This summer marks 25 years since one of the greatest moments of my career, winning Olympic gold in Barcelona. It often feels like the last 25 years have flown by as quickly as the 9.96 seconds it took to run the race!
A quarter of a century on and I’ve just turned 57. In my mind, I don’t feel any different to how I felt on that day in 1992. I still feel in good shape and to this day I spend more time at the track than I do in my house. However, as I’ve grown older, I’ve become much more mindful of the potential threats to my health than I ever was then.
I’ve recently started working with the men’s health charity Prostate Cancer UK and have learned some startling statistics. As a black man over 50, my risk of prostate cancer is double that of a white man the same age. One in four black men will be diagnosed with prostate cancer in their lifetime – the equivalent of one member of a 4×4 relay squad.
The prostate is an invisible gland; you can’t see it, you can’t feel it. In fact, 17% of men don’t even know they have a prostate.
If I’m being honest, until lately, I was one of the many thousands of men who knew next to nothing about the vital, walnut-size, reproductive gland inside me. More than 11,000 men die from prostate cancer every year in the UK, but over the next 10 years Prostate Cancer UK is ramping up its investment in research and has set a goal to transform the disease into one that the next generation will not fear.
Despite the odds being stacked against black men, just saying the word “prostate” within many black communities remains a massive taboo subject. Still, in 2017, the disease is simply not spoken about and, if it is, it’s in a “hush-hush, don’t tell anyone” type of way. How can it be that something that affects so many black fathers, uncles, sons and friends is continually swept under the carpet and ignored?
My health has always been important to me. When I was in the prime of my career, it was the most important thing. I was conscious of my diet and keeping myself in shape. I had to; other than a pair of running spikes, my physical and mental fitness was all I had – my career depended on it. Unbeatable; indestructible; that’s what I wanted to be, and I believed I was.
As I’ve grown older, my diet is still vital, but I’ve come to realise that no matter how well I eat or how fit I am, I am not indestructible – nobody is. But there are defence measures I can take and arming myself with knowledge is by far the most important.
If prostate cancer is caught early, more often than not, it can be successfully treated. The problem lies in the fact that when it’s in its early stages the disease is just as invisible as the gland itself – it has no symptoms.
This is why awareness of the potential threat, talking to your doctor and spreading the word among men is so important – it saves lives.
I’m currently fronting Prostate Cancer UK’s campaign, Stronger Knowing More, to get black men to face up to their risk of prostate cancer and take action. If you’re a black man, you’re not only more likely to get prostate cancer, you’re more likely to be diagnosed at a younger age.
This challenge is a marathon, not a sprint, and if we’re going to beat it we need to break down the taboos and start talking. It’s only by doing this that we can put a stop to the number of men who die from the disease every year.
In the second of our three-part Speak your Mind series, we meet Georgia, 22, who suffered from eating disorders through her teenage years. Thinspiration Tumblrs inspired her to lose weight but that spiralled to starvation and bulimia. Now recovered, she wonders why black women are rarely identified as having eating disorders
When doctors and patients realised that scurvy had reappeared, in separate outbreaks in Zimbabwe and Sydney recently, they were stunned. “I couldn’t believe it,” Penelope Jackson, one of the Sydney victims, recalled, “I thought, ‘Hang on a minute, scurvy hasn’t been around for centuries’.”
Shame followed, as it often does with scurvy. “Does scurvy just affect developing countries?” asked Newsweek 24 of the Bulawayo emergency in Zimbabwe. “I couldn’t believe you could be obese and malnourished,” said Jackson. “We have sent a team to attend to it,” the Bulawayo city council curtly announced, by way of a plenary reply to such questions about the disease.
We forget about scurvy – deliberately perhaps. And we seem to forget as well just how simple it is to cure and prevent. As Jenny Gunton, the clinician at the Westmead Institute in Sydney, pointed out, scurvy is prevented if we don’t boil vegetables to a paste, and as for the cure: “It’s so easily treated with one vitamin tablet a day” or by fresh vegetables and fruit. When the rules for eating properly are neglected by a significant sector of the population, and their forgetfulness is allied with government cutbacks for social services, the outlook for outbreaks gets a lot grimmer.
The recent sieges in Aleppo and Mount Sinjar have doubtless been accompanied by unreported scorbutic outbreaks. Over the last few years there have been a steady trickle of stories of individual cases in Europe and the US – an eight-year-old in Wales died of cardiac arrest brought on by severe scurvy in 2011, and a toddler in Michigan who couldn’t walk and was successively tested for Guillain-Barré syndrome, osteomyelitis and cancer until physicians finally diagnosed scurvy.
But now that multiple cases are appearing in a single place, it suggests that either bad choices of diet are becoming more common, or that institutional food programmes are failing. Or that both are occurring simultaneously.
Vitamin C – the life sustainer
Human beings have, in common with a few other species (apes, fish, fruit bats and guinea pigs), an inability to synthesise vitamin C out of their own bodies. Although it contributes nothing to body mass, vitamin C is vital to life: without it death is inevitable. For centuries this was not really a problem, but once the western powers started sailing the great oceans of the earth in search of riches and territory, scurvy became a serious issue for sailors such as Bligh and his mutinous crew on the Bounty. Commanders and administrators who understood the benefit of frequent stops for refreshment, especially oranges, lemons and limes, could alleviate it. But no one discovered the secret of an entirely reliable preventive at sea because it was hard to preserve juice without destroying the crucial vitamin it carried.
Commanders who understood the benefit of frequent stops for refreshment, especially oranges, lemons and limes, could alleviate scurvy. Photograph: Getty/iStockphoto
The illness itself is actually a fairly simple progression. Once the content of vitamin C in blood plasma falls from 40 micromoles to 10, as it did in among diabetics at the Sydney Westmead Clinic, then the body stops producing collagen, the protein that glues us together and ensures our hydraulic systems operate smoothly. Cartilage disappears, hair and teeth fall out, bones weaken, skin bruises as the capillaries rupture, and soon it ulcerates: old wounds and fractures unknit, tendons stiffen and artery walls collapse.
Mucus tissue begins to rot, and come away from bone that is blackened by leaking blood. At the same time brain function is compromised. Vitamin C is an extremely efficient antioxidant that is the first line of defence against potentially damaging waste products generated by normal metabolic activity. It has a number of further functions, such as supporting the production of neurotransmitters such as serotonin and dopamine, the chemical messengers of the brain. Without them, neuronal signalling – feeling and thinking – can be compromised. And so the deficit of the vitamin contributes to the powerful and obsessive fantasies of scorbutic patients (usually of food) that alternate with profound lassitude, likened by one specialist to “a falling down of the whole soul”.
The illness brought on odd effects in the imaginations of victims, as historical accounts show. Tears were very common, even among rugged old tars. The Scottish naval physician Thomas Trotter remarked: “In dreams they are tantalised by the favourite idea; and on waking, the mortifying disappointment is expressed with the utmost regret, with groans, and weeping, altogether childish.” (Observations on the Scurvy, 1792, 44).
This soul hath been/ Alone on a wide wide sea:/ So lonely ‘twas, that God himself/ Scarce seemed there to be
“Our mental sufferings were such as defy description,” wrote Thomas Beale, author of the Natural History of the Sperm Whale and a favourite of Herman Melville, “and nothing but being placed within the same situation could convince those who have not the power to imagine its monotonous dreariness.” The repulsion felt by the eyewitness and the abjection endured by the victim of scurvy combined to make even this narrow band of sympathy uninhabitable. The great ballad of scurvy, Coleridge’s Rime of the Ancient Mariner, explores the radical loneliness of the scorbutic seaman and the impossibility of its story ever being fully told: “O Wedding-Guest! This soul hath been/ Alone on a wide wide sea:/ So lonely ‘twas, that God himself/ Scarce seemed there to be.”
Outbreaks of scurvy on a ship were, according to Captain William Bligh, disgraceful, a sign of bad management, so when his surgeon diagnosed scurvy on the Bounty he promptly had it re-diagnosed as rheumatism. On his 3,000 mile journey from Tahiti to Kupang he could not bear to look at the sick among his crew, whose leaden pallor and sunken eyes made them look like the walking dead.
And when Robert Scott’s company became scorbutic in Antarctica on his first expedition, he was furious with Ernest Shackleton for getting it so badly, and was glad to pack him off home. On the second expedition, when scurvy re-appeared, he said: “The great thing is to pretend that there is nothing to be alarmed at.” He even thought of suppressing any mention of it in his log. On whaleships Herman Melville noticed that scorbutic sailors would hide their symptoms as long as they could, for “sickness at sea is so heartily detested”.
