Death by Numbers: 23:59:60 (but it doesn’t have to be that way)

I have finally moved into the digital age and discovered podcasts.  Radio 4 is my thing and these days, (retired day that is) I have discovered that I can get to listen to my favourite Radio 4 programmes as and when I want. Of course, I habitually listen to the Archers, which for younger readers is a long running contemporary rural drama (and I secretly think that the Kate and Jakob romance has been based on mine and J’s relationship - you can decide which of us is Kate and Jakob). My many other favourites include: ‘More or Less’, ‘Women’s Hour’ (yes, I’m in touch with my feminine side), ‘All in the Mind’ and ‘Seriously’.

Now as many regular readers might know, I do like an explanation provided by numbers and one of the ‘Seriously’ episodes last week -‘Leap’ - provided me with my week’s numeric fix! It was produced and introduced by the delightful Eliza Lomas, and featured the performance artist Monster Chetwynd - apparently the first performance artist nominated for the Turner Prize (she didn’t win). To be absolutely honest, I’m not sure how Eliza managed to keep a straight face, as she engaged with Monster, ‘erm, Monster what do you think?’, but I’m probably stuck in my ways. That said, listen to the podcast, as it is both humorous and informative.

As you might think, there is a clue in the title as to what the focus of the programme was about – yes Leap Year, the 29th February. Leaving aside “Monster’s” somewhat bizarre push back on the sexist notion that it is the only day when a woman can propose marriage to a man, I was fascinated by the numbers behind each Leap Year.  Apparently, it takes our Earth approximately 365.242189 (or 365 days, 5 hours, 48 minutes, and 45 seconds) to circle once around the Sun. It’s those pesky extra numbers after the 365 days that cause all the problems. Without having an extra day once every four years, we would lose almost six hours every year. Thus, after just 100 years, a calendar without any leap years would be out by some 24 days in relation to fixed seasonal days such as the Spring and Winter Equinoxes.

Things become even more complicated when atomic clocks are used to measure the passage of time and we can easily find ourselves in the atom oscillations, universal time, leap seconds (to add or not), uneven rotations of the earth and changing lengths of each day. But let’s not go there. Most of us are content to measure time using more familiar points of reference: the alarm clock, train time, steps run, meals eaten, the amount of sleep enjoyed each night, marriage/divorce, birth and of course the ultimate measure, death. How we each fill our time will be different, and likely to change at various times of our life.

However, death will come for us all. According to The Marmot Review: 10 Years On, published last week, how soon that might happen is changing also. In the UK, we have enjoyed nearly a hundred years of increasing life expectancy. Now that situation has stalled and life expectancy is now reducing although the actual numbers of people dying continues to rise. It’s the ‘baby boomers’ who appear to be the problem, and yes I say that in the full knowledge that I’m one of these folk. More people than ever are being admitted to hospital in the year of their death than at any other time in their life.

Marmot focused on the social determinants of health and wellbeing. He noted that health inequalities reflected other societal inequalities. If you ask many student health professionals what causes cardiac disease, they might start with clogged arteries, caused by eating junk food, not taking exercise, smoking, stress and having too much alcohol each week. However, whether they would get to asking the question as to why people make these choices is another matter. And of course, it’s the social determinants that often make the difference.   

These start at birth, where and into what circumstance we are born, how we grow, where we live, work and our age all enhance or diminish our ability to flourish or not. This was something discussed at two meetings I attended last week. The first was our Annual Mortality Review. At this meeting, the year’s analysis of every week’s death audit is collated and presented. In particular, we look at deaths that might be avoidable. The national figure states that 3% of all deaths in hospital are avoidable. At Wrightington, Wigan and Leigh NHS Trust (@WWL) our avoidable deaths’ rate is 1.3%. We do lots to ensure the quality of care we provide is the best it can be, and yes given the ‘baby boomer’ challenge, we could do with more beds, but the reality is we need to build resilience in our communities. Which is where my second meeting came to the fore.

It was a ‘start the conversation’ type meeting, held in the magnificent surroundings of the Old Wigan Courts. Representatives from many different organisations came. We were asked to focus on how to develop our community wealth – the five principles of which are easy to put on a PowerPoint slide but can be more difficult to enact. The principals include: ensuring fair employment opportunities; harnessing the collective power of the collective financial resources inherent in integrated organisations; thinking locally about procurement approaches (how and where we spend our money); adopting a socially responsible approach to property ownership; developing shared approaches to local economic opportunities.

There was much sharing of what was already going on and an enthusiastic forward consideration of what might be possible – I left feeling both buoyed up with the possibilities, but also a little sad that I’m probably out of time when it comes to seeing this work come to fruition. However, one of my take home messages from the death audit was that men who get married live longer than those who remain single – J and I are getting married in April… …just saying…