps to tackle homelessness and food poverty;
Reinvesting in our National Health Service and valuing and supporting all public sector workers;
Putting children’s rights, their health and their welfare at the centre of all policies;
Rethinking our defence and international policies to promote peace, justice and human rights, and to curb the power of the arms industry;
Reforming our electoral system so it more genuinely reflects our society and works for the good of all.

As I continue to read through the party manifestos and listen to the news and what people are sharing on Facebook and elsewhere, that is what I will be trying to judge it all against. At the moment I genuinely am undecided what way I will vote, so it would be really good to hear from others what your priorities are, and how you feel any of the parties match up against them.

[1] Yesterday, Lois and I spent a thoroughly enjoyable evening with some friends who had all voted to leave the EU, were somewhat right of centre politically, and were deeply engaged, well-informed and highly thoughtful. It was an inspiring and refreshing evening.

November 19, 2019

Austerity, income inequality, and the unprecedented rise in infant mortality for the poorest in our society

Changes in infant mortality

For the past twenty years I have been researching child mortality both in our country and overseas. One of the most encouraging aspects of this has been the steady decrease in child deaths over this period and for many decades before throughout the world. There have been some particularly positive achievements in this, with deaths from cancer, external causes and violent deaths in children all falling by more than 50% in England and Wales since the 1970s, while Sudden Infant Death Syndrome (SIDS) fell by over 80% (Sidebotham, Fraser, Fleming, Ward-Platt, & Hain, 2014). Globally, under five mortality rates have fallen by more than 50% since 1990 (Unicef, 2019).

Sadly, though, those huge achievements have not been maintained, and a recent paper in the British Medical Journal has shown that, for those in the most deprived areas of our country, infant mortality has actually been rising since 2013 (Taylor-Robinson et al., 2019). The gap between the most wealthy and the most deprived, having been reducing for many years, has now started to increase. While there are some limitations in their research, the overall pattern seems very clear. In this graph from that paper, infant mortality in the most deprived local authorities is in pink at the top of the graph, with the least deprived in brown at the bottom.

Changes in infant mortality rates by local authority deprivation quintile (Taylor-Robinson et al.., 2019)

Politics, Poverty and Austerity

In the run up to a general election, with all the political posturing going on, it is hard not to conclude that this reversal in infant mortality is linked to a combination of poverty and austerity, with increasing wealth inequalities, reductions in welfare benefits for families with children, and real-terms cuts to the NHS, local authority children’s services, social care and public health budgets. It is notable that throughout the Labour administration from 1997 to 2010, infant mortality fell, particularly in the most deprived areas of the country. The reversal in this trend seemed to kick in just a few years after the change of government.

It seems to me that we need a clear change in policy (and not just electioneering promises) if we are going to see a reversal of this recent trend and a change in the life-chances of those who are most disadvantaged in our society. Perhaps we should be judging our political parties, not so much on what they promise to do, but on their actual track record in tackling poverty and inequalities, ill-health and child mortality.

In the context of increasing health inequalities in England, policies that reduce poverty and social inequalities and investing in child health and social care are likely to reduce the occurrence of infant mortality and that of many other adverse child health outcomes. – Taylor-Robinson et al., 2019

Sidebotham, P., Fraser, J., Fleming, P., Ward-Platt, M., & Hain, R. (2014). Patterns of child death in England and Wales. Lancet, 384(9946), 904-914. doi:10.1016/S0140-6736(13)61090-9

Taylor-Robinson, D., Lai, E. T. C., Wickham, S., Rose, T., Norman, P., Bambra, C., . . . Barr, B. (2019). Assessing the impact of rising child poverty on the unprecedented rise in infant mortality in England, 2000-2017: time trend analysis. BMJ Open, 9(10), e029424. doi:10.1136/bmjopen-2019-029424

October 8, 2017

The health costs of energy inefficient housing: once again, it is the poorest who pay the highest price

The process of moving house has enlightened me about the Energy Performance Certificate (EPC): a measurement of the energy efficiency of a building, and a legal requirement for all properties being sold or rented (yet another advantage of our EU membership, apparently).

Energy Performance Certificates

The EPC gives a grade, from A to G, on how efficient the building is, how much it costs to heat and light, and what its carbon dioxide emissions are likely to be. It also gives suggestions on how the energy efficiency could be improved.

Our current home has an EPC grade of D (about average for the UK), uses about 36,000 kWh of energy for heating each year, and produces about 9.1 tonnes of CO2. The house we are buying is somewhat worse, being in band E. It uses about 23,000 kWh (being a smaller property), but produces about 11 tonnes of CO2.

However, for an investment of around £20,000 we could improve that to band C, cut our CO2 emissions by a third, live more comfortably in a warmer home, and cut our energy costs substantially.

We can afford to do that.

Energy Vulnerability

Not so those on low incomes or state benefits, who suffer a triple whammy. People living in either private rented or public housing are more likely to be living in energy-inefficient properties; they are more likely to experience energy vulnerability and be unable to pay their electricity or heating bills; and they have no control over improving the energy efficiency of their homes, while the private landlords have no incentive to fork out the capital to do so, and the austerity-driven local councils are unlikely to prioritise this over other more pressing demands.
Frustratingly, though, this isn’t just about feeling good about doing our bit to help tackle climate change, nor even about feeling a bit more warm and comfortable during the winter months. Living with energy vulnerability has a direct impact on our health. Last week I attended a seminar exploring the health costs of energy inefficient housing in the UK and France. The authors pointed out that people living in homes in bands F and G have an overall higher mortality, as well as substantial risks of ill-health, not to mention the impact on lost days at work, and for children, poorer educational outcomes.

Conversely, a relatively small investment now in improving the energy efficiency of our public and private rented housing could have huge impacts on the NHS budget, not to mention the very real impact on the lives of those who can’t afford to stay warm.

End Fuel Poverty

According to the End Fuel Poverty Coalition, 2.35 million households in England are living in fuel poverty. Surely it doesn’t need to be that way?