Levelling up the edges: creating a network to address the health data challenges of England’s coastal communities
In 2021 the Chief Medical Officer, Professor Chris Whitty, published an influential report on the health of England’s coastal communities. It summarised what had long-been recognised: that life expectancy, healthy life expectancy and disability-free life expectancy are all lower in coastal areas, and the Standardised Mortality Ratios for a range of conditions, including preventable mortality, are significantly higher in coastal areas than non-coastal.
In compiling his report, he described the lack of available data on the health of coastal communities as ‘striking’. He recommended that ‘learning networks of those leading population health in these areas should be encouraged, linked to academic institutions with an interest in building the knowledge base on health improvements’ (recommendation 3.7).
In response to this the Eastern Academic Research Collaboration (Eastern Arc), which comprises the universities of East Anglia, Essex, Kent and Sussex, established the Coastal Data Network (Coda) in 2022.
The Eastern Arc region--stretching from Norfolk in the North to Sussex in the South--offers an invaluable context in which to develop a network. The region is a complex one, with six counties and three unitary authorities, six NHS integrated care boards and 36 separate NHS trusts. Of its 9.3m population, 30-40% live on the coast, rising to 100% in coastal unitary authorities (Southend and Brighton and Hove).
Some of its coastal communities are the most deprived areas in the country (e.g., Great Yarmouth, Waveney, Jaywick ,Swale, Thanet and Hastings), and many have an ageing population, poor transport and infrastructure, isolation, substandard housing, lack of skills and work opportunities, and seasonality.
Coda has allowed academics and stakeholders to explore the issues of public health data in detail, to learn from each other, and work together to develop solutions. In its first year, the Network hosted two workshops that identified the barriers to data collection, analysis and use. Approximately 50 participants took part from over 20 different organisations, identifying a range of issues, including: risk-averse data owners, the proliferation of agencies involved, a lack of integration, and inaccurate metadata.
Further workshops and an ongoing webinar series have led to a broad and growing membership (n=155, representing 54 organisations), that has collaborated on grant submissions (n=3, with discussions about 2 others that were not taken further), has organised workshops (n=3) and co-hosted conferences (n=2), and has delivered a workshop for healthcare professionals on behalf of a regional ICB (Norfolk and Waveney).
Whilst Coda has not shied away from the challenges it faces--particularly for clinicians and practitioners to find time to engage, and the costs associated with hosting events and participant travel--its members recognise the value of the project, and this is evidenced in the case studies outlined in the article. It is only through such networks that we can learn from each other, that we can collaborate together, and that we can effectively corral the data and start to tackle the 'coastal excess' of disease that Whitty identified.
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Dr Martyn Patel, Norfolk and Norwich University Hospital NHS Trust, Norwich Medical School, University of East Anglia, Phil Ward, Eastern Academic Research Consortium (Eastern Arc), Dr Elizabeth Ford, Brighton and Sussex Medical School (BSMS), and Dr Emily Murray, Centre for Coastal Communities, University of Essex