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Talk 200 is a new lecture and podcast series from The University of Manchester, launching to mark our bicentenary: 200 years of making a difference.
This year we’re reflecting on our past, celebrating our present and looking to the future – and Talk 200 invites listeners to be part of the journey.
Our podcast host, Manchester aficionado, author, and University alumnus Andy Spinoza will be joined by a diverse line-up of guests from our community – pioneering academics and notable figures, inspiring staff, alumni and students – to discuss topics such as health, digital and AI, climate change, and equality and justice.
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Unknown
Hello and welcome to Talk 200, a lecture and podcast series to celebrate The University of Manchester's bicentenary year. Our 200th anniversary is a time to celebrate 200 years of learning, innovation, and research. 200 years of our incredible people and community, 200 years of global influence.
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In this series you'll be hearing from some of the nation's foremost scientists, thinkers, and social commentators, plus many other voices from across our University community as we explore the big topics affecting us all.
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Unknown
I'm Andy Spinoza, the host of Talk 200 and I'm pleased to introduce the first lecture of this series. In this episode, Chris Whitty, Chief Medical Officer for England, the UK government's Chief Medical Advisor and Head of the Public Health Profession discusses the past, present and future of health inequalities. As a society we face the hard truth that the more socioeconomically disadvantaged someone is the higher their risk of poor health.
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Unknown
The world's greatest killer is not any one individual disease but the unequal way in which people are born, grow, live, work and age. Listen on to find out what the main drivers of inequalities and disparities in health are how these have changed over time and why addressing them must remain a major public health priority. Please note this is an audio recording.
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of Professor Whitty’s live lecture at the University's The Whitworth art gallery. For the full experience, including the opportunity to see Professor Whitty’s accompanying slides, you'll find the video recording on our YouTube channel, @universityofmanchester and on our bicentenary site, manchester.ac.uk/talk200.
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Unknown
It's a great honour to be here, and when the President invited me to discuss inequalities I was very keen to do so because this really is what drives a huge amount of public health. I'd like just to start off, because this is a global University with one slide about the global situation because I think it is stark and it makes the point very clear. This is a famous update of a famous slide.
00;02;40;01 - 00;03;18;17
Unknown
Every country in the world is lined up with its income on the bottom axis and the lifespan / life expectancy on the left axis. Two things really worth highlighting with this, and then one additional encouraging point... The first is that the line is extremely predictable. Poverty drives poor health outcomes in every country in the world but, more positively, the great majority of countries in the world not actively at war are moving steadily from the bottom left of this graph to the top right,
00;03;18;20 - 00;03;47;29
Unknown
and the graph scale is not clear on this but it starts at around 50. At the point this University started, the lifespan in this city was in the 20s and when the NHS was formed, the lifespan in the UK was roughly where it is in most countries in Africa today. So, things have improved in every part of the world, but there is a very long way to go.
00;03;48;02 - 00;04;11;19
Unknown
Now I'm now going to move over to the UK, and specifically England, and again this map I think tells a story that does not need laying out too heavily. The darker on the right the colour, the greater the level of deprivation - this is the 10 deciles of deprivation - and on the left, is under 75 mortality in the country.
00;04;11;19 - 00;04;26;03
Unknown
Those maps are essentially identical. Poverty and deprivation drives premature mortality with extraordinary predictability.
00;04;26;06 - 00;04;57;23
Unknown
Now this is true in whichever kinds of infection or non-communicable disease you look at for different reasons, but I also want to highlight another reality of this. And on the left here, I've put a map of child mortality under five in the 1850s, and on the right, a map of covid in its initial period in the UK in this century.
00;04;57;25 - 00;05;28;12
Unknown
And I think two things - there's a good point and there's a bad point. The good point is child mortality, of course, has massively improved over that time, but the bad point is the areas of deprivation, where premature mortality occurs, are incredibly deep-rooted and have remained the same in this country in many areas, including around Manchester. So this is something which I think we have to tackle as a matter of national priority.
