1. Life expectancy at birth by gender and by electoral ward for Barnet
The foundations set out in the Government’s White Paper Our Health, Our Care, Our Sayi
proposed helping people stay healthy and independent whilst providing choice in their care
services and to tackle inequalities in health. As a result, Barnet Council and Barnet PCT
seeking to commission care that encourages independence, promotes greater choice and that
will help communities to develop local networks of support which can improve health and
wellbeing, as well as encouraging people to live independently as long as possible.
Barnet’s Community Strategyii outlines its vision on improving the social, economic and
environmental well-being of the borough. It focuses on four key themes:
 investing in children and young people
 a safer, stronger and cleaner Barnet
 growing successfully
 a healthier Barnet (including sub theme: older people).
The government continues to emphasise the importance of tackling ‘health inequalities’, i.e.
significant differences in health and well-being and access to health care that still exist between
different groups in our society. There are differences in life expectancy, hospital admission
rates, the risk of serious accidents and the risk of death from illness in different parts of the
borough. Differences in life expectancies in different parts of the borough are shown in Figure
1.
The main causes of ill-health death
The main causes of ill-health and death have changed in the last 150 years from infections
such as measles and TB, accidents and malnutrition, to diseases such as heart attack, stroke
and cancers. This shift from infectious and respiratory disease deaths to circulatory (principally
coronary heart disease and stroke) deaths is shown in Figure 2.

2. Figure 1: Life expectancy at birth by gender and by electoral ward for Barnet
Index of Multiple
Deprivation (2007)
Very high
83.1
High High Barnet
82.1
Moderate East
Low 76.7 Barnet
81.5 77.3 Oakley
Very low
79.4
Underhill
82.6
83.3 83.3
Edgware 82.9 Totteridge Brunswick
78.2 Park
79.7
83.1 81.5
Hale
Mill Hill
78.9 84.3
79.7 Coppetts 78.8
West Woodhouse
79.0 Finchley
Burnt 76.0
81.4 Oak
Finchley East 81.0
Church Finchley
75.7 Colindale 83.4 End
82.5
79.3 77.6
Hendon
75.6 Garden
West Suburb 82.0
Hendon
83.8 Golders 76.0
82.7 Green
77.7 Childs 85.2
Hill
77.8 81.0
82.7
81.4 78.7
84.7
76.5
81.4
Source: London Health Observatory

3. Figure 2: Age-standardised mortality rates for selected broad disease groups, 1911-2003, England & Wales
800
Age-standardised deaths per 100,000
600 circulatory diseases
400
respiratory disease
cancers
200
infections
0
1911 1921 1931 1941 1951 1961 1971 1981 1991 2003
iii
Source: Office for National Statistics
These changes principally come about because of the widespread availability of a clean
drinking water supply, the introduction of universal childhood immunisation, better housing and
better food. But this has led to diseases related to lifestyle becoming more common. Many
years ago, a doctor called Elliot Joslin said, “Genes load the gun, but it’s lifestyle that pulls the
trigger”. In other words, many of us may have a genetic predisposition to certain diseases, but
how we choose to live our lives will influence whether we develop those diseases or not and, if
we do, how severely they will affect us.
This is most apparent with smoking, which is the most important preventable risk factor for
death from cancer and cardiovascular disease.iv,v (It is also important to remember that, in
addition to the unequivocal evidence that smoking damages the smoker’s health, there is also
substantial evidence that exposure to second-hand tobacco smoke (e.g. smoke from other
people’s cigarettes) harms non-smokers.vi,vii,viii,ix,x )
A further example of the way in which our own lifestyle can affect our health is overweight and
obesity. In 2004, a House of Commons select committee noted that ‘On present trends, obesity
will soon surpass smoking as the greatest cause of premature loss of life. It will bring levels of
sickness that will put enormous strains on the health service, perhaps even making a publicly
funded health service unsustainable.’xi
Overweight and obesity increases the risk of developing diabetes and high blood pressure
(itself a risk factor for stroke). Overweight and obesity increases the risk of developing arthritis,
especially of the hip and knee. And obesity, a high fat diet and inactivity have also been shown
to increase the risk of breast cancer.xii,xiii shows the ‘relative risk’ (i.e. how much more (or less)
something is likely to occur) of developing different diseases in people who are obese. For
example, Table 1 shows that an obese woman is nearly 13 times as likely to develop diabetes

4. as one who is not obese, and an obese man is three times as likely to develop bowel cancer as
one who is not obese.
Table 1: Relative risks of health problems associated with obesity in women and men
Disease Relative risk (women) Relative risk (men)
Non-insulin
12.7 5.2
dependent diabetes
High blood pressure 4.2 2.8
Heart attack 3.2 1.5
Cancer of the bowel 2.7 3.0
Angina 1.8 1.8
Gallbladder disease 1.8 1.8
Cancer of the ovary 1.7 N/A
Osteoarthritis 1.4 1.9
Stroke 1.4 1.3
xiv
Source National Audit Office
Another example of lifestyle issues affecting health is the misuse of alcohol. In addition to
alcoholic liver disease, alcohol misuse can cause a variety of health and other problems. For
example, driving under the influence of alcohol substantially increases the risk of having an
accident. Excessive alcohol intake is associated with antisocial behaviour and street violence,
as well as domestic violence. Alcohol is implicated in 78% of assaults and 88% of criminal
damage.xv Excessive alcohol intake also affects people’s ability to work and, when it becomes a
significant problem, this can often lead to job loss.xv

5. i
Department of Health 2006 – Our Health; Our Care; Our Say
ii
London Borough of Barnet April 2008 – Barnet- A Sustainable Community Strategy for Barnet 2008 - 2018
iii
http://www.statistics.gov.uk/CCI/nugget.asp?ID=1337&Pos=6&ColRank=2&Rank=352 (accessed 14
October 2008)
iv
Bartecchi CE, MacKenzie TD, Schrier R. The human costs of tobacco use (I).New NEJM 1994;330:907-12
v
Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years' observations
on male British doctors.Br Med J 1994;309:901-911
vi
Eriksen MP, Gottlieb NH. A review of the health impact of smoking control at the workplace. Am J Hlth
Prom 1998;13:83-104
vii
Hackshaw AK, Law MR, Wald NJ. The accumulated evidence on lung cancer and environmental tobacco
smoke. Br Med J 1997;315:980-988
viii
Zaridze DG, Peto R, (eds). IARC Scientific Publications No. 74. International Agency for Research on
Cancer. Lyon, 1986
ix
Morris PD. Lifetime excess risk of death from lung cancer for a U. S. Female never-smoker exposed to
environmental tobacco smoke. Environmental Research 1995;68:3-9
x
Siegel MS. Involuntary smoking in the restaurant workplace. JAMA 1993;270(4):490-493
xi
House of Commons Health Committee. Obesity. Third Report of Session 2003-04. London: The Stationery
Office. 2004
xii
McPherson K, Steel CM, Dixon JM. Breast cancer – epidemiology, risk factors and genetics. Br Med J
2000; 321: 624-8
xiii
Hunter DJ and Willett WC: Diet, body size, and breast cancer. Epidemiol Rev 15:110-132, 1993.
xiv
National Audit Office. Tackling Obesity in England. National Audit Office, London. 2001
xv
London Health Commission. Towards a London alcohol and drugs strategy – proposals for the mayor.
London Health Commission. London, 2001