Stuart Maconie’s splendid examination of England’s North, Pies and Prejudice, is prefaced with an exchange between Rose Tyler and the Doctor from an early episode of Russell T. Davies’s regenerated Dr Who: ‘If you’re an alien, how come you sound like you come from the North’ asks Rose. ‘Lots of planets have a North’ replies the Doctor, in a definitive Mancunian tone.1
Indeed they do, though sometimes the North is the East, or a specific locale, or the poor.
Owen Jones, author of Chavs – The Demonization of the Working Class, recently dismissed the English North–South divide as a myth.2 There is one division that matters, he argued, ‘those who have wealth and power, and those who do not’. If wealth and power are concentrated in the South, the point would seem rather to be that territorial divisions reflect and reinforce socioeconomic ones.
Responding in the New Statesman, James Maxwell pointed to the disproportionate impact on the North of public sector cuts, and to the long-standing disparity in infrastructure investment within the UK.3 London and its surrounding areas, according to IPPR North, receives over 80% of all planned transport spending, and an estimated 15 times greater share of arts and culture funding than other English regions.
Here, the comparison drawn by Bambra et al., in our guest editorial, of England’s North–South divide with that between East and West Germany before and after unification is pertinent.4 The principal causes of the German convergence of mortality have been identified by Vogt and Gampe as availability of health care and increasing pension levels.5 Since the North of England already enjoys health care that appears to be the match of, or superior to that elsewhere in country, this suggests that economic inequality remains the UK’s biggest problem in achieving geographical equality of health, wellbeing and life expectancy.6
This is no surprise to students and practitioners of public health, and has been a central message of reports from Black to Marmot.7 Yet public health debate is still too often focussed on individual behaviour and choice, and public health practice on efforts to influence those, notwithstanding the widespread recognition that those behaviours and choices are powerfully shaped by external factors. Many of these are beyond the influence of public health practitioners or the institutions that have primary responsibility for public health.
In this context, we have taken the opportunity as editors of our first Journal of Public Health issue to revise the categories in which articles are presented. While we recognize the importance of health improvement, health protection and health care services in the study and practice of public health, we also feel the need to reflect the relative importance of approaches at societal and personal levels. To this end, we have restructured the core content according to: In this edition, only four of these categories appear—Behavioural Factors is absent—although we plan to focus on alcohol in the next issue, with articles that will fall under this heading as well as under others. We invite submissions that consider public health with these categories in mind. Other sections, e.g. Chekhov’s Corner, Perspectives, Training & Education, will continue to appear on an ad hoc basis.
- Wider Determinants of Health (politics, economics, environment)
- Life Course and Epidemiology (self-explanatory)
- Behavioural Factors (e.g. tobacco use, alcohol)
- Interventions (prevention and services)
- Methods (self-explanatory)
Finally, a small correction to our esteemed predecessors; in his valedictory editorial, Gabriel Leung described us as both as being ‘of Newcastle’.8 In fact, we are both of Durham University while one of us (E.M.) is also Director of Public Health for Newcastle. Either way, we are delighted at the opportunity to steer the journal, and add to it what we hope will be a usefully Northern perspective as well as a global (or even planetary) one.
1 Maconie S., Pies and Prejudice: In Search of the North, 2007 London Ebury Press
2 Jones O. The north-south divide is a myth – and a distraction, Guardian 4 May 2014
3 Maxwell J. Of course there is a north-south divide – and of course it matters, New Statesman 7 May 2014
4 Bambra C, Barr B, Milne E. North and South: addressing the English health divide, J Public Health, 2014, vol. 36 (pg. 183-6)
5 Vogt T, Gampe J. Money or Medicine? The contribution of rising income and improving health care to the East-West German mortality convergence, 2013 Population Association of America: 2014 Annual Meeting (pg. 1-7) Boston
6 Bevan G, Karanikolos M, Exley J, et al., The Four Health Systems of the United Kingdom: How Do They Compare? 2014 London The Health Foundation
7 Marmot M., Fair Society, Healthy Lives: tThe Marmot Review, 2010LondonThe Marmot Review
8 Leung GM. Mission accomplished: over and out, J Public Health, 2014, vol. 36 pg. 1
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