00;05;28;14 - 00;05;53;19
Unknown
Some of the reasons for this are relatively easy to explain, and, with will and determination, possible to tackle. I'm of course going to highlight smoking, and I’m delighted that the government is aiming for a smoke-free generation. People being addicted to smoking in their childhood, and then suffering for the rest of their lives something they do not wish to do,
00;05;53;22 - 00;06;19;18
Unknown
a great majority of smokers wish they'd never started and are forced to carry on by addiction, is one of the most appalling situations that leads to avoidable mortality in this country. On the left, we have deaths from respiratory diseases, particularly chronic obstructive pulmonary disease, but others…, and on the right, lung cancer deaths. Smoking drives a very large proportion of the difference that we see here,
00;06;19;21 - 00;06;51;16
Unknown
so this is a relatively straightforward relationship because smoking is the…, the companies that promote smoking essentially do so among the most vulnerable. But, there are also more complex relationships. This, for example, is on the right, liver cancer in the UK. And people often, rather I think simplistically, say well, that's because there's more drinking in people who are living in more deprived areas,
00;06;51;17 - 00;07;17;16
Unknown
that is not true. In fact, the amount of alcohol and the number of people drinking it is higher in some of the higher socioeconomic groups but the patterns of drinking are more harmful, so this is a bit more complicated. The more granular you look at the data for all of these diseases, the starker the differences become, and this has two implications.
00;07;17;18 - 00;07;50;25
Unknown
The negative one is we have an enormous gradient when you look at a granular level between the wealthiest and the least wealthy parts of our society. But on the positive side, from the point of view of what we can do, this tells us where we should go. There is a very clear concentration of poverty and deprivation related in illness and disability and short lives, and those are the areas we should be concentrating much of our effort,
00;07;50;27 - 00;08;17;10
Unknown
and this is true at however micro level you go. This is a classic presentation, in this case of Manchester. You can do this for almost any city in the world where there is a 10-year gap in very short distances between more deprived and less deprived parts of the city and the same would be true in London, Glasgow, or indeed Paris and New York.
00;08;17;12 - 00;08;52;20
Unknown
Now, the reason the deprivation drives this premature mortality is multifactorial. Some of the factors are relatively clear, straightforward, and should be addressed through public health. Many of them are much more complex and based on issues around diet, housing, working, environment, education… For example, education is highly protective against dementia and many other conditions, smoking, as we talked about. But also importantly, there is something called the inverse care law.
00;08;52;20 - 00;09;23;28
Unknown
Those who need most medical help tend to be those who get it least, and this is a very important mission of the University, in training doctors nurses and other health professions, to ensure that we have people to serve those who are in the greatest need. So, that's one huge driver of inequalities in this country but I want to highlight another one which I think is less discussed. And that is age.
00;09;24;01 - 00;09;51;15
Unknown
And here the maps are very different. In fact, they are to some degree almost mirror images of one another in parts of the country. In the dark blue are the percentage of the population who will be over 75 years old - and, as you can see, this is because of the pattern of migration internally in the UK - going to be very heavily in rural, semi-rural and coastal areas.
00;09;51;17 - 00;10;15;13
Unknown
And that is because the pattern of migration in the UK is generally for people to move into cities and towns in their late teens, or early 20s, and to move out typically after two children. So, this pattern means that the aging of society is happening in the periphery and the cities are remaining forever young. And you can see that very clearly
00;10;15;13 - 00;10;43;22
Unknown
in these demographic pyramids on the left, where Manchester’s on the left, because of its student population, in large part to which this University contributes, has a very young demographic. But the equation has to balance, and therefore other parts of the country are aging extremely rapidly. And, this is leading to a vision of certain forms of disease. So, diseases of young age are concentrating in the cities.
