A new study into health in the former coalfield communities finds serious inequalities, says Liam Hughes.

Britain's coalfield communities were once the hub of the nation's economy. But, over the last 50 years, they have had to adapt to industrial change and decline.

This has left many communities with a legacy of economic hardship and health inequalities. Occupational disease still affects older people, while a lack of jobs has damaged the health of the younger generation.

Regeneration efforts in former mining communities have, all too often, focused on replacing lost jobs and revitalising industrial sites. Tackling health inequalities has been lower down the list of priorities.

New research suggests direct action is now needed to reduce the health inequalities in England's coalfield communities, with local authorities, primary care trusts and the voluntary sector sharing responsibility for delivering good health.

It says that waiting for health improvements to come about as a natural consequence of regeneration efforts is unjust, and may even contribute to continued poor economic performance. Our coalfield communities deserve better than that.

The research was commissioned by the Healthy Communities Programme, which is funded by the Department of Health and managed by the IDeA. It found big differences in the fortunes of the 55 local authorities in England which contain former coalfield sites. Between 1994 and 2007, 32 had experienced a decline in their economic activity ranking, while 23 had seen an improvement.

Urban coalfield areas seem to have fared worse than their rural counterparts, in terms of economic activity. Problems were greater in the North West and West Midlands former coalfield areas, and not so pronounced in the North East, South Yorkshire or the East Midlands.

The research shows that most of the former coalfield areas are still characterised by higher rates of mortality than the average for England. These rates are higher whether one considers death rates for the whole population or focuses on early mortality – under 75 years of age.

In fact, the health inequalities in former coalfield authorities increased between 1994 and 2007, as these areas lagged behind other parts of the country in terms of reducing mortality.

The picture is similar when we look at the major causes of mortality – cancer, coronary heart disease and stroke. Most of the coalfield areas have above-average rates for these conditions.

And although there have been improvements across the country, these advances have not been so great in the former coalfield areas – meaning that once again, they lag behind England's other local authority areas.

Health is now seen as the responsibility of all statutory organisations, and local government has a major part to play – particularly given its expertise in working at community level and engaging with local people.

Cllr David Rogers, chair of the LGA community wellbeing board, says local councils can play a key role in improving the health of their communities.

He says: ‘Health is no longer seen as being simply the responsibility of the NHS. Councils and the NHS are working on complementary issues, but each has the capacity to act in different ways.'

While the temptation to go for ‘quick wins' is immense, real improvements in health can only be achieved by considering health and wellbeing holistically, through the whole range of services which impact on health inequalities – from housing quality to fuel poverty.

Councils can also help the NHS in identifying need in the poorest communities, and helping to re-gear services such as screening, immunisation and smoking cessation in ways that will increase take-up.

The IDeA has a specific focus on helping local authorities with their work on reducing health inequalities, particularly through the healthy communities programme. It aims to build the capacity of local authorities, working with their communities and partners, to: