The doctor who wants to make his town better
GP Mark Spencer explains why he is overseeing an ambitious year-long project in his town aimed at improving the health of people in his town.
I've been a GP in Fleetwood, Lancashire. for over 25 years. Have I had a positive influence on people's health? Well, hopefully yes, but only on an individual one-to-one basis.
Detecting early cancer, recognising the early symptoms of heart disease and helping people with depression certainly improve their health - but this is more about managing illness rather than keeping people well.
My view is that over these past 25 years, the overall health of Fleetwood hasn't really improved much at all.
Modern sedentary, high-calorific lifestyles are certainly not helping.
So how can we create health?
When I suggest to patients that stopping smoking, knocking the vodka on the head and eating more healthily would help them, a fairly common response is: "Why should I? What's the point? My life is rubbish. Getting through today is hard enough so why bother about tomorrow? Just give me some pills and I'll be out of your way".
What if we could make a pill that created years of added healthy life? It would be a Nobel Prize winner for medicine!
However, people don't need a wellness pill.
They need hope. They need to be able to look forward to tomorrow. They need to choose to be healthier today so that they can enjoy tomorrow with their children and their grandchildren.
Hope, a sense of purpose and control over your own life and your environment will bring major health benefits for individuals and the whole community.
Fleetwood will be trying to put this into practice over the next 12 months.
"Healthier Fleetwood" is about making Fleetwood a healthier place to live for current residents and generations to come. It will focus on "what makes me well" rather than "what's made you ill".
Nationally, the gap in life expectancy between the richest and poorest in society is widening - and in the most deprived part of Fleetwood, life expectancy is significantly lower than the national average.
The town is an area of high deprivation with high prevalence rates for all long-term conditions.
It's clear that the traditional public health messages around stopping smoking, drinking less alcohol, losing excess weight and taking more exercise just aren't being listened to in deprived communities.
There is hope and local inspiration already out there and we plan to draw on that.
The Willow Garden Project is one such example. We aim to use this as our inspiration for creating more green spaces across the town and then encourage volunteers to look after them.
As a GP I can prescribe exercise through the Y-Active Project run by our local YMCA.
Some people really enjoy gym-based exercise, but lots don't.
I'd like to be able to prescribe gardening as an alternative. This not only increases activity rates but also increases social interaction and has a positive effect on the local environment.
One of the green spaces would be a dedicated Dementia Garden featuring health promoting herbs and vegetation, plus reminiscence spaces.
As well as looking after public green spaces, our volunteer gardeners would also tend to the gardens of the elderly who are no longer able to look them themselves.
Again this will not only have positive physical benefits but it will also reduce the degree of social isolation experienced by the elderly and housebound.
Another area that we aim to look at is food.
Food can be health-promoting or it can cause long-term illness.
I believe that we have lost basic cookery skills. Young people don't cook because their parents never taught them. Ready-meals and high-calorie processed food is the order of the day.
So, let's teach Fleetwood how to cook again. Specifically, as a fishing community, let's get them cooking fish!
Moreover, parents and their children have lost the social interaction of cooking together and eating together.
So, we plan to bring a food teacher into our primary schools and then, using the facilities of Fleetwood Town Football Club - another local inspiration - we'll have them cook for their parents and then sit and enjoy the meal together.
This is Healthier Fleetwood. This is the start of our journey.