00;10;43;24 - 00;11;21;29
Unknown
I have picked out sexually transmitted infections, I could have chosen many others - this is a disease of youth, by large, not exclusively obviously - and on the right, I've picked out dementia, a disease principally of older age. These are in completely different parts of the country, driven by different risk factors. So, this separation of diseases, which is actually accelerating or at least progressing very rapidly now, is going to present us with very different problems in the future to those that we face today.
00;11;22;02 - 00;11;46;27
Unknown
And, of course, most diseases are a combination in terms of their risk factors of age and deprivation. So, here's coronary heart disease. And the two things that drive it are age and deprivation. So coronary heart disease rates are high where there is both age and deprivation around the coastal strip, for example, or in any place where there is either a high level of older people or a high level of people living in deprivation.
00;11;47;00 - 00;12;23;02
Unknown
What's spared are the areas of the country that are both affluent and young. If you superimpose most universities onto that map… I don't need to complete the sentence. And, the same is true for mental health. For complex reasons different parts of the lifespan, but obviously a growing concern, already a very major area where our research has been less effective than in some of our other areas of work.
00;12;23;04 - 00;12;44;27
Unknown
When we look at individual diseases, and I will come on to my views about what we should do next but I'd wanted just to finish describing the issues, some, let's just take cancers, and I've chosen cancers because Manchester University has put…, has over many years contributed so much to our understanding of both epidemiology and the treatment of cancers,
00;12;45;00 - 00;13;11;29
Unknown
some cancers are very heavily associated with deprivation - obviously lung cancer, head and neck cancer, liver cancer at the top on the left there for men, on the right for women lung, again, stomach cancers, vaginal cancers. These are very strongly predicated on poverty. And smoking plays a very major part, as I'll come on to. But, many of the cancers have very little gradient,
00;13;12;02 - 00;13;41;13
Unknown
so they will not be driven by deprivation but they will be driven by age because almost all cancers, not all, are very strongly age-related, so they will go in different directions in different parts of the country. And to make this in a sense slightly even more concerning, what I have here this is unpublished data by the Cancer Research UK, who kindly allowed me to show it. On the left-hand of each of these bars,
00;13;41;16 - 00;14;10;07
Unknown
these are all major cancers, is where the 10-year cancer survival was in the 1970s, and on the right is where they are now. There have been some stunning improvements. Melanoma, breast cancer, prostate cancer, Hodgkin's lymphoma - these have improved in terms of their survivals immeasurably compared to, measurably but very highly, compared to where they were, um, some decades ago.
00;14;10;09 - 00;14;34;19
Unknown
At the bottom, however we have a group of cancers - oesophageal cancer, lung cancer, pancreatic cancer - and these are the ones in which there is a major socioeconomic gradient, so what we have been doing, and this is not deliberate but it is a reality, is making substantial progress in those cancers where deprivation is not a major driver and making much less progress in those cancers where deprivation is a major driver.
00;14;34;22 - 00;14;56;28
Unknown
And that is just a reality that's a fact. You can see on the numbers, not for want of trying, but that is a reality. And once you then put together large numbers of diseases, you then see a picture which complicates this further. Most people actually do not, by the time they get near to the end of their life, have a single disease.
00;14;56;28 - 00;15;30;07
Unknown
They usually have multiple diseases - what's sometimes called multimorbidity. This unsurprisingly increases with age, so age is a major driver of this, but for anyone under the age of 80, it also is very significantly accelerated by deprivation. So people living in deprivation will typically get multimorbidity, multiple diseases in one person, making it much harder for them, their families, and for their health care, up to a decade or more earlier than those living in areas of relative affluence.
00;15;30;09 - 00;15;55;26
Unknown
So, this again, has a very major inequality component both on age and on deprivation. Finally, before I move on to a slightly more cheery part of my talk, but I did want to lay out the problem really clearly, it is important to acknowledge that whilst many things in child health have improved, we are setting up serious problems for ourselves in the future
00;15;55;29 - 00;16;25;26
Unknown
and the biggest one, I think, to highlight at this point, is people living with overweight and obesity. And the deprivation gradient on this in children is simply shocking. You can see the data on the left, and where this is found in the UK on the right, these people will live with problems which will cause them longer term issues, cardiovascular issues, diabetes, cancers, mechanical problems, for the rest of their lives.