The cause, and the cure, eluded scientists for years. It didn’t help that scurvy was often innocently confused with other nutritional illnesses. The blindness sometimes ascribed to scurvy was owing to lack of vitamin A.
It was not until 1933 that ascorbic acid was finally isolated. Up until that point nobody had been absolutely sure what it was in food that prevented or cured scurvy. Before that date the theories fell into two schools: that scurvy was caused by toxic food, which was false but not possible to disprove; or that there was some virtue present in food independent of its nutrient value – a sap, latex, or nitrous salt – which was true but not provable.
James Lind’s magnificent feat of clinical observation in 1747, when he proved that citrus fruit cured scurvy, was hindered from a full application by his belief that tainted food was indeed the cause of scurvy, and therefore while oranges and lemons definitely operated as a remedy, they could not (according to him) prevent the onset.
This caused Trotter the frustration shared by many historians of this malady when hindsight offers them an unobstructed view of important people making mistakes about its origin and cure. In his Observations on the Scurvy (1792) he cited the paragraph in Lind’s postscript (“I am fully confirmed … that whatever weakens the constitution, and especially the organs of digestion, may serve without any other cause to introduce this disease … even among such as live on fresh vegetables, greens, or the most wholesome diet, and in the purest air”), and added, “This paragraph . . . is one of the most unaccountable that has ever crept into the records of medicine”.
A painting depicting passengers and crew from Manila reaching for oranges and lemons, some antidotes to scurvy. Photograph: Robert E McGinnis/Getty/National Geographic Creative
But even though we have known how to prevent scurvy with absolute certainty for nearly a century, still it recurs and resurfaces because of the ever present trickery of the fact that, as Gunton puts it of November’s outbreak, “It highlights a danger that you can consume plenty of calories yet not receive enough nutrients.” If people feel full, then they believe they are well nourished. This was the very same mistake the brilliant medical men of the 17th century were trying to correct. Very simply; sufficient body mass and malnutrition can co-exist.
If people feel full, then they believe they are well nourished
And still, populations throughout the world are proclaiming their ignorance of this truth. A survey of North American students discovered that 14% of those tested had concentrations in the blood below the medically accepted minimum level for normal health. An average person needs to consume up to 300 milligrams of vitamin C a day to maintain maximal circulating levels and preserve the estimated whole body pool of 1,500mg.
The reality is that we can be scorbutic even before we get bruising and stiff legs. The brain survives longer than any other organ, owing to the additional protection afforded the transport of vitamin C into the cerebrospinal fluid in which it bathes and from which the major brain cells are supplied with the antioxidants they need. But even that citadel will succumb when the level of the vitamin falls low enough.
More work is being done now on conditions such as sepsis, chronic fatigue syndrome, and symptoms of diabetes. But this research pales in comparison with the rise in the consumption of sugar, especially by young people, and the enforcement of recent policies of austerity by western governments. Figures quoted in the Guardian at the same time as the Sydney outbreak revealed that diagnoses of malnutrition in Britain have increased by 44% in the five years to 2015. Ignorance about food among individuals and misguided state policies concerning diets of the young and the elderly: these are the nurseries of scurvy, and always have been.
Jonathan Lamb is Mellon Professor of the Humanities at Vanderbilt University and author of Scurvy, The Disease of Discovery.
With thanks to Professor James May and Professor Fiona Harrison, Vanderbilt University Medical Centre, who helped with the medical aspects of scurvy.
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The government is on course to impose steep cuts in public spending from April and increase taxes by the end of the decade to their highest level as a share of national income since 1986–87 to combat the UK’s persistent budget deficit.
But slower economic growth following the Brexit vote will still leave the UK with one of the largest black holes in public spending in the developed world, meaning the next government must find £40bn to eliminate the budget deficit in the next parliament, according to the Institute for Fiscal Studies.
“For all the focus on Brexit the public finances in the next few years look set to be defined by the spending cuts announced by George Osborne,” said IFS director Paul Johnson.
“Cuts to day-to-day public service spending are due to accelerate while the tax burden continues to rise. Even so the new chancellor may not find it all that easy to meet his target of eliminating the budget deficit in the next parliament.
“Even on central forecasts that is going to require extending austerity towards the mid-2020s. If the economy does less well than hoped then we may see yet another set of fiscal rules consigned to the dustbin.”
The leading tax and spending thinktank said downgrades in GDP growth over the next four years will strain the public finances, which are already on course to be £13bn worse off in this financial year than forecast, after weak growth in tax receipts.
Highlighting the pressure on the chancellor, Philip Hammond, the IFS’s annual assessment of the public finances found that Britain’s ageing population and increasing demands on the NHS will blow a large hole in the government budget over the next two parliaments.
It said: “Demographic and non-demographic pressures are projected to put upward pressure of 1% of national income on health, social care and pension spending by 2025.
“Taking into account possible negative effects from lower growth, the government may need to enact further measures worth £40bn (in 2016–17 terms) in order to eliminate the deficit in the next parliament,” the report said.
Deep cuts in welfare benefits are due to take effect from April alongside cost cutting in Whitehall department budgets. Yet the government still plans to pay for large giveaways in the form of a higher income tax personal allowance at the basic and higher rate and was expected to maintain freezes on fuel duty that totalled £4.5bn a year.
The IFS said the promised spending and slower growth would force the government to implement tougher austerity, even though the chancellor has abandoned his predecessor’s pledge for a budget surplus by 2020.
It said: “Real levels of day-to-day public service spending have actually fallen very little overall in the last three years. The rate of reduction is set to speed up after this year, with cuts of nearly 4% due between 2016–17 and 2019– 20.
“In addition, tax is rising as a share of national income and by 2019–20 is due to reach its highest level since 1986–87.”
It said a deficit in 2016-17 of 3.5% of GDP, or £68.2bn, was £12.7bn higher than the Office for Budget Responsibility, the Treasury’s independent forecaster, had predicted in March 2016.
“This increase was not a result of a downgrade to the forecast for economic growth, but arose as a result of weak growth in tax receipts – in particular, income tax, National Insurance contributions (NICs) and stamp duty land tax – and faster growth in local authority spending,” it said.
Hammond said in the autumn statement last year that he plans to boost public investment spending beyond pre-crisis levels as a proportion of overall public spending, with much of the extra cash to be spent on transport infrastructure.
However, many departments will need to make further savings on day-to-day spending by the end of the parliament.
The IFS said: “Public spending, especially on health, pensions and overseas aid will be higher as a share of national income than in 2007–08, while spending on schools, defence and (in particular) public order and safety will be lower.”
When I decided to fund a TV commercial on Christmas Day, I didn’t realise it would lead to the start of a campaign to ask large businesses to change their approach to charitable giving and support small charities.
Here’s how that came about.
After I was diagnosed with acute myeloid leukaemia, which left me in need of a gruelling stem cell transplant, I spent the best part of 2014 in hospital. While there I benefitted from the amazing work that charities do, so when I left hospital I wanted to give something back.
I not only wanted to give the gift of funding but of awareness. I settled on a Christmas Day TV advert to highlight the work of a specific charity, as well as advertising on product packs. But when I approached some of the UK’s leading charities, I was shocked to be made to feel as if I had to prove myself and my brand to earn their approbation. Sadly I was too small for them, and they were too big to care.
Wilfred Emmanuel-Jones. Photograph: The Black Farmer
The experience made me look beyond these big, well-known charities to the smaller ones doing extraordinary work on a shoestring. They are overlooked when it comes to big corporate giving but their work is just as important, if not more so. I vowed then and there to do something to help.
I have written and directed a two-minute TV commercial (with no mention of the products I sell) and have secured a prime time spot on Channel 4 on Christmas Day, timed to air just after the Queen’s Christmas broadcast. This is the advert I wantto use to shine a light on these small-time heroes.
I approached a small, Tetbury-based national charity called Hope For Tomorrow, which works tirelessly to provide mobile chemotherapy units to local NHS Trusts so patients don’t have to travel for hours for treatment. The charity leapt at the chance to work with me because such opportunities to raise awareness of their work don’t come their way often, and I was thrilled to be involved with such a great cause.
But I was shocked by the huge gap between big and small organisations in the charity sector. The larger charities get the lion’s share of corporate giving, leaving the smaller ones scrabbling for scraps.
