Infrastructure populism: on the politics of building big, or failing to

When it comes to infrastructure, they’re all all talk. Image: Getty.

It is famously said of Italian dictator Benito Mussolini that at least while he was dragging his country into a war in which over half a million of his citizens died, he was also making sure the trains ran on time. The murdering fascist wasn’t all bad: he did sort out Italy’s railways.

Now, shockingly, it turns out this is all complete claptrap and Mussolini actually did very little to improve the rail system. Popular beliefs to the contrary are all just part of the fascist myth that he built up around himself to validate his governance.

It’s fake news, but the widely believed claim strikes to the core of a bigger issue: politicians hijacking transport as an easy way to connect with voters. Because, despite Chris Grayling’s best efforts, getting from A to B is an aspect of modern life that can hardly be ignored; effective roads are required to keep the population fed and public transport needed to get people to work.

Like Mussolini before him, this is something Donald Trump has recognised. Among the cries