00;16;25;29 - 00;16;49;26
Unknown
They were set up to fail by the system we have in place and this is driving obesity in areas of deprivation, so these are the problems that I think we clearly must, as a society, address. Now, what should we do about it. Well, I think the first thing to say is, I consider this is a largely solvable problem,
00;16;49;28 - 00;17;14;12
Unknown
if we are very serious about it, and this is both good and bad news. What this slide shows, and this is possibly the single most important slide I would show here, is that those who live in the most deprived areas live for shorter periods, but they also live for a much long longer absolute number of years in ill health. Now, what that tells you - that's a bad thing.
00;17;14;15 - 00;17;34;16
Unknown
But what that also tells you is that, if you can shorten the period of ill health, and you should be able to because biologically they're exactly the same people as the people in the bottom, they may live longer but they'll have less time feeling unwell, they'll have less time in the NHS, they'll have more time with their families, indeed, they'll have more time in economic employment,
00;17;34;20 - 00;17;56;21
Unknown
many of these people are becoming unwell early in their working lives in reality. So, shrinking this period of illness, what's called, slightly pompously, compressing morbidity, should, in my view, be the central aim of what we should be trying to do in these groups and I consider this as achievable because what we need to do is delay disease.
00;17;56;23 - 00;18;16;05
Unknown
If we all live to 150, we would all get cancers, and dementia, and heart disease, and many other things. But we don't. If we can push diseases off to the right, we will shorten the period people live with them and, indeed, if we can push them off to the right beyond the point that someone naturally will die, because we will all die, then they won't have them at all.
00;18;16;08 - 00;18;39;15
Unknown
So, if you were going to die at 80 and you have your dementia at 85, it's never going be a problem. So pushing disease off to the right will compress morbidity. It will mean people live longer. But it will also improve their lives and, indeed, reduce the amount of work the NHS has to do to support them. Why do I think that this is a realistic possibility?
00;18;39;16 - 00;19;05;07
Unknown
Well, because if you look and take the long view of medicine, it has had a stunning achievement in dealing with the diseases to which we have put our minds systematically, scientifically, and politically. So, this is the second half, roughly, of Manchester University's existence. In the first half, infectious diseases disappeared very largely from public view. They were still there just at the beginning of this -
00;19;05;07 - 00;19;34;26
Unknown
they're the dotted line at the bottom. Then we had a substantial increase in cardiovascular disease in this country, driven principally by smoking, but also by air pollution, working environments, and a variety of other factors, dietary and others, that peaked in around the 1950s. We then had a systematic attempt using primary prevention, stop smoking services and campaigns, all the things that reduced air pollution would be examples of that,
00;19;34;28 - 00;19;58;04
Unknown
secondary prevention, which came a bit later down that path, where we started reducing blood pressure, dealing with high cholesterol and areas of that kind, and curative services, and the improvements we've seen moving from a situation where roughly one in two people in the UK died of heart disease to roughly one in four, which is where we've sort of moved to now.
00;19;58;07 - 00;20;23;21
Unknown
That has been done by a combination of primary prevention, secondary prevention, and curative services. It can be done, just as we achieved it with infection. And, if you look at the extraordinary improvements in infection over the time that this University has been in existence, we've seen the end of cholera, typhoid, diphtheria, tetanus, TB, very largely, and the bacterial diseases.
00;20;23;21 - 00;20;46;20
Unknown
And I'd just like to highlight, on the right, this sad painting by Lowry from 1935 - The Fever Van. The medical officer of health would arrive, a child who had an infectious disease would be taken from their parents, all their belongings will be destroyed, they' be taken by the state into isolation, and their parents might never see them again.