This is a flaw in the charity sector, and much of the problem comes from an unbalanced relationship with business. Large organisations mainly work with large charities that already have a global level of awareness. It’s almost as though businesses are glory hunting when it comes to charity partnerships, to the detriment of smaller charities.
I have launched a campaign calling for large corporations to support small charities and shout about the ones they are already supporting. So whatever your cause, please sign my pledge and help to make a change this Christmas.
I have also dedicated a page on my Black Farmer website to help businesses and small charities find each other. As businesses, it’s important to show that we care for bigger things than just the products we sell.
Talk to us on Twitter via @Gdnvoluntary and join our community for your free Guardian Voluntary Sector monthly newsletter, with analysis and opinion sent direct to you on the first Thursday of the month.
When I first discovered I had breast cancer, I felt shocked and afraid. I thought maybe there had been a mistake. I was 52, and didn’t have any symptoms: there were no lumps, just what I thought was a cyst under my armpit. I’d gone to hospital to get it checked, and had a mammogram and biopsy.
A week later I received several calls from the doctor, which I didn’t respond to until a voicemail asked me to come in. This was over the holiday period, and I went with a family member who herself had gone through a recent diagnosis and treatment for breast cancer and understood the process. That’s when they told me I had stage two cancer. I remember thinking that this couldn’t be right. I’m healthy and fit, and play a lot of sports.
I believe black women are less likely to go for screenings because the prevention work is not targeted at us
As a black woman, breast cancer wasn’t something I had received much information about. No one in my family had had it, and I don’t remember learning about it in school. When you pick up a breast cancer leaflet you tend to see a white woman staring back at you. I never saw it as an issue that specifically affected me.
But, of course, it does. In fact, new analysis shows that black women in England are twice as likely to be diagnosed with advanced breast cancer as white women. This is for many reasons, including possible differences in tumour biology, low awareness of symptoms and screening, and barriers to seeking help. In my community here in Leeds I know two women who have lost their lives to breast cancer, one of them only 49 years old.
I believe black women are less likely to go for screenings because the prevention work is not targeted at us. It would be great if larger charities made sure that their messaging reached women of colour.
There are charities working with black communities already, such as Black Health Initiative (BHI), but we need help spreading the message. BHI has a national cancer programme – BME Cancer – which launched in the House of Commons in 2014 and addresses the disparities within cancer among diverse communities. This kind of outreach and awareness cannot be time-limited; we need to keep going until it’s clear everyone is getting the message. After all, many from these communities support the national cancer fundraising drives, such as Stand Up To Cancer, Macmillian’s Coffee Mornings and Race For Life. Let’s be deliberately inclusive rather than accidentally exclusive when it comes to tackling inequalities. We have enough evidence to show it’s time for action.
My journey taught me to be more open and talk more. I had a mastectomy, reconstructive surgery, chemotherapy and three weeks of radio therapy. My treatment involves being on a drug for five years. I also have a mammogram every year. On being diagnosed, I felt a tinge of sadness, not knowing who to tell. But then I found some great support here in Leeds among other black women. It helped me get through some difficult days. It’s so comforting knowing that you’re not alone and that someone else is going through the same journey as you. We are able to share stories and talk, hold each other’s hands and raise awareness.
Only last week someone approached me, as they had to go for a mammogram and didn’t know what was going to happen. I gave them just a brief description of my experience, as I didn’t want to instil fear in them, but it was good to be candid and open. I hope I helped reassure them.
I just wish there was more awareness nationally. If the government, charities and those who hold the financial pot through fundraising do not recognise a need for inclusion when it comes to breast cancer awareness, then black women will continue to die at a higher rate. It’s as simple as that.
Black women in England are more likely to get advanced breast cancer than white women, new analysis by Cancer Research UK and Public Health England shows.
It was concluded that late-stage disease affected almost twice as many black women (22% of black African women and 22% of black Caribbean women) than white women (13%).
Experts say this is for many reasons, including possible differences in tumour biology, low awareness of symptoms and screening and barriers to seeking help.
While spotting the disease early is key, Heather Nelson of BME Cancer Voice, said in an interview with the BBC: “Women of colour are less likely to go for screening.
“You’ll get leaflets through your door and they will be predominantly of white, middle-class women. There’s no representation of South Asian, African descent et cetera.
“If you get information like that, you’re going to look and think, ‘That’s not about me.’”
One woman said to the BBC: “A lot of us black people bury our head in the sand: ‘Oh, me, well, I don’t need to go, there’s nothing wrong with me.’”
But lots of work has taken place around breast cancer prevention. In October, the international community celebrated Breast Cancer Awareness Month. The pink ribbon has become a symbol to express moral support for women with the disease.
So, why is this work not reaching everyone? If you’re a black survivor of breast cancer, we want to hear your thoughts. When did you find out you had cancer and what has your experience been? What do you think of the prevention messages available? Does it talk to a diverse range of communities? Why do you think that black women are less likely to go for screening?
Black sesame seeds are known for its fabulous nutritional profile and they are rated as the world’s healthiest foods. Sesame seeds contain an important phyto-nutrients such as omega-6 fatty acids, flavonoid, anti-oxidants, vitamins, and dietary fiber with potential anti-cancer as well as health promoting properties.
The black sesame seed may be small, but it is a powerful food. The nutrients found in sesame seeds may contribute to cardiovascular health, reduce inflammation, support respiratory health, protect against colon cancer and osteoporosis as well as other conditions.
7 Healthy Reasons to Eat Black Sesame Seeds
Relieves Arthritis
The high copper content in black sesame seeds helps in reducing pain and swelling associated with arthritis. In addition, this mineral keeps your bones and joints flexible and healthy.
Improves Eye Health
As per traditional Chinese medicine, eyes are closely related to liver healthy. When liver is affected the eyes become tired and dry and vision may become blurred. Black sesame seeds are a natural tonic for liver, which in turn is believed to nourish and support eyes’ function.
Prevent Cancer
Black sesame is the one that have the highest phytosterol content among all seeds, which is inevitable in the fight against severe disease such as: leukemia, multiple myeloma, colon cancer, lung cancer, beast cancer, etc.
Prevents Anaemia
One cup of black sesame seeds contains about 20 mg of iron, which is about 115% of your daily recommended intake of iron, the mineral that is essential for transporting oxygen around your body.
Prevent Osteoporosis
Eating black sesame seeds regularly, provides you with good intake of zinc and calcium, both minerals that are needed by the body for good bone health.
Reduce High Blood Pressure
Black sesame seeds have been proven to be an effective way to reduce blood pressure. They contain a high concentration of magnesium, a compound that can actively reduce hypertension.
Anti-diabetic
Black sesame seed is one such condiment which possesses anti-diabetic properties. As sesame seeds contain magnesium and other vital nutrients which improve the plasma glucose in hypersensitive diabetic patients.
Black communities in London are disproportionately more likely to breathe illegal levels of air pollution than white and Asian ones, new research seen exclusively by the Guardian shows.
The study for the mayor of London shows black, African and Caribbean people account for 15.3% of all Londoners exposed to nitrogen dioxide (NO2) levels that breach EU limits, but they account for just 13.3% of the city’s population.
The proportion of white and Asian individuals exposed to the dangerous NO2 levels is lower than the fraction of the population they account for, said Aether, the consultancy which produced the report.
Southwark, Lambeth and Hackney were among the boroughs with an overlap of both a higher proportion of black residents and
other’ ethnic groups are more likely to be exposed to above EU NO2 limit value concentrations than those in areas with a high proportion of white people,” said the Aether study. “This effect is not seen for areas with a high proportion of Asian groups.”
pollution graphic
But because of the “very mixed ethnic geography of London”, the pattern is less strong between ethnicity and exposure than the one between deprivation and exposure, Aether found. In areas with poor air quality, 32% of people living there were from the most deprived groups, versus 7% from the least deprived.
“This research shows the disproportionate impact air pollution has on deprived communities in London,” said Aether’s director, Katie King.
“We have known for some time now that poor families end up living in cheaper housing which is often in close proximity to busy roads,” said a spokesman for the air quality unit at King’s College London.
However, he said the new study’s use of proportionate data was misleading, as in absolute terms there are more Asian and white people exposed to high NO2 levels.
Last month, the Black Lives Matter UK group linked ethnicity and environmental issues during a protest at London City airport – although the protestors were also criticised for their largely white membership.
