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London's ethnic minority groups have poorer health, report shows

BMJ 2004; 328 doi: (Published 08 April 2004) Cite this as: BMJ 2004;328:854
  1. Lynn Eaton
  1. London

    A report from the London Health Commission shows how the capital's black and ethnic minority communities are more likely to have poorer health than white groups; this is a finding based on 10 health indicators, including life expectancy, housing, and crime.

    It is the third report on health compiled by the London Health Commission, which was set up by the mayor of London in 2000 to improve the health and wellbeing of Londoners. The report is published in collaboration with the Greater London Authority and the London Health Observatory, one of nine regional public health observatories set up after the government published its white paper on health prevention in 1999 (Saving Lives: Our Healthier Nation).

    It highlights how, despite overall life expectancy for London being around the national average and generally increasing, in some boroughs it is much lower, and is frequently dependent on social deprivation factors.

    London-wide, life expectancy is currently 75.7 for males and 80.7 for females, compared with 76 and 80.6 for England as a whole. But for males born in the boroughs of Lambeth, Southwark, Lewisham, Greenwich, Camden, Islington, Hackney, Tower Hamlets, Newham, and Waltham Forest—all of which have significant ethnic minority populations—life expectancy is one year less than the average.

    Wealthier boroughs, mainly in the west of London, had better life expectancy than the England average. These included Richmond, Harrow, Barnet, Kingston, Bromley, and Kensington and Chelsea.

    A female born today in the east London boroughs of Tower Hamlets or Newham, where there is a high ethnic minority population, has a life expectancy of 78.9 years, compared with 84.1 years if she were born in Kensington and Chelsea.

    However, no conclusions can be reached about the impact of ethnic differences on life expectancy because ethnicity is not currently recorded on death certificates. Legislation would be required to change this, and the Office for National Statistics is considering such a change, although details of the proposals have yet to be put to parliament.

    The report also highlights a significantly higher number of child pedestrian casualties among Black African-Caribbean children; the number for Asian children is low. This is not limited to boroughs with a high number of African-Caribbean children, but tends to be London-wide. The Greater London Assembly is to look further into the reasons for this.

    Infant mortality in seven London boroughs with a high ethnic minority population is 7 or more per 1000 live births, considerably higher than the average of 5.4 for England and Wales.

    The London mayor, Ken Livingstone, said “For too many people, this report shows that the London experience is about living with persistent inequality in access to services and in the range of opportunities available. Collective will and collective action are needed to tackle this problem.”


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