00;20;46;22 - 00;21;19;29
Unknown
Those kind of pictures are now not seen because medical science has, by combination of prevention and treatment, de-risked those diseases. So I've just taken cardiovascular disease and infection in their contexts. And in many of these areas these improvements continue. So, this is from 1970 through to just before the covid pandemic. This is um coronary heart disease in younger people.
00;21;20;02 - 00;21;47;04
Unknown
And again, a stunning improvement over that period, where the difference between men and women has significantly reduced because that was largely driven by much higher smoking rates in men, those have come down, sadly rates in women went up, coming down again now. But public health and curative medicine combined have achieved a great deal. Scientists here, as elsewhere, have contributed to this.
00;21;47;06 - 00;22;11;19
Unknown
We could, by the single action of stopping smoking, substantially reduce the cancers which are most prevalent in areas of deprivation. One in five deaths from cancer in this country are due to smoking, maybe going up to one in four. And a fifth of cancer deaths in the UK are due to lung cancer, the overwhelming majority of which is smoking.
00;22;11;19 - 00;22;21;17
Unknown
So, here is something we know what to do, and it is simply a matter of - do we have the political will to do it?
00;22;21;19 - 00;22;57;18
Unknown
Then, moving on to some of the issues of older age… As I said earlier on, I think that we now need to think very seriously about what we're going to try and do to support people in older age and to improve their health in a realistic way. And, if you talk to the average person walking up and down Oxford Road, and say to them: “I can give you two years of life in bad health, or one year of life in good health”, the overwhelming majority will say “I want the one year of healthy life where I can see my family, see my grandchildren, enjoy my, my existence”.
00;22;57;18 - 00;23;19;24
Unknown
Not all, this should be someone's individual choice. As a profession, we have in medicine, we have in science, concentrated for a long, long time on trying to improve longevity, and we have achieved that, to a very large degree. On the bottom of these graphs, what you can see is under-75 mortality - it's been falling for a long time,
00;23;19;24 - 00;23;35;12
Unknown
I'll come to the caveat of that. Over-90 mortality has hardly moved at all now for a long period of time. And that we should not see as a failure, provided those people are living good lives.
00;23;35;14 - 00;24;12;00
Unknown
Finally, I'd like to finish with a one bit of cheerfulness, and then one bit of moderately cheerfulness, and then a summary. This is what has happened to life expectancy in England over the period that this University has existed. I put the arrow where the University began. And I’m not claiming causality, but there is undoubtedly association, scientists have done so much, as have the doctors and nurses trained in this University, done so much to contribute to this extraordinary turnaround in mortality.
00;24;12;02 - 00;24;32;15
Unknown
There's a but to that. If you extend the line further to the end, all of Europe, not just the UK, it's often ascribed to an individual country, all of Europe saw an infection point roughly at the time when the big financial hit occurred. That's not particularly surprising to anyone in public health. We all know that if you reduce wealth, you reduce health.
00;24;32;17 - 00;24;51;02
Unknown
You shouldn't be surprised if the opposite is also true. It is true. You can see it on that graph. This is every country in Europe, big country in Europe. But there are two things you should see with this. The red line is the UK. The dark blue line is the rest of Europe. And we have been drifting down the leaderboard for some time, slowly.
00;24;51;04 - 00;25;16;21
Unknown
It's not one particular issue. And then, of course, covid had a major hit for everybody in the UK, and elsewhere, and we've got to recover also from that. So, my summary from all of those points: health inequalities due to deprivation and those due to age are both serious. We need different approaches to them and they are diverging geographically.
00;25;16;23 - 00;25;37;05
Unknown
It's no longer going to be realistically possible to only go to areas of deprivation. I think we need to think about both. We have as a major aim, shrinking the period of ill health. Because if we do that, longevity will follow as night follows day. But the principle point is that people want to live a good and independent life.