The study compiled King’s data on NO2 concentrations in 2013 – the most recent available – census results, official statistics on deprivation and ethnic profiles of small areas in London. In total, 1.9 million people in London were exposed to NO2 concentrations above the EU’s annual average limit.
The work is an update of a report which the former mayor Boris Johnson was accused of burying when Khan took office. That earlier report showed 433 primary schools were exposed to NO2 above the limits in 2010, with that number falling to 360 by 2013 in today’s study, showing some areas have got cleaner.
Transport for London (TfL) published a consultation on Monday seeking Londoners’ views on Khan’s new measures to tackle the problem. They include whether to introduce a £10 emissions surcharge in October 2017, the so-called T-charge, which will mostly apply to pre-2005 diesel cars.
Khan and TfL are also consulting on whether to bring in an enlarged “ultra low emissions zone” (Ulez) in 2019 rather than 2020 as previously planned, charging owners of dirtier cars £12.50 to enter. Both charges will be in addition to the existing £11.50 congestion charge.
“Toxic air in London is a health emergency that requires bold action, including introducing charges for older polluting vehicles and expanding the Ulez,” said Khan.
Environmental groups and thinktanks welcomed the proposals, but Friends of the Earth said the mayor needed to go further.
“To bring down London’s air pollution as quickly as possible, Sadiq Khan must extend the Ulez for all vehicles across the whole of London; and create a plan for phasing out diesel on London’s roads altogether,” said Sophie Neuburg, a campaigner at the green group.
Next week the government faces a court case brought by environmental law firm ClientEarth over what it says is an inadequate plan to reduce NO2 pollution.
“Today’s announcement sends a clear message to the government that it needs to get a grip with this public health crisis. This is a national problem that needs a national solution. That is why we are taking them back to court next week,” said Alan Andrews, a ClientEarth lawyer.
There’s a scene in BBC2’s A World Without Down’s Syndrome?, which airs tonight, in which Sally Phillips, Bridget Jones’ Diary actor and mother of a son with Down’s, shows a video of a disabled girl competing at a gymnastics competition to a woman who chose to end her own pregnancy. The interaction isn’t designed to guilt the woman who made a different decision – Phillips is an empathetic presenter and describes herself as pro-choice – but it is a snapshot of how the conversation around disability and abortion is routinely set up: one woman’s choice versus another’s.
We see this in articles praising women who choose to have their child despite the fact a foetal abnormality has been detected, often asking other female readers: what would you do? Or the tone of news items in which women express doubts or fears about raising a disabled child. Katie Price was described as having “confessed”when she said she probably would have had an abortion if she’d known her son Harvey was going to be severely disabled, as if the thought, let alone the act, was a heinous crime.
On the other hand, I’ve seen women with disabled children – and disabled people themselves – be asked incredulously (often by complete strangers) why an abortion wasn’t chosen. Such attitudes are particularly alarming in a climate where disabled people are increasingly perceived as a costly burden to the state.
When it comes to disability and pregnancy, we are routinely stuck in this sort of black-and-white dichotomy: having a disabled child is said to be a tragedy or inconvenience that should always be avoided, while women who do choose to abort a foetus with abnormalities are vilified as “shallow” and “selfish”. Neither is accurate nor addresses the issues that really matter.
The truth is there is still considerable prejudice around disability. We live in a culture where disabled people’s lives are often said to be worth less, and difference is equated with failure or negativity. Even Paralympians are described in some media reports as “suffering” from their disability. It’s not alarmist to accept that the way as a society we understand disability can directly impact on how individuals feel about bringing up a disabled child.
Medical professionals – the very people pregnant women rely on – are not exempt from spreading such attitudes. Phillips has spoken of the way that, after her son was born with Down’s, her doctor broke the “bad news” and the nurse cried. (Her child’s disability wasn’t detected during pregnancy.)As the NHS looks set to introduce a more effective screening for Down’s syndrome, it’s a valid moment to question how we view disability as a society, and to accept that women, and of course men, deserve accurate information in order to make an informed decision.
But in doing so, we should be vigilant of how quickly this conversation can be derailed. It is an ongoing strategy of anti-choice groups to hijack disability, generally as a way to reduce women’s reproductive rights. This sort of faux concern tends to be less about disabled people’s equality and more about women’s inequality. (And though we’re often cut out from the discussion, disabled women can be the ones who are pregnant.) Days before Phillips’ documentary was even set to air, the Mail used it as an opportunity to run an article claiming women “are being pressured to abort babies” with Down’s.
And yet anti-choice campaigners and media organisations who purport to wish to “protect” disabled foetuses tend to be very quiet – or in the Mail’s case, very vocal – about the support disabled people should receive once they are out of the womb. Raising a child with a severe disability can be exhausting and difficult, as well as wonderful, and this is much harder when the state cuts play centres for disabled children, respite care and transport. Phillips herself admits she was lucky to be able to afford to hire a live-in nanny to help with her disabled child, an advantage women on low incomes struggling alone can only imagine.
And we need to talk about that too, if we are going to really have this discussion. We need to admit that things such as economic and gender inequality, as well as perceptions of disability, impact on our supposedly free choices. And we need to argue for positive change, such as more government support for disabled children (and adults), and more inclusion of disabled people in all parts of society.
As we all know, life, let alone disability or raising children, is not black and white but rather filled with multiple shades of grey. I hope Phillips’ documentary starts a long overdue and nuanced conversation. Both women and disabled people deserve better than simplistic judgments.
It’s 6.45am at Camden ambulance station in north London, and the day shift is just beginning. Andy Donovan, who will drive the ambulance I will accompany for the next nine hours, is making me a cup of tea. His more senior paramedic partner, Dean Lowes, is running a few minutes late. When he does arrive, Lowes looks very sorry for himself: he’s got an ear infection, picked up on a friend’s stag weekend in Budapest. Lowes is the ambulance’s first case of the day. They nip off to the nearby Royal Free hospital in Hampstead to get some ear drops. Paramedic, heal thyself.
All this delays us for more than an hour, and we’re not ready to “go green” – telling the London ambulance service’s call centre near Waterloo station that they are available for a job – until after 8.30am. Lowes, who along with Donovan is featured in the BBC’s new three-part series on London’s overstretched ambulance service, is suitably embarrassed. “This never happens to me,” he says. “I’m never ill.” But full marks for at least getting here. Crewing an ambulance is challenging at the best of times.
Soon after going green, our first assignment comes in, flashing up on a monitor at the front of the ambulance. It’s just about as unpleasant as it could be. One word: “HANGING”, and the location. It is a “Red One” – the top-priority call sign, meaning life-threatening. Lowes and Donovan’s speed of reaction is electrifying. One moment, Lowes had been playing a Kings of Leon track on his mobile and saying how much he liked the band; the next, the ambulance is tearing south towards King’s Cross.
The call comes through at 8.49, and we get to the scene five minutes later. My heart sinks when I realise it is student accommodation. Two policemen are arriving simultaneously, and we all head up two floors in the lift to a stuffy, antiseptic white corridor. I go up with the policemen, who are bemoaning the fact their car was the closest to the scene. “You had a feeling it was going to be a funny day,” one says to the other. “You said you had a feeling in your bones.” “Yeah,” says the other with a grim laugh, “I should shut the fuck up.” In situations like this, black humour is sometimes the only way out.
Lowes, as senior paramedic, is first into the little study-bedroom. He has to decide if the student, who appears to have hanged himself, is dead, or, in the official language they use, to declare “life extinct”. It takes him just moments to satisfy himself that he is. The student is pronounced dead at 8.57. I can’t bring myself to look at the body – the young man is fully clothed – for too long. What strikes me most is how peaceful he looks, and how red his hands are – the blood drains down to the hands and feet, a sign he has been dead for several hours.
Within minutes there are half a dozen police on the scene, taking a statement from the traumatised fellow student who discovered the body, talking to the staff in the hall of residence, looking through the young man’s possessions to establish his identity. It has ceased to be a medical emergency and become a police inquiry – and a personal tragedy for the family who do not yet know what has happened. It appears the young man, who was 23, was anxious about a dissertation he had failed to deliver. What a terrible, pointless waste.
This is a shocking beginning. A suicide by hanging is rare. It is the first Lowes has witnessed. “He looked like a wax dummy,” he says as we wait downstairs while he does the paperwork to certify the death. “It’s when you see his passport and the picture of how he looked when he was alive that it hits you. That humanises it.” Having been a body, he becomes a person. “I try not to look at a dead person’s effects too much,” says Lowes, “because you start to build a little story about them.” “You can’t go into it too deeply,” adds Donovan. “There’s a lot of stuff you lock in the box.”
