Understanding the barriers to health and care in Cornish fisheries
Research by the University of Exeter, focusing on Cornwall's fishing community, aims to inform health interventions targeting cardiovascular disease and related issues such as stress and lifestyle risks.
Funded by NHS England’s Innovation for Healthcare Inequalities Programme, Health Innovation South West, CIOS ICB, Cornwall Council and Exeter University are collaborating to understand the unique health disparities experienced by Cornwall’s coastal communities, known as ‘coastal excess of disease’.
Combatting Cardiovascular Disease (CVD) is a priority all partners, given its severe impact on premature deaths in deprived areas.
The UK fisheries sector faces significant uncertainty due to socio-economic, environmental, and policy changes, including Brexit and mandatory medical certificates. These shifts in policies impact on the health and behaviour of people within fishing communities, and their perceptions of healthcare providers.
As such, the University of Exeter led a focused piece of research to inform public health interventions addressed at the Cornish fishing community in light of new regulatory requirements to address health inequities. To gain insights into health issues, access barriers and attitudes towards cardiovascular disease management, seven semi-structured interviews were conducted with health workers and fishing industry professionals, and four focus groups were held with a total of 30 individuals from the fishing community in three locations across Cornwall.
Key drivers of poor health in fishing communities include stress, fatigue, and lifestyle risks. Common health issues include musculoskeletal problems, dental issues and CVD. Stress, diet, and smoking are major contributors to CVD. Constraints to healthcare access include variability in GP services and financial barriers. Supplementary healthcare services, such as dental care, receive positive feedback, but gaps in coverage persist, with small-scale fishermen particularly affected.
This research highlights the need for innovative ways of healthcare in order to meet the health and care needs of the fishing community, including flexibility in service provision, recognising and acknowledging the concerns of coastal communities, building trust, addressing literacy & digital skills and interlinked health issues, and promoting autonomy.
- Research recommendations:
- Service provision built on trust and understanding the fishing way of life
- Tailored support that reflects the fishing community’s needs and preferences
- Inclusive and comprehensive service delivery
- Early intervention and prevention
- Shaping future policy through evidence-based advocacy.
- The findings of the research have shaped the way in which organisations participating in the project work together and engage with the fishing community going forward.
- This project has also been highlighted at regional events as a case study of how to deliver health care to meet specific needs of an underserved population at risk of disease.
- Further funding has been achieved to host an event that will further the dialogue between the fishing communities and the project delivery plan.
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You are stressed out all the time… its over regulated and will kill us, you know. People will have heart attacks.
Summarised from one individual from the fishing community
