Global Comment

Where the world thinks out loud

England’s North-South divide is a lesson in inequality

The Yorkshire countryside

 

The north – south divide is a well-documented phenomenon in England. Historically, the south has been wealthier and structurally favoured, with government investment in the south far outweighing what northerners receive, exacerbated by lower employment levels and worse health outcomes for those in the north. People in the south benefit from a quarter more disposable income than their northern counterparts, up from a fifth 15 years ago, and this is felt in every pocket.

Now, research carried out by the University of Manchester has found that there were 14,333 more premature deaths in the north of England than the south in 2015, with 29% more deaths among 25-34 year olds in the north than in the south in 2015. This is compared to 2.2% more deaths in this age group in 1995 and 8% more in 1965. A 35-44 year old living in the north is 49% more likely to die suddenly than their equivalent in the south, compared to 3.3% more likely in 1995 and 21% higher in 1965.

For the purposes of the study, England was divided into the north (the north east, north west, Yorkshire and the Humber, East Midlands and West Midlands) and the south (the east, south west, London and the south east). Data from the Office of National Statistics was analysed to compare death rates between 1965 and 2015, and the numbers were looked at without considering causes of death, which means that the researchers have been unable to give solid reasoning behind the numbers.

However, the patterns they identified are undeniable.

Researcher Iain Buchan said, “Five decades of death records tell a tale of two Englands, north and south, divided by resources and life expectancy – a profound inequality resistant to the public health interventions of successive governments”.

“A new approach is required, one that must address the economic and social factors that underpin early deaths, especially in younger populations, and one that focuses on rebalancing the wider economy to help drive investment in northern towns and cities.

Fellow researcher Tim Doran, from the University of York, is hopeful that further data analysis will help the government to identify and address the causes of this drastic inequality.

He said, “These important findings were made possible by examining public health data – held by the NHS and other agencies – dating back decades. The data, technology and skills now exist to better understand population health and develop public policies to improve it proportionately”.

The British Medical Journal, which published the study, reports that “Explaining the rapidly widening divide in young adult mortality between North and South over the past two decades will require detailed analysis of specific causes of death and the plausible explanations, including epidemiological, social, economic and migratory factors. The most common causes of death in this age group are suicide, poisoning, land transport accidents and liver disease”.

The research that is required will be intensive, but it is essential if this culling of young lives in the north is to be abated. This is not a small variance in mortality that can be written off by statistical inaccuracies or biased data, it is a dramatic difference in life expectancy for people living in England, purely based on the bit of the country they live on.

This is brutal and it is unfair, and the government must demonstrate a true commitment to equalising and balancing the importance of northern and southern lives.

Margaret Whitehead, a Professor in public health at the University of Liverpool, and Tim Doran, Clinical Research Fellow at the University of Manchester, warn that deprived communities in the north have “borne the brunt” of the recession, with government spending cuts that “will hit the hardest in the north”. And given that 37,000 people a year die earlier in the north than they would have done in the south, this is a situation that must be addressed quickly and with determination.

Those of us who live in the north, despite the fact that we are apparently one-fifth more likely to die before the age of 75, do so because it is a fantastic place to be. But without the structural, infrastructural, employment and economic equality that we need, we are going to be poorer than the south in every possible sense (except for scenery and sense of humour).

Matching – or improving on – the funding and equivalent services that southerners receive is a must. Whatever attempts have already been made to reduce inequalities have either failed or underwhelmed in their efficacy, and specialists must be consulted and listened to if we are to start challenging the inevitability with which northerners face their fate.

Photo: Michael Oakes/Creative Commons