A paramedic team leader turns up. He doesn’t say so, but Lowes and Donovan know he is there for their welfare – to make sure that having to deal with the young man’s death has not affected them too severely. “If you want to take a bit of a break, that’s fine,” the team leader tells them. They don’t particularly, although they do have a fag standing next to their ambulance. The morning is hot, and people stroll past the student block, laughing in the late-summer sunshine, not realising that inside a promising young life has been extinguished.
By 11am, they are ready to roll again. They go green, pressing the button that declares the ambulance available, and in a second – literally – their next assignment flashes up. It’s another Red One – a cardiac arrest in West Hampstead, a couple of miles to the north. The siren screams, I lurch around in the back of the ambulance feeling sick, and Donovan swears at the vehicles that block his way, costing him vital seconds that could mean the difference between life and death.
Call handlers at the emergency operations centre in Waterloo. Photograph: Glenn Dearing/BBC/Dragonfly
The job is undeniably exciting, or at least seems so to me. Horrible, of course – no one wants to discover dead bodies – but also fascinating because of its unpredictable nature. You have no idea where you will go next or what you will have to deal with. “That’s the beauty of it,” Donovan had told me earlier. “You never know what you’re going to from job to job.”
It’s like roulette, I suggest, and he tells me that is exactly what they call the last job of the day. If you go green with, say, half an hour left of your shift, the call centre will play “red roulette”. Instead of giving you a less urgent call (categorised from C1 to C4, depending on the degree of seriousness), they will give you something life-threatening. It seems mad, but the logic is that whatever you do is likely to take hours – every callout seems to generate a mountain of paperwork – so you may as well go to something that is worth your while. A practical, if heartless, way of looking at it. Paramedics often work 12-hour shifts, and I can’t imagine what it’s like to get a final Red One at the very end.
We get to West Hampstead in about six minutes. Another ambulance is already on the scene, as well as team leader April Barter, who has come by car. I bumped into her earlier at the ambulance station in Camden, and she was complaining about having nothing to do that morning. Now she has something to do. A man in his 60s has had a cardiac arrest – a heart attack in which his heart has stopped completely – and the struggle is on to save him.
The man is lucky. I hadn’t realised where we were when we arrived, but then it dawns on me – it’s a bridge club, and dozens of middle-aged and elderly card players are watching the paramedics’ attempts to revive their fellow participant. Even before the first crew arrived, some medically trained members of the club had starting giving him CPR (cardiopulmonary resuscitation), that pounding of the chest that aims to kick the heart back into action. Without their prompt action, he would be dead. The paramedics continue the CPR – by now his chest looks as if it has caved in, but apparently this is quite normal – and administer defibrillation, an electric shock designed to correct his heart rhythm.
After half an hour of attention, his heart is functioning again and he can be taken to hospital. He is still unconscious, but has a reasonable chance of surviving. His bridge partner, who tells me they had just played a very successful rubber, offers to go to hospital with him, while his wife is given the news at home. There is an impressive calm at the club as the man is carried out. Who knew bridge could be an extreme sport – or bridge players so unflappable?
A cardiac arrest involving two crews generates an especially large volume of paperwork, and we are stuck outside the Royal Free for more than an hour while all the forms are filled in. Soon after we deliver the man to the hospital’s heart centre, Barter tells me he has regained consciousness. “The fact he’s awake, his eyes are open, he’s moving around tells us his brain has more oxygen. Although potentially it has been starved of oxygen for a short period of time, that’s a really positive sign and it’s a potentially good outcome for him. That’s a massive lift for us. Good times.” She says she is “buzzing”. “If I can make a difference to one person in a day, then I go home happy,” Donovan told me earlier. It looks as if he and his colleagues have made that difference today.
It is that difference, rather than the material rewards of the job, that attracts Lowes and Donovan. “You don’t do this job if you want money,” says Lowes, who is 37 and comes from the north-east of England. “It has other benefits. You go home and you sleep at night. You don’t take any work home with you. You might take some kind of emotional stuff away at the end of the day but, as far as the working day is concerned, once you’re finished, you’re finished.”
Lowes, who is a fully qualified paramedic, tells me he earned £36,000 last year. Thirty-year-old Donovan, a friendly, buoyant east Londoner who is one rung below his partner in terms of clinical qualifications, says he earns £20,000 a year basic, which rises to about £28,000 with the inner-London allowance, rest-break compensation (they will typically work through their breaks) and overtime, lots of overtime. They are contracted to work 37-and-a-half hours a week, but can do up to 56. Without the overtime, they would struggle financially. The staff need the relentless pressure on the service to earn enough to live.
The upside, apart from the drama of the job and the satisfaction of saving lives and helping people at moments of crisis, is the flexibility. “There are a lot of other things out there that I wouldn’t want to do, sitting behind a desk being one of them,” says Donovan. “At least in this job you’ve got a little bit of freedom. Once you’re out on the road, you’re your own boss.”
While the paperwork for the cardiac arrest case is being done, I talk to Gary Nicholls, one of the paramedics in the first crew to arrive. He has clocked up almost 24 years on the job – Lowes and Donovan have each done seven. “You never know what the next call is going to be,” he says. “That’s what keeps us interested. But it doesn’t matter what comes down on the screen, we can always deal with it. The workload can be relentless, but your colleagues are there to get you through the shift.”
The London ambulance service was put into “special measures” last year because of a number of failings, including staff shortages, poor response times, lack of leadership and concern that the service was ill-prepared to deal with a major terrorist attack. The cynic in me thinks the BBC series – and my ride in the ambulance today – are part of the PR fightback, and maybe they are, but there is no doubting the commitment of the dozen or so paramedics and backup staff I meet. This is a service under pressure, but by no means one that has lost heart. Nicholls really does believe they can deal with anything, including his first job that day – chasing a naked man who it was feared was high on drugs across Hampstead Heath.
It is already well past 1pm. The complexity of the jobs, the paperwork and the fact that you need a bit of a breather mean crews will only do four or five callouts in a nine-hour shift, and six or eight in a 12-hour one. Just before 1.30pm, Donovan and Lowes go green again. This time it’s a Red Two – slightly less urgent but still potentially life-threatening, a woman in Kilburn with chest pains and breathing problems.
She is sitting on the stairs of her house when we arrive six minutes later. She looks remarkably well, and within about two minutes of arriving Lowes has diagnosed an anxiety attack. She had a heart bypass operation five years earlier, and clearly fears a heart attack. She has already been to hospital for a checkup that day, and now wants to go back, despite getting the all-clear earlier. It is unlikely there is a serious problem, but Lowes and Donovan can’t take any chances, so take her to the Royal Free. It’s not their most productive couple of hours, but they talk to her respectfully, calm her down, deliver her to A&E and fill in a fresh set of forms.
It’s now 3 o’clock, and we’re on our way back to Kilburn. This time they’ve received a less urgent C2 call, after an earlier Red One to another fatality was aborted. The monitor in the ambulance advises “man in his 70s with severe behavioural change”. When we get to the flat, we find an elderly man close to collapse – probably through dehydration – and his wife at the end of her tether. She thinks he has undiagnosed dementia, and there are suggestions he can be violent towards his family, though today he can barely raise himself from the sofa.
It is an example of the social work side of paramedics’ work. They check him over physically, but he is in reasonable shape apart from the dehydration. What he may need very soon is a place in a care home. That is the shadow that falls across the conversation Lowes has in the corridor with the man’s wife – the sad but all-too-common conclusion of a 50-year marriage – while Donovan talks to the man’s son about sport.
As their appearance in the BBC series shows, they are very good at being de facto social workers, counselling the anxious, the elderly, the confused, the demented. “When I first started this job, going into people’s homes took a bit of getting used to,” says Donovan, “but because you’re wearing a uniform, in the eyes of the public you’re a goodie. You’re welcomed into most situations, whether it’s for social reasons or for emergencies.”
Lowes calls the man’s GP, who promises to come round. For the moment, there is nothing more that can be done. More paperwork and another cigarette in the afternoon sun. The shift is drawing to a close, and the crew do not fancy any red roulette. There is a general callout for an ambulance, any ambulance, to go to Victoria station, where a girl has fainted. They decide it’s too far and head back to base. That’s enough excitement for the day.