00;25;37;08 - 00;26;02;26
Unknown
Shrinking period of illness is the key to that. In my view, this is entirely possible if we aim to at least delay disease and start in the areas of deprivation, which you can see extremely easily if you just map them out. And we should have the same self-confidence to do that as the people who addressed infectious diseases and cardiovascular disease in the last century, where they just said, we're just going to do this.
00;26;02;28 - 00;26;32;17
Unknown
Wider social interventions, non-health interventions are, of course, essential. But we, as a profession, need to target primary and secondary prevention. Primary prevention, we do it to everybody before they get disease, secondary prevention as an individual intervention, when people have got particular risk factors. And finally, turning to Manchester. Manchester has some of the best scientists, one of the largest medical schools, one of the most important areas of training for nursing.
00;26;32;19 - 00;26;47;28
Unknown
And it has also some of the greatest inequalities in the country. If you wanted to start somewhere, you couldn't start in a better place than Manchester. This is a serious thing we want to tackle. And good luck.
00;26;47;28 - 00;27;17;19
Unknown
Thank you, Chris, for a really vivid and shocking presentation of both medical and social science, evidence of the connection between social inequality, place (where we live) and health outcomes, and, by implication, the requirement for interdisciplinary teams and interdisciplinary solutions to get to your clear vision of healthy end of life. We now have time for questions from the floor.
00;27;17;20 - 00;27;42;01
Unknown
My first question, I think, comes from the second row. Thank you. Thank you, Colette. I've been keeping an eye on Slido, and the first question that we've had through is: ‘How can partnerships, strategic partnerships between philanthropists, universities and other stakeholders, be leveraged to address health challenges effectively?’ So I think the question in one sense answers itself. You need money for research.
00;27;42;01 - 00;28;03;12
Unknown
You need money for some of the interventions that we need. The state does that well in some areas. Philanthropy has had an enormous role in others, and I worked, for example, a lot with the Bill and Melinda Gates Foundation internationally, with the Welcome Trust here, and other philanthropists as well. But I do think that universities have a very major role to play for two reasons.
00;28;03;15 - 00;28;22;03
Unknown
They train the people who will be still working on this problem in 40 years’ time, and they undertake the research. That means we can tackle it in new ways, accepting that if you don't move on, don't be surprised if the problems stay the same. So, universities, I think, have an absolutely central role to this in multiple ways. Accepting that if you don't move on, don't be surprised if the problems don't stay, stay the same. So, universities, I think, have an absolutely central role to this in multiple ways.
00;28;22;06 - 00;28;52;23
Unknown
Thank you. And just behind you. Thank you. Thank you so much for a wonderful talk. I really enjoyed that. My name's Anthony Jones. You spoke so eloquently about the classical diseases. And in order to improve people's health, you need change in behaviour for which mental health is obviously crucial. You didn't speak much about that, and I wondered whether you'd want to comment on that aspect.
00;28;52;25 - 00;29;20;26
Unknown
Yes. So, I mean, on one side, I decided that I was given a very stern instruction that I had to stay within 20 minutes. So, I decided I didn't want to do it poor justice by giving essentially giving a glib answer. On mental health, I would make three points on this. The first of which is mental health tends to first present in late childhood, adolescence, or early adulthood. Very different to many of the other diseases I was talking about.
00;29;20;28 - 00;29;40;04
Unknown
This also means it tends to concentrate in urban centers, and I think we are much less systematic about facing that reality. We know that there is a significant workforce problem - both for child and adolescent mental health, and also with adult health, so that's an issue. But I think there are two things that we have not really tackled adequately.
00;29;40;06 - 00;30;03;04
Unknown
The first is scientific. The treatment of most the diseases I deal with now is transformationally different than when it was, when I was a medical student. In mental health, an awful lot of what I do now for the non-severe mental health, and even that specialists do for more severe disease, is very similar to what it was. Implying that, in science, we have not managed that transformational achievements achieved elsewhere.
