Your health and where you live

Where you live has a big an impact on your health. Medical research increasingly shows that if you live in a place that feels good about itself and where people care about each other then you will do alright.

The first thing a community requires is to feel safe. Anyone seeing the havoc created by the gang violence in Limerick and the ensuing relief when John Dundon was convicted is observing a community yearning for safety. Now that community can move on to think about health issues and how to respond to its poor health statistics.

In his book Bowling Alone, Robert Putnam charts the decline of communities in the United States. He bases his argument on the disinterest in the once very popular bowling clubs. Using detailed analysis of civic participation he reports on the fall-off in local people joining their clubs and societies. Even those who join are taking less part in such clubs and are unwilling to take leadership positions which ensures they will unravel and close. This is partly due to the rise in individualism and the focus on the self, resulting in more sedentary inward-looking individuals.

This focus on self results in loss of a community response to local needs and to even defining such needs. A good example of this is the loss of local shops. Corporations gradually see fragmentation of a community as a business opportunity where people see price and convenience as more important than a local family providing local produce that allows them to stay in the community. The social interaction in a local shop is replaced by better prices in a big busy warehouse style emporium . Who can blame us in our current economic state?

When Eastern Europe moved from its stalled economy to western style economics, the resultant unemployment caused big rises in ill-health and early deaths. The more sudden the transition to western style economics the greater the morbidity and mortality. This change caused personal and community loss that has been measured in health terms. It takes a fairly uninformed person to argue for Eastern European style government but personal freedom has had big costs for them. They experienced community fragmentation in a few years, whereas we have had greater time to adjust and have mostly avoided the health problems. We haven’t avoided the toll on community however.

Practical things to help your community

Join something and take part. Putnam estimates that joining a club or society is equivalent to giving up smoking in terms of health benefit. It makes us less self centred, gives the enjoyment of acquiring a new skill and helps us cope with other people. The icing on the cake is to make sure someone runs it in order to ensure it lasts – maybe you.

Buy local food. This is often a seasonal activity but it uses money locally and avoids food travelling great distances. The multiples emphasise the national origins of their food but local markets help recreate the social and economic interactions that we gave up too easily. You can’t underestimate the value of someone saying ‘haven’t see you for awhile – were you away?’ This requires the time and interest that makes a community work.

Support local sports clubs. These clubs must be the last of the unsullied local institutions and long may they last. They need space, lights, volunteers and organisation. Children who live near sports fields are less likely to be overweight and as a result fitter for the future. Unused or unsupervised sports fields can all too easily become open spaces for alcohol abuse for the underage.

Give employment over charity. Our need right now is employment for both economic and self esteem reasons. The Eastern European experience shows the direct link between health and unemployment. It is too easy to throw a few bob in a collecting box but more difficult to argue for jobs or to invest in or encourage a business that will provide local employment however small.

Patronise your local pub. As a community we are not going to give up alcohol anytime soon. We have given up too easily on our local pubs and handed the sale of alcohol over to petrol station and off-licence chains. Many such family run businesses have closed but still act as community centres and give more supervision of alcohol intake than the of slabs of beer bought in the “offie” for home consumption. Home drinking results in larger measures and in all too easily finishing off “the lot”. Such alcohol patterns destroy personal and community health.

Avoid cynicism. We’ve been through a lot. The sacred cows are now methane. It has left us with what the Chinese call ``mind disease”. To become a proud purposeful community we need to have worldly wise positive people who have moved on from the self hate we have engaged in for the last few years. People who are hopeful have better outcomes with serious illness while if we expect the worst we will probably get it.

As they say : Ar scath a cheile a maireann sibh : we live in each other’s shadow

Tom O’Dowd is a practicing GP & professor of General Practice at Trinity College Dublin