As we drive back to Camden, their monitor is reporting that University College hospital has been temporarily closed, St Mary’s in Paddington is accordingly under severe pressure and the Royal Free is “breaching” – A&E is missing its waiting targets and patients are being left in ambulances longer than they should be. It’s going to be quite a night shift, and Lowes and Donovan are happy to be out of it. But tomorrow they will be back, and who knows where the spin of the roulette wheel will take them?
Ambulance starts on BBC1 at 9pm on 27 September.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
The epidemic of Alzheimer’s takes an enormous toll. The disease ravages the brain, robbing people of memory and awareness, and disconnecting them from those they love. And it’s increasing: according to the Alzheimer’s Association, Alzheimer’s is now the 6th leading cause of death in the U.S. Some 5.4 million Americans now suffer from it, affecting millions of households. But the race to find treatments is uncovering many promising new developments, including black currants. The powerful antioxidants in these tiny, dark berries may help slow the disease’s damage, and prolong lives.
An Assault on the Brain
Of all the dementia cases in the U.S., Alzheimer’s accounts for some 80 percent. The disease results in badly reduced mental abilities and tragic, debilitating memory loss. Researchers have linked Alzheimer’s to abnormal clumps in the brain, known as amyloid plaques, and tangled bundles of fibers called neurofibrillary tangles. The specific role these plaques and tangles play in the disease is not entirely known. But scientists believe they help block communication among nerve cells and disrupt the vital processes those cells need to survive. The death of these nerve cells is what causes the devastating symptoms of Alzheimer’s.
Protection in Black Currant Extract
What makes black currant so promising in the fight against Alzheimer’s is its concentration of potent anti-oxidants. These anthocyanins may help prevent the degradation of blood vessels and Alzheimer’s-related dementia. Cholesterol build-up in the walls of blood vessels causes a reduced flow of blood to the brain, which can cause vascular dementia.
Researchers presented a promising paper to the American Heart Association, showing that anthocyanins from black currant extract may have beneficial effects. A membrane-enriched black currant extract, supplied by Iprona AG under their BerryPharma brand, was tested for its effect on the arteries. The study compared the effects of the extract to the effects of a placebo. The extract helped improve flow, and resulted in a decrease of the plaques associated with the disease.
Reducing Protein Levels in the Brain
A study on mice with Alzheimer’s disease was recently published in the Journal of Nutritional Biochemistry. Researchers fed one group of mice anthocyanin-enriched bilberry and black currant extracts, and the other group a control diet. As a result, the mice fed the extracts showed far lower brain protein levels than the mice fed the control diet. These proteins — called asamyloid precursor proteins (APP) — are thought to be a key risk factor for Alzheimer’s. The mice who were fed the extracts also showed far less spatial memory loss than the mice fed the control diet.
Delaying the Damages of Aging
Tufts University research, published in the Journal of Alzheimer’s Disease, studied the effects of high-antioxidant fruits on oxidative stress in brain cells — another factor linked to risk of Alzheimer’s. The study found that these fruit extracts (such as black currant, boysenberry, cranberry, strawberry, dried plum, and grape) had a strong protective effect. It was noted that the high levels of anthocyanins and polyphenols in dark berries may help protect aging brain cells, slowing the onset of Alzheimer’s.
A Traditional Cure
Black currant has long been a traditional cure, used to treat digestive ailments, colds, and flu. Black currant seed oil is an increasingly popular anti-inflammatory. But now it’s clear that this little berry may also help fight the devastating effects of cognitive decline. We’re learning more about ways to help stay healthy as we age, including the importance of keeping our minds and bodies busy. We’re also learning about the power in natural ingredients. By midcentury, reports the Alzheimer’s Association, someone in the U.S. will develop the disease every 33 seconds. The news that black currants hold so much potential is promising indeed.
We know that pain thresholds vary from person to person – one person’s nudging inconvenience is another’s unbearable distraction – but the colour of your skin, in the US at least, can be a factor in deciding whether or not you receive pain medication.
New research from the US shows that black patients who arrive at emergency rooms complaining of back or abdominal pain are significantly less likely to be given opioid painkillers, such as codeine, than their white counterparts, even when pain levels and insurance coverage are the same. Pain is the most common reason Americans visit the ER, and the researchers in Boston looked at five years’ worth of records across the country for patients who had complained of general pain with an unclear cause.
This effect has been found across healthcare settings – black children with appendicitis are significantly less likely get any painkillers for moderate pain or opioid-type drugs for severe pain. Doctors from the University of Pennsylvania reviewed 20 years’ worth of studies in 2012 and found the same, calling this “the treatment gap”. The review’s lead author, Dr Salimah Meghani, says that to stop the disparity, doctors need to be educated about its cause, and this is most likely unconscious bias. The problem, she says, “may be addressed by helping health providers identify their blind spots”.
In April, another study found that half the white medical students surveyed believed at least one false statement about black people having “thicker skin”, “faster-coagulating blood” or “less sensitive nerve endings”. Medics who believed one of these facts also rated black pain lower when viewing case studies. Authors of this research believed it was down to these entrenched ideas about “biological differences” between races that may be informing doctors’ decisions on when to prescribe.
Dr Austin Leach, a pain medicine consultant who serves on the council of the British Pain Society, says there is no biological reason for different prescriptions. “Physiological studies suggest that pain perception is the same across ethnicities,” he says, adding that there is no evidence that this happens in the UK. Some races are predisposed to certain illnesses – the rate of strokes for African Americans is double that of the country’s white population – but the treatment of pain should be the same.
In this latest study, researchers claim that a particular type of unconscious bias – assuming that black patients are abusing meds – is to blame, despite the fact that opioid abuse is more prevalent in white communities.
The study’s lead author, Dr Astha Singhal, a professor at Boston University, says the key point is that they found a discrepancy only in vague pain-related conditions, commonly associated with drug-seeking behaviour, rather than conditions with obvious causes, such as bone fractures. “While the disparity we found is surely not a good thing, it might have indirect advantage to the black patients of minimising their exposure to opioids,” she says.
The theory that black communities are being “shielded” from opioid addiction by not being prescribed the drugs in the first place is a controversial one. Other studies have shown that diagnosis of issues from back pain to cancer is slower for black patients. The line is unclear to many doctors, including Singhal. “It raises the question – is it still an advantage if the cost is bearing untreated or undertreated pain?”
We know that pain thresholds vary from person to person – one person’s nudging inconvenience is another’s unbearable distraction – but the colour of your skin, in the US at least, can be a factor in deciding whether or not you receive pain medication.
New research from the US shows that black patients who arrive at emergency rooms complaining of back or abdominal pain are significantly less likely to be given opioid painkillers, such as codeine, than their white counterparts, even when pain levels and insurance coverage are the same. Pain is the most common reason Americans visit the ER, and the researchers in Boston looked at five years’ worth of records across the country for patients who had complained of general pain with an unclear cause.
This effect has been found across healthcare settings – black children with appendicitis are significantly less likely get any painkillers for moderate pain or opioid-type drugs for severe pain. Doctors from the University of Pennsylvania reviewed 20 years’ worth of studies in 2012 and found the same, calling this “the treatment gap”. The review’s lead author, Dr Salimah Meghani, says that to stop the disparity, doctors need to be educated about its cause, and this is most likely unconscious bias. The problem, she says, “may be addressed by helping health providers identify their blind spots”.
In April, another study found that half the white medical students surveyed believed at least one false statement about black people having “thicker skin”, “faster-coagulating blood” or “less sensitive nerve endings”. Medics who believed one of these facts also rated black pain lower when viewing case studies. Authors of this research believed it was down to these entrenched ideas about “biological differences” between races that may be informing doctors’ decisions on when to prescribe.
Dr Austin Leach, a pain medicine consultant who serves on the council of the British Pain Society, says there is no biological reason for different prescriptions. “Physiological studies suggest that pain perception is the same across ethnicities,” he says, adding that there is no evidence that this happens in the UK. Some races are predisposed to certain illnesses – the rate of strokes for African Americans is double that of the country’s white population – but the treatment of pain should be the same.
In this latest study, researchers claim that a particular type of unconscious bias – assuming that black patients are abusing meds – is to blame, despite the fact that opioid abuse is more prevalent in white communities.
The study’s lead author, Dr Astha Singhal, a professor at Boston University, says the key point is that they found a discrepancy only in vague pain-related conditions, commonly associated with drug-seeking behaviour, rather than conditions with obvious causes, such as bone fractures. “While the disparity we found is surely not a good thing, it might have indirect advantage to the black patients of minimising their exposure to opioids,” she says.
