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.

 
 
 
 

To make electric vehicles happen, the government must devolve energy policy to councils

The future. Image: Getty.

Last week, the Guardian revealed that at least a quarter of councils have halted the roll-out of electric vehicle (EV) charging infrastructure with no plans to resume its installation. This is a fully charged battery-worth of miles short of ideal, given the ambitious decarbonisation targets to which the UK is rightly working.

It’s even more startling given the current focus on inclusive growth, for the switch to EVs is an economic advancement, on an individual and societal level. Decarbonisation will free up resources and push growth, but the way in which we go about it will have impacts for generations after the task is complete.

If there is one lesson that has been not so much taught to us as screamed at us by recent history, it is that the market does not deliver inclusivity by itself. Left to its own devices, the market tends to leave people behind. And people left behind make all kinds of rational decisions, in polling stations and elsewhere that can seem wholly irrational to those charged with keeping pace – as illuminted in Jeremy Harding’s despatch from the ‘periphery’ which has incubated France’s ‘gilet jaunes’ in the London Review of Books.

But what in the name of Nikola Tesla has any of this to do with charging stations? The Localis argument is simple: local government must work strategically with energy network providers to ensure that EV charging stations are rolled out equally across areas, to ensure deprived areas do not face further disadvantage in the switch to EVs. To do so, Ofgem must first devolve certain regulations around energy supply and management to our combined authorities and city regions.


Although it might make sense now to invest in wealthier areas where EVs are already present, if there isn’t infrastructure in place ahead of demand elsewhere, then we risk a ‘tale of two cities’, where decarbonisation is two-speed and its benefits are two-tier.

The Department for Transport (DfT) announced on Monday that urban mobility will be an issue for overarching and intelligent strategy moving forward. The issue of fairness must be central to any such strategy, lest it just become a case of more nice things in nice places and a further widening of the social gap in our cities.

This is where the local state comes in. To achieve clean transport across a city, more is needed than just the installation of charging points.  Collaboration must be coordinated between many of a place’s moving parts.

The DfT announcement makes much of open data, which is undoubtedly crucial to realising the goal of a smart city. This awareness of digital infrastructure must also be matched by upgrades to physical infrastructure, if we are going to realise the full network effects of an integrated city, and as we argue in detail in our recent report, it is here that inclusivity can be stitched firmly into the fabric.

Councils know the ins and outs of deprivation within their boundaries and are uniquely placed to bring together stakeholders from across sectors to devise and implement inclusive transport strategy. In the switch to EVs and in the wider Future of Mobility, they must stay a major player in the game.

As transport minister and biographer of Edmund Burke, Jesse Norman has been keen to stress the founding Conservative philosopher’s belief in the duty of those living in the present to respect the traditions of the past and keep this legacy alive for their own successors.

If this is to be a Burkean moment in making the leap to the transformative transport systems of the future, Mr Norman should give due attention to local government’s role as “little platoons” in this process: as committed agents of change whose civic responsibility and knowledge of place can make this mobility revolution happen.

Joe Fyans is head of research at the think tank Localis.