In spite of being one of the richest nations in Europe, England has some of the worst health inequalities. And within England, some of the very lowest life expectancies can be found in the north.
Analysis published yesterday by IPPR North shows us that, if you’re from the north, you can expect to spend a larger proportion at the end of your life in poor health. In all three of the northern regions, healthy life expectancy – the age at which, on average, people see the end of good health – is lower than the state pension age. This means that northerners, on average, don't even begin to collect their state pension until their health has begun to deteriorate.
At its lowest, healthy life expectancy can be over in the 40s. And neighborhoods where healthy life expectancy is lowest are disproportionately concentrated in the north. Shockingly, in one Salford neighbourhood it's 46, compared to the English average of 63.
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Life expectancy too, in addition to healthy life expectancy, is unacceptably low in parts of the north. In one neighbourhood in Blackpool, the average male life expectancy at birth is 68, compared to the English average of 79.
This pattern, of a north disproportionately affected by health inequalities, can be seen too in specific diseases. Lung cancer is more prevalent in the north’s cities, and liver cancer is strikingly prevalent in Merseyside, Cheshire, Greater Manchester, Northumberland and Tyne & Wear.
Of course, a number of complex factors affect poor health. One of these is air pollution – a big concern for many of the North’s major cities.
Take Greater Manchester, for example. The city region has the highest rate of emergency admissions for asthma in the whole country, and recent research by IPPR North shows that the poor air quality in Greater Manchester alone will cost 1.6 million life years in the coming century and £1bn each year to the economy.
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These stark findings should lead policymakers to ask this key question: is the economy of the North actually detrimental to the health and well-being of its people?
As part of the answer to this question, it’s important to consider the quality of northerners’ jobs. Not only is there an association between whether someone is in work and their health, but the nature of employment is also a determining factor. And it’s important to note that employment-related health problems disproportionately affect people with disabilities, ethnic minorities, and those from disadvantaged socioeconomic groups.
Poor working conditions, lack of job security, long hours, shift work, low pay: situations often seen in the ‘everyday economy sectors’ including health and social care, retail and hospitality, and routine manual occupations – all contribute to poor job quality. Change is needed.
In order to allow more people to enjoy their retirement in good health, we need to work to increase healthy life expectancy. The disparity between the north and south in healthy life expectancy may be significant, but it’s not insurmountable.
One answer? Policymakers should make improving the health and well-being of people a strategic goal of economic policy across the UK, especially in the north.
To achieve this, improving the quality of work in the north is essential. Yes, we need growth to happen – but not for its own sake. Instead we need growth that enables all people to see its benefits.
Inclusive growth is already an aim of many northern areas, and some mayors are in the process of creating employment charters to improve job quality in collaboration with business. However, in order to deliver positive outcomes for the north in general, this needs a radical up-scaling. Northern leaders aren’t currently equipped with the tools and budgets that they need. However, even without greater resources, small steps can and should be made.
Businesses must invest in their workforces and local areas, and aim to deliver high quality work – creating better places to live, and delivering better livelihoods for people.
Most importantly, for people to benefit from economic growth, the Northern Powerhouse agenda should focus on delivering economic justice. Economic policy is a powerful tool that can be used to improve health, well-being, and the quality of work. To do so, central government must support inclusive growth at the regional level, considering the health inputs and outcomes of local economies and embedding a ‘health in all policies’ approach into decisions made within the next phase of the Northern Powerhouse.
Leah Millward is a co-author of State of the North 2018. She tweets @LeahMillward.