The theory that black communities are being “shielded” from opioid addiction by not being prescribed the drugs in the first place is a controversial one. Other studies have shown that diagnosis of issues from back pain to cancer is slower for black patients. The line is unclear to many doctors, including Singhal. “It raises the question – is it still an advantage if the cost is bearing untreated or undertreated pain?”
I was only recently made aware of some startling statistics: one in four black men will be diagnosed with prostate cancer in his lifetime; one in 12 will die from the disease. This is double the risk faced by white men in the UK.
Perhaps even more concerning is the fact that 86% of black men are oblivious to the heightened threat prostate cancer poses to their health, putting thousands in danger of being diagnosed at a late stage when treatment options are limited.
The prostate gland is an important component of the male sex system, but 92% of black men don’t know what it does, 62% don’t know where it is and nearly one in five is unaware he even has a prostate.
As a black man, I find these statistics worrying, especially as prostate cancer is a disease that can be successfully treated if caught early enough. Men over 50 and men with a family history of prostate cancer also face a higher than average risk of the disease.
Related: What 12 Years a Slave tells us about 21st century black mental health
What can we do to make sure more black men understand the added danger they face and take the necessary action that could save their lives?
Although increasing awareness is obviously a vital priority, health professionals can play a crucial role as well. Black men not only face an increased risk of prostate cancer, they are also more likely to develop the disease at a younger age. The PSA blood test is the first step men can take to identify whether anything might be wrong with their prostate; however the test is riddled with complexities and there is still a lot of confusion among GPs as to who is entitled to the test and from what age. Some remain unaware that black men face a higher than average risk and there are a number of black men who report being denied a PSA test from their GP.
The charity Prostate Cancer UK has recently produced a set of consensus statements from a panel of independent clinical experts to help GPs use the PSA test more effectively. As part of this, experts recommend that all men should be able to access PSA testing from the age of 50, but men at higher than average risk of prostate cancer (including black men) should be able to access the test from age 45.
Related: Black men face inequalities in cancer care
My constituency, Streatham in Lambeth, has one of the highest black populations in the country, which is why this issue is so important to me as their MP. I want to make sure that all GPs, not only in my constituency but across the UK, help to raise awareness of the increased risk of prostate cancer in black men and have the knowledge to initiate these important conversations with the community.
Although we still don’t know why black men face a higher than average risk, my message is clear: with one in four black men being diagnosed with prostate cancer, it is up to us in the community to act. Please speak to your dads, uncles, brothers and friends and make sure every black man over the age of 45 is wise to the risk we face. Don’t let people die from embarrassment. Ignoring prostate cancer won’t beat it.
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Are you happy living in Bilston? “Why wouldn’t I be?” giggles a young mother pushing a stroller through a pub car park on the Stowlawn Estate.
My question is not as daft as it sounds. Seventy-one years ago, this corner of the Black Country town was part of a pioneering social experiment, devised by exiled Viennese philosopher Otto Neurath and a visionary town council, to “make Bilston happy”.
Today, the happiness industry is a lucrative business. In recent years we’ve had a government happiness tsar, and bookshelves groaning with bestsellers including Stumbling on Happiness, The Secrets of Happiness, and The Pursuit of Happiness.
But Bilston got the jump on them all in 1945 when it invited Neurath, then lecturing in Oxford, to become its consultant on human happiness. The hope was he could bring a visionary approach to housing to Bilston, as he had done to the rebuilding of post-war Vienna.
Heaven knows, Bilston needed something to cheer it up. “Surely no place could have grown up as ugly as this without some evil mind having deliberately planned to wipe out every trace of beauty,” wrote socialist politician Fenner Brockway about this town of more than 31,000 people in 1932, in his book Hungry England.
Brockway was visiting the Black Country town, scarred by years of coal mining and pollution from blast furnaces and factories, to see its notorious slums. “I find it difficult to describe the first house I visit. It would be more suitable for chickens than human beings … There are some streets which show efforts to maintain respectability and an appearance of comfort; but most folk seem to have given in. Poverty has got on top of them.”
Otto Neurath in 1945. Photograph: Otto and Marie Neurath Isotype Collection, University of Reading
Ten years later, despite building new council estates, Bilston still led the way in Britain for all the wrong reasons. A 1943 civic survey found that 1,400 tons of smoke particles per square mile were falling on Bilston each year, which local historian Frank Sharman colourfully suggests is “roughly the weight of 11 blue whales or 233 elephants per annum”.
According to Sharman, a national survey of housing conditions assessed the number of families in each local authority area who were living in “overcrowded conditions”. “The figure for England and Wales as whole was 3.8%. In Bilston it was 13.7%.” A later civic survey, just before the end of the war, found that of 7,771 houses in Bilston, 2,655 were unfit for human habitation.
Bilston, then, needed thousands more new houses for slum dwellers – and one of the prime sites for building those new council houses was land in the north-west of the borough. Today Stowlawn is green and pleasant, an estate of whitewashed houses, verdant verges and bucolic trees. But in the late 1940s, it was land which had been plundered for coal and road stone and then abandoned. “It was not exactly a greenfield site,” says Sharman. “Even calling it ‘brownfield’ would have been a bit optimistic.”
Neurath made us feel that the pursuit of beauty and happiness could be achieved by the common man
This plan to rebuild Bilston and rehouse its slum dwellers was fairly well advanced when in early 1945, Bilston’s town clerk, AV Williams, had an epiphany in Wolverhampton. He was there to attend a lecture given to the International Friendship League; the speaker was Otto Neurath, and his subject was “Housing in Vienna”.
Williams was impressed by the socialist philosopher’s humane vision: “He made one believe in the dignity of human beings.” Soon after, Neurath was invited to Bilston to see the nature of its housing problem and help eradicate it. “He made us feel that the pursuit of beauty and happiness could be achieved by the common man,” Williams explained.
Neurath believed that the common man – and woman – could and should have a role in designing their own homes. It was a perspective he had become committed to in the aftermath of the first world war in Austria, when he helped revolutionise working-class housing in the era of Red Vienna – the nickname of the capital between 1918 and 1934 when, following the collapse of the Habsburg Empire, its city government was ruled by social democrats.
It was a time and place when acute housing shortages had led to conditions of inhuman squalor – conditions, it’s not fanciful to argue, that applied to inter-war Bilston too.
During this time, Vienna became a crucible for communal living. Architecturally, the era is synonymous with vast apartment blocks such as the Karl Marx Hof and the Rabenhof, featuring communal facilities ranging from bathhouses, laundries, kindergartens, libraries and even kitchens.
Neurath was gaining fame at the time as a member of the Vienna Circle of “logical positivist” philosophers, and for developing the pictographic language isotype, one designed to help grasp by means of pictures complex information.
He was an unusual socialist, improbably influenced by Samuel Smiles, the Scottish Victorian reformer whose 1859 book Self-Help appealed to Neurath’s sensibility. Smiles had argued that poverty was caused largely by irresponsible habits and that human progress, perhaps even happiness, would come from the poor being given what Smiles called “the means of education, and of exerting freely all the powers of his godlike nature” .
The Stowlawn estate is more green than black today, but are its people happy? Photograph: Neil Jeffries
This philosophy – the Christian sense of mission notwithstanding – inspired Neurath. He thought happiness could be achieved if workers could be educated on the principles of house design and communal living, and then be involved in the creation of their living spaces rather than having it inflicted on them from above – and he tried to put these ideas into practice in Vienna.
Shortly before this Jewish thinker was compelled to emigrate as Austrian fascists came to power in 1934, he saw the opening of the Werkbundsliedung, an estate of 70 houses in south-west Vienna that, as Dr Sabrina Rahman, co-curator of a recent exhibition called Bilston’s Happy Housing explains, “offered working-class families the opportunity to purchase or rent homes designed by a diverse group of 31 international architects”.
According to Rahman, “the Werkbundsiedlung remains one of the most important estates in modern architecture”. And the hope was Neurath could realise something similar in England’s Black Country.
Before Neurath came to Bilston, British architect Sir Charles Reilly was already sketching plans for Stowlawn estate, using ideas the Viennese would have found sympathetic, if a little more patrician. As Frank Sharman points out: “The chief feature of Reilly’s plans was that the houses should be built around greens, somewhat in the style of a village green, which Reilly seems to have seen as an archetype of a good community. And on each of these greens there would be a club, containing library, reading rooms, billiards room and catering facilities – to which families could go to eat or from which they could order meals to be delivered.”
