Being born in the north of England can take a decade off your life expectancy

Blackpool, sickest town in England. Image: Getty.

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.

 
 
 
 

Joe Anderson: Why I resigned from the Northern Powerhouse Partnership

Liverpool Lime Street station, 2008. Image: Getty.

The Labour mayor of Liverpool has a few choice words for Chris Grayling.

I resigned from the board of the Northern Powerhouse Partnership this week. I just didn’t see the point of continuing when it is now crystal clear the government isn’t committed to delivering the step-change in rail investment in the North that we so desperately need. Without it, the Northern Powerhouse will remain a pipedream.

Local government leaders like me have been left standing at the altar for the past three years. The research is done. The case has been made. Time and again we’ve been told to be patient – the money is coming.

Well, we’ve waited long enough.

The only thing left is for the transport secretary to come up with the cash. I’m not holding my breath, so I’m getting on with my day job.

There’s a broader point here. Rail policy has been like a roller-coaster in recent years. It soars and loops, twisting and turning, without a clear, committed trajectory. There is no consistency – or fairness. When London makes the case for Crossrail, it’s green-lit. When we make the same case for HS3 – linking the key Northern cities – we are left in Whitehall limbo.

Just look at the last week. First we had the protracted resignation of Sir Terry Morgan as Chairman of HS2 Ltd. Just when we need to see firm leadership and focus we have instead been offered confusion and division. His successor, Allan Cooke, said that HS2 Ltd is “working to deliver” services from London to Birmingham – the first phase of the line – from 2026, “in line with the targeted delivery date”. (“In line?”)

Just when HS2 finally looked like a done deal, we have another change at the top and promises about delivery are sounding vaguer. Rumours of delays and cost over-runs abound.

Some would like to see the case for HS2 lose out to HS3, the cross-Pennine east-west line. This is a bit like asking which part of a train is more important: its engine, or its wheels. We need both HS2 and HS3. We are currently left trying to build the fourth industrial revolution on infrastructure from the first.

If we are ever to equip our country with the ability to meet rising customer and freight demand, improve connectivity between our major conurbations and deliver the vision of the Northern Powerhouse, then we need the key infrastructure in place to do that.


There are no shortcuts. Ministers clearly believe there are. The second piece of disappointing news is that officials at the Department for Transport have already confirmed to the freight industry that any HS3 line will not be electrified, the Yorkshire Post reports.

This is a classic false economy. The renaissance of the Liverpool Dockside – now called Superport – is undergoing a £1bn investment, enabling it to service 95 per cent  of the world’s largest container ships, opening up faster supply chain transit for at least 50 per cent  of the existing UK container market. Why squander this immense opportunity with a cut-price rail system?

Without the proper infrastructure, the North of England will never fulfil its potential, leaving our economy lop-sided and under-utilised for another generation. This is not provincial jealousy. Building a rail network that’s fit for purpose for both passenger and freight will remove millions of car journeys from the road and make our national economy more productive. It will also be cleaner, cheaper and more reliable. Our European neighbours have long understood the catalytic effect of proper connectivity between cities.

Similarly, linking together towns and key cities across the North of England is a massive prize that will boost growth, create jobs and provide a counterweight to Greater London, easing pressures on the capital and building resilience into our national economy.

To realise this vision, we need the finance and political commitment. Confirmation that the government is pushing ahead with HS3 – as well as HS2 – is now sorely needed.

With Brexit looming and all the uncertainly it brings in its wake, it is even more pressing to have clarity around long-term investment decisions about our critical infrastructure. Given the investment, the North will seize the chance.

But until ministers are serious, I have a city to run.

Joe Anderson is the elected Labour mayor of Liverpool.