New analysis from the Health Foundation, using data and modelling from the Office for National Statistics (ONS), has revealed stark inequalities in premature deaths across England and Wales.
The analysis finds that, in the local authority areas with the highest rates of premature deaths, people are almost twice as likely to die before the age of 75 than those in the areas with the lowest rates. It highlights the deep and entrenched inequalities that hold back the UK’s health and follows on from a recent study from the Foundation that showed our health is falling behind other high income countries.
The new analysis looks at the reasons behind the striking variation in premature deaths in different parts of the country. It finds that by far the biggest contributors are socio-economic factors such as the levels of education, types of occupation and the level of deprivation in an area. Ethnicity and being born outside the UK also play a role, although this is much smaller.
The analysis finds that - taken together - socio-economic factors, ethnicity and being born outside the UK account for 61% of the variation in premature deaths rates between different areas whereas, on their own, ethnicity and being born outside the UK account for 7% of the variation.
The analysis shows that premature death rates are highest in the North West, Yorkshire and Humber and, in particular, the North East, where all but one local authority have premature death rates above the average rate for England and Wales. This aligns with previous research including our recent study of health in high income countries which has found that the North East has lowest life expectancy in England and particular health challenges associated with long term economic decline.
The new analysis found that the impact of socioeconomic factors, ethnicity and being born outside the UK on premature death rates varies between local areas. For example, in Blackpool, these factors almost entirely explain its higher premature death rate. This points to the urgent need for action to address the socio-economic factors behind this. However, in other areas, these factors do not entirely explain higher premature death rates, highlighting the need for further understanding of other drivers of these disparities.
The analysis also looked at four of the leading causes of death - cancer, cardiovascular disease, diabetes and respiratory diseases. The gap in premature death rates was widest for deaths associated with diabetes and respiratory diseases. In the local authorities with the highest rates, people are around three times more likely to die before 75 from these conditions. This compares with cancer, where people are less than twice as likely to die early in the local authorities with the highest rates.
The new analysis follows the publication of the 10-Year Health Plan which reiterates the government’s goal to halve the gap in healthy life expectancy between the richest and poorest regions. To meet this goal, the Foundation has called for a new strategy to tackle health inequalities, alongside long-term action to rebuild the nation's health and promote economic recovery in deprived areas.
Charles Tallack, Director of Research and Analysis at the Health Foundation, said: "Across the country, people’s lives are being cut short. The opportunity of living a long and healthy life is still far too dependent on the socio-economic conditions people live in – this is unfair and avoidable.
"Following the government's 10-Year Health Plan, our analysis adds fresh urgency to the need for coordinated, cross-sector action to address health inequalities. A thriving society needs all the right 'building blocks' of health in place, such as jobs, homes and education. The government’s health mission promised just such an approach, but this is currently missing in action. The need for bold, concerted action to address the UK’s faltering health is becoming increasingly urgent."
Daniel Ayoubkhani, Head of the Health Research Group, Office for National Statistics, said: "This analysis shows a clear association between where you live and your risk of dying prematurely. When accounting for differences in age and sex, we see that there are substantial differences in premature mortality rates across local authorities in England and Wales.
"For the first time, we have explored the role of ethnicity, whether someone was born in the UK, and socioeconomic characteristics in geographic variations in premature mortality, revealing that these factors explain much, but not all, of the differences in premature mortality rates between local authorities."