These ideas chimed not only with Neurath’s but with the new Labour government’s housing minister Aneurin Bevan’s vision of a New Jerusalem in Britain – of mutually supportive, mixed communities. Bevan wrote in his introduction to the 1949 Housing Act: “We should try to introduce in our modern towns and villages what was always the lovely feature of English and Welsh villages, where the doctor, the grocer, the butcher and the farm labourer all lived in the same street.”
Bilston’s housing: each house represents 100 homes, the black houses are uninhabitable. Photograph: Otto and Marie Neurath Isotype Collection, University of Reading
Neurath went further in his philosophy of how Bilston’s new estates could create such communities and make the town happy. Some were noted down by AV Williams from meetings with Neurath at the time, and are cited by Frank Sharman. Even now they seem wonderfully sane and pertinent ideas for how we should – but often don’t – live:
“On estates,” advised Neurath, “mix up individuals: married and unmarried, old and young. Do not create ghettos of, for example, old people who, if they are stuck altogether in flats, will feel isolated, lonely and unwanted. If you put them in with young people, they can do things like babysitting and feel useful and wanted.
Care must be taken to avoid the accidental creation of a lunatic asylum
“Unmarried persons can be divided into those who will eventually marry and those who never will. If you put them all into one block of flats, the marrying kind will move out and you will be left with nothing but people who will never marry. Care must be taken to avoid the accidental creation of a lunatic asylum.
“You must study the existing community structure in the slums you are rehousing, and ensure these connections are not broken upon the new estate. Bear in mind that different people had different needs, and do not plan housing on a ‘one size fits all’ basis. You have to work out what sorts of houses and flats to build and who to put in them.”
One big idea Neurath was keen on was an exhibition of the plans for the benefit of those who would be living in these new houses. “You must consult the people who were to be re-housed and educate them on housing matters,” he told Bilston’s town clerk and his colleagues. “You should do this through an exhibition which made the issue understandable by anyone – through the use of isotypes – and that such an exhibition should be somewhere which was accessible to the people who were to be re-housed.” Nowadays, perhaps, this sounds like common sense; in 1945 it was a radical overturning of a patrician social order.
But before Otto Neurath could make Bilston happy, he died unexpectedly aged just 63 in his Oxford home in December 1945. His widow Marie recalled that he was reading a newspaper article about happiness before he passed away, and then commented on what he had read to her.
“What does happiness mean?” he reportedly said. “I can tell you what I mean by happiness. If godfather would come to me and say: ‘Dear Otto, I make you an offer as you are living now with your books and your work and your wife. You can live for ever and ever but you will never be more prosperous than you are now. Will you accept?’ ‘Yes, dear godfather. I gladly accept.’”
After his death, Marie went back to Bilston to fulfil her husband’s happy dream. She set up his planned exhibition in a disused store on Bilston’s Oxford Street, aimed at getting slum dwellers and other ordinary citizens to see what was being planned.
Oaklands Green on the Stowlawn estate, 1950. Photograph: City of Wolverhampton archives
The year after Neurath’s death, Ella Briggs, who had worked with Otto in 1920s Vienna, became one of the main architects of the Stowlawn estate. She intended to build eight-house terrace blocks around common greens as her predecessor Reilly had envisaged, keeping designs simple to reduce building costs in the post-war austerity era. Bilston council gave the resultant streets rustic names such as Lawnside, Fairway, and Oaklands – evoking a bucolic mood in much the same way earlier and snootier developments such as Hampstead Garden Suburb did in north London.
‘It is a happy place’
What remains of the original vision for Stowlawn today? When I stroll around the estate, I notice many of the houses remain white-painted, which was unusual for 1940s British council estates and gave this corner of Bilston a continental, crypto-Bauhaus vibe. For a while, Stowlawn was known as the White City.
Stowlawn in 2016 is undeniably peaceful and green, and no doubt a nice place to live, but it’s also a traditional English bodge – a history of compromises, frustrations and muddling through inscribed on every brick, every blade of grass.
I look in vain for the community clubs Reilly envisaged – they were never built. Many of Stowlawn’s greens were replaced with new houses when land was in short supply in the 1960s. Nowadays only Lawnside Green remains, and even it is planted densely with shrubbery and bears a sign saying “No Ball Games” – which, I suspect, Neurath would have frowned at.
Much of the original vision for the estate got dismissed by central government or obliterated by later developments, argues Frank Sharman. He then points out a particularly poignant irony in Stowlawn’s evolution.
In 1979, Margaret Thatcher was elected prime minister, and soon after embarked on a sell-off of Britain’s council estates, as part of her policy of reducing the public sector and giving the market free reign. Sharman notes that she used to hand out copies of the Viennese economist Friedrich Hayek’s The Road to Serfdom which, she said, set out her economic vision – one of minimal state intervention and negligible public ownership.
Bilston Steel workers striking for better wages in January 1980. Photograph: David Bagnall/REX
“Such ideas were, of course, anathema to Otto Neurath, who had spent much time advocating the necessity of government regulation of the free market and a degree of central planning,” writes Sharman in his superb history of the Stowlawn estate. “In fact, it seems that Hayek’s book had been written with the specific intention of refuting Neurath. And on Stowlawn the game played out – the planned community lost out to the forces of the unbridled free market.”
Did Bilston ever get happy? Well, one thing worth saying is that it was never quite as unremittingly miserable as Fenner Brockway portrayed it. My late mother went to Bilston Girls’ High School, on the southern edge of Stownlawn while the estate was being built in the late 1940s. It was a neo-Queen Anne-style building that had opened in 1929 and is now converted into luxury flats. That school, perhaps, was emblematic of the more genteel Bilston that existed alongside apocalyptic slums and industrial hell.
And my late father used to work at Quasi-Arc, the British Oxygen Corporation’s electrical welding division, in Bilston in the 1960s. That business, like many other of the Black Country’s heavy industries, is long gone. It wasn’t just the Thatcherite sell-off of council houses that changed Bilston; it was also her ideological commitment to destroying the industries that toxically thrived here.
In 1979, emblematically, the year Thatcher was elected was the year the final steel cast was made at the Elisabeth furnace at Bilston’s Spring Vale steelworks. The entrancing flames from that furnace, that I used to savour as they lit the Black Country at night from my nan’s back step in Wednesbury, were gone forever. Never such squalor, nor such grandeur, again.
Bilston, town of furnaces, flames and inhumane squalor, once looked like Mordor; now it’s more like Hobbiton.
No ball games allowed in the Stowlawn estate. Photograph: Neil Jeffries
These days, I reflect, as I walk from Stowlawn back to the tram stop to take me to Birmingham, I’ll bet the smoke particles falling on Bilston amount to rather fewer than 233 elephants per annum. This is, in many ways, not so much the Black Country as the Green Country. Bilston, town of furnaces, flames and inhumane squalor, once looked like Mordor; now it’s more like Hobbiton.
Otto Neurath may not have succeeded in making Bilston happy, and the ideas he set out may only have been realised in botched form – and even then diluted further. But perhaps it got there anyway. His vision of encouraging people to participate in the creation of a happier Bilston didn’t die with him.
Online, there’s a fascinating interview from 1975 with a Bilston town planner on local news programme ATV Today. With a superbly straight face, this nameless civic champion suggests putting tin foil over the gasometer so that it interestingly refracts the sunlight, pumping out coloured smoke rings from disused factory chimneys, covering an abandoned gantry with wire netting to make the Black Country’s biggest aviary, transforming the abandoned railway line into a green corridor complete with picnic areas, fishing holes and cycle paths. It’s not just Viennese philosophers who have visionary ideas for urban living.
Related: Story of cities #34: the struggle for the soul of Milton Keynes
Better yet, the interviewee invites town citizens to submit their own ideas to make Bilston beautiful. Otto Neurath would surely have liked that: anything to get locals involved in planning the circumstances of their own happiness.
True, Neurath’s vision of cities composed of mutually supportive, mixed communities, living together in harmony isn’t exactly voguish in our era of gated communities, sheltered accommodation, streets too dangerous for kids to play in. But it would be a fool or a snob who said Bilston isn’t a happy place.
“I’ve lived here all my life and I want my daughter to be as happy here as I’ve been,” says the young mother outside the pub which, I belatedly notice, is called The Happy Wanderer. “It is a happy place.”
Stuart Jeffries’s book Grand Hotel Abyss: The Lives of the Frankfurt School will be published by Verso in September
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