00;30;03;04 - 00;30;25;00
Unknown
So I consider that a scientific failure, by us, collectively, that we should be aiming to address. The second is the significant rise in people reporting mental health concerns and mental health issues in younger age over the last period, which was accelerated by covid, but it was clearly happening before that. We do not have an adequate explanation for that.
00;30;25;00 - 00;30;46;16
Unknown
How much of it is diagnostic changes? How much of it is actual changes in risk factors? What we should do about that? So, here we have a significantly increasing problem. And I don't think we have put adequate resource intellectually, as well as monetarily, into trying to solve it. So, I think the gap you point out is a is a very, very important one.
00;30;46;22 - 00;31;17;00
Unknown
And, as the map of mental health burden I showed demonstrates, as with many other areas, this is quite concentrated in bits of, the particular bits the country, including around here. Do I have more questions? Another one from Slido. Thank you. We've had a couple of questions built around a similar theme, which is about – one from Stephen Lowe in the online audience – ‘Deprivation ties into access to greenspace and lifestyle. Are there connections between healthy environments and healthy populations?
00;31;17;06 - 00;31;45;05
Unknown
And how do we influence this?’ There are, very clearly, connections between unhealthy environments and poor health subsequently. And there are multiple ways this plays through. Some of them are relatively straightforward to describe, like crowding, for example, very strongly associated with certain infections, lack of access to exercise, exercise is a major protective factor for many diseases, physical and mental.
00;31;45;07 - 00;32;13;16
Unknown
There's also areas which intrinsically sound as if they should be correct, like green spaces, coastal spaces provide better health outcomes, and that is true, but it is a complex relationship. And if you look, for example, at coastal areas, which are both beautiful and have coast, and often green areas, they often also have high concentrations of poor health. So, I think we should accept that there is clearly a correlation, but is often quite a complex one. And one
00;32;13;16 - 00;32;35;27
Unknown
which, I think, we need to unpick. I think as we're moving into a greater concentration on things like social prescribing, I think we should be trying to, to make a much clearer differentiation between the impacts on physical and mental health due to the environment. Thank you. So we have one more question, and I'm going to give the privilege to our Professor Dame Nancy Rothwell.
00;32;36;00 - 00;32;57;13
Unknown
Well, first of all, thank you, Chris. That was fantastic. Interesting, the stark geographical differences. Do we, or should we, be putting in different health care systems based on geography of known incidence? Because I'm not aware that we do. You know, much more concentration on mental health where there are young people in cities, much more concentration of the diseases of the elderly.
00;32;57;15 - 00;33;25;13
Unknown
And it seems to me that there is a powerful argument for it now. Yes, I think we should be accepting that because the diseases of deprivation, the diseases of older age are separating geographically and that is going to continue. The logical response to that is to actually redeploy our resource, both scientific and technical, and also public health, to essentially go down those two different areas, accepting there's a lot of overlap.
00;33;25;15 - 00;33;43;01
Unknown
And of course there are large sums of older people in urban environments, just as there are many people now living in deprivation and in good health in rural ones. But I think it does not make sense to try and provide the same service and the same ratios everywhere in the country. When you start looking at those graphs and see where they're heading.
00;33;46;15 - 00;34;09;23
Unknown
If you enjoyed listening to Professor Chris Whitty’s lecture on health inequalities, be sure to stay tuned for the rest of our Talk 200 series. We'll be speaking to a diverse line-up of guests, including staff, students, academics and other notable figures who will provide insight on a range of issues, spanning cutting-edge developments in digital and AI through to inequalities in accessing justice in legal systems.
00;34;09;28 - 00;34;10;25
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Head to
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manchester.ac.uk/200
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manchester.ac.uk/200
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to find out more about this series
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and all the activity taking place across our bicentenary year,
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including our free festival
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Universally Manchester
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from the 6th to the 9th of June.
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Use the hashtag
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‘#UoM200’
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to engage with Talk 200
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and our wider bicentenary celebrations
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on social media.
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Thank you for joining us for this episode of Talk 200, a University of Manchester series.
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Until next time.