East Kent Health Divide: Four Coastal Constituencies Top Kent for Depression, COPD, Heart Disease and Stroke
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Follow Kent’s coastline from Herne Bay through Thanet and Sandwich, down through Deal and Dover and on towards Folkestone and Hythe. The scenery changes. In the latest parliamentary health data, the same four constituency names keep coming back.
On paper, they’re four different parliamentary constituencies: Herne Bay and Sandwich, East Thanet, Dover and Deal, and Folkestone and Hythe. Yet across eight separate measures of recorded ill health, those four constituencies occupy every one of Kent’s top four positions. The order changes. The four names don’t.
The pattern runs through depression, COPD, coronary heart disease, epilepsy, high blood pressure, peripheral arterial disease, stroke or transient ischaemic attack, and the GP register covering schizophrenia, bipolar disorder and other psychoses. We analysed all 21 health measures for all 18 Kent parliamentary constituencies — 378 constituency-condition observations — and for those eight conditions no fifth Kent constituency breaks into the top four.
That doesn’t make these four places Kent’s “sickest” constituencies, and it certainly doesn’t prove that living beside the sea causes ill health. But a geographical pattern repeated across mental health, lung disease, cardiovascular disease and neurological conditions deserves more than a glance at a league table. It raises the more important question: why does the same part of east Kent keep appearing?
Depression provides the most immediately understandable example. In Herne Bay and Sandwich, the estimated proportion of adult GP patients recorded with depression is 21.58% — more than one in five. East Thanet follows at 19.76%, Folkestone and Hythe at 18.96%, and Dover and Deal at 18.88%. The equivalent figures are 14.87% across the South East and 14.27% for England.
For Folkestone and Hythe, that means recorded depression prevalence is around 28% higher than the South East figure. Yet depression turns out not to be the sharpest coastal difference buried in the spreadsheet.
The lung figures are harder to ignore
Look instead at COPD — chronic obstructive pulmonary disease. Herne Bay and Sandwich records 3.15%, Dover and Deal 3.07%, East Thanet 3.05% and Folkestone and Hythe 2.96%. The South East figure is 1.72%.
So all four east Kent constituencies are roughly 73% to 84% above the South East COPD estimate. In simple terms, the difference is between roughly three recorded patients in every 100 locally and fewer than two in every 100 across the region.
Then the pattern repeats again. Herne Bay and Sandwich has Kent’s highest estimate for coronary heart disease, Folkestone and Hythe the second highest, Dover and Deal third and East Thanet fourth. Rearrange those same four names and they also occupy Kent’s first four places for hypertension, peripheral arterial disease, stroke/TIA and epilepsy.
For those of us in Folkestone and Hythe, the wider spreadsheet is particularly uncomfortable reading. The constituency is in Kent’s top three for 15 of the 21 measures and top five for 17. It ranks first for epilepsy, learning disabilities, rheumatoid arthritis and the schizophrenia/bipolar/psychoses register; second for eight further measures, including coronary heart disease, diabetes, hypertension, dementia and stroke/TIA.
Those figures cannot simply be added together into some invented “overall illness score”. Different registers cover different age groups, the same patient can appear on several registers, and the conditions aren’t directly comparable. The significance lies instead in the repeated ranking pattern.
Kent had already found a coastal effect
Now comes the part that matters: this isn’t the first warning. Kent Public Health had already identified a coastal health excess five years ago, using different data and a different geographical approach.
Health and Wellbeing of Coastal Communities in Kent
Its 2021Health & Wellbeing of Coastal Communities in Kent report compared coastal and non-coastal communities using GP disease-register data. Before adjustment, COPD prevalence was 60% higher in coastal towns than non-coastal Kent, coronary heart disease 37% higher, depression 23% higher, smoking 26% higher, hypertension and obesity 22% higher, diabetes 21% higher, and asthma 14% higher.
There’s an obvious explanation for some of that. Coastal Kent has an older population, and some communities also suffer considerable deprivation; both can push disease prevalence upwards. KPHO knew that and tested for it.
The excess didn’t disappear.
After adjusting for demographic differences and deprivation, KPHO still found higher coastal prevalence across every disease it examined. The adjusted coastal excess was approximately 41% for COPD, 25% for coronary heart disease, 18% for depression, 13% for diabetes, 12% for hypertension and 10% for asthma; smoking and obesity also remained higher.
That finding matters because it knocks down the easiest explanation for what we’re seeing now. Age and deprivation plainly matter, but Kent’s own analysis concluded that they didn’t account for the entire coastal difference.
And the consequences weren’t confined to GP registers. KPHO found premature mortality from all causes was worse in coastal communities, while Dover, Folkestone and Herne Bay were among the towns containing wards where under-75 mortality was significantly worse than England. Premature cancer mortality was also higher across coastal than non-coastal Kent, with a standardised mortality ratio of 113.5 compared with 96.7.
292-page Mental Health Needs Assessment, published in April 2025
The geography turns up again in KCC’s much more recent, 292-page Mental Health Needs Assessment; published in April 2025 . Its Mental Health and Wellbeing Index gives Kent an overall score of 0.60, but Thanet scores 0.45, Dover 0.55 and Folkestone and Hythe 0.56; Sevenoaks, by comparison, scores 0.69. KCC describes the poorer performance as being skewed towards the east of the county.
The same report found recorded depression varying enormously at neighbourhood level and said that, generally, prevalence was higher in eastern Kent. Thanet, Folkestone and Hythe and Dover were among the districts significantly above the Kent and Medway prevalence in the 2022/23 QOF data.
What the figures can — and cannot — tell us
There is an important brake to apply here. Parliament’s constituency figures are modelled estimates, built by joining 2024/25 GP-practice QOF prevalence data to information about where registered patients live and then aggregating the results geographically. The House of Commons Library explicitly says they are not exact counts.
Nor does a depression register measure everybody who is depressed. KCC itself warns that some people with symptoms won’t present to their GP and some who do won’t receive a diagnosis. Recorded prevalence can therefore reflect underlying illness, but also diagnosis, healthcare use and recording practices.
Those limitations mean we cannot use this dataset to say that the coast caused these conditions, or that an individual living in Folkestone is necessarily at greater risk than an otherwise identical person living elsewhere. What we can say is narrower, but still striking: the same east Kent geography repeatedly sits at the top of Kent’s recorded prevalence rankings, and an earlier KPHO analysis found a coastal health excess even after adjusting for demography and deprivation.
Kent Public Health didn’t merely describe that problem in 2021. It recommended treating coastal towns with high excess disease as priorities, making management of long-term conditions more proactive, and developing plans around smoking and alcohol. It said every disease it had investigated showed a coastal excess.
Five years later, a different dataset, produced by a different public body and using newer GP data, has put the same part of east Kent back under the spotlight. It doesn’t tell us whether Kent’s interventions worked, failed or were sufficient — that requires another investigation — but it does leave a question that’s becoming increasingly difficult to avoid: Kent knew there was a coastal health gap, so what followed, what resources were directed at it, and can anyone demonstrate that the gap is actually closing?
