Thursday, 20 June 2013

Go as you Please: Public health in the neighbourhood

Posted by Heather Yoeli

Living in nondescript surburbia between a miniature Tesco, a dodgy pub, a neighbourhood vet, a vast psychiatric hospital and an unexpected nature reserve, it makes life interesting. A couple of months back, an enterprising chap attempted to turn our abandoned local sub post office into what his planning application euphemistically termed a ‘hot food takeaway’. He did not succeed, mainly because of the hyperbolic nimbyism of residents alarmed that the proposed chippy might bring greasy elements into the hood and depreciate yet further local property values but partly (I hope, at least) because psychiatric inpatients are highly at risk of obesity and its associated diseases and therefore having a ‘hot food takeaway’ a chip’s throw away from the windows of their ward would therefore be a bit unhelpful. 

A few weeks ago, then, a new business not requiring of additional planning permission opened on the old sub post office site: the Go as you Please funeral service. It is a bold enterprise, to say the least. Rather than the twee lilies and discreetly blacked-out shopfronts of most funeral parlours, the Go as you Please proudly displays its coffins to the street. At the moment, they’re showcasing three coffins: an emo-gothic purple floral coffin with a mischievous nod to the archetypal lily, a faintly jingoistic Union Jack coffin which might save the need to drape a proud flag, and a photo-montaged Beatles one presumably for those wanting to have All you need is Love sung at their funeral. The semiotics of the storefront assaults us with the profoundly taboo and challenging questions: how would you choose to die, and how would you like to ensure that you are remembered? I wonder what my neighbours think. I know what they thought about the putative ‘hot food takeaway’, but I don’t know what they think about the funeral parlour. We live in a culture which can comfortably talk about both the ways in which we make our communities unhealthy and the things we do that are bad for our health, but it’s a culture nevertheless which rarely, if ever, speaks openly about death.

I wonder whether the presence of the Go as you Please coffins has dented the sales of alcohol, tobacco and confectionary at the local Tesco. If it were possible to submit a Freedom of Information request to a major supermarket chain, I might be tempted to ask them. More seriously, though, I wonder what impact the Go as you Please coffins have had upon the thoughts and feelings and behaviours of inpatients living on the nearby hospital wards. If I could produce a research proposal aimed at providing an answer which would sufficiently benefit the inpatients themselves, I might be tempted to approach their NHS Trust’s R&D people to discuss some sort of study. But to be honest, I’d be a bit nervous of raising the idea with my colleagues, simply because, again, ours is a culture far more comfortable with discussing obesity than death.

And if that reluctance to engage with death as the ultimate endpoint of sick environments and unhealthy lifestyles is a cultural tic embedded even within the social norms of public health, how does that affect what and how we choose to research?


  1. We recently undertook analysis of the British Social Attitudes Survey data from 2012 which looked for the first time in the history of that survey at attitudes to death and dying amongst a representative population group (see It indicates that things are changing. Most people expressed a degree of confidence around discussing death and planning for end of life. 70% claimed to feel comfortable talking about death; just 13% feel uncomfortable doing this. We spend so much time researching in this area that I guess there is a danger we may have ‘gone native’ and lost our own capacity to see how others find the topic distasteful or insensitive, but the survey results would indicate that people don’t quite treat death as the taboo or sequestered phenomenon that they once did.

  2. There is also a national organisation called Dying Matters which specifically helps in with everything associated with death and dying too.
    Its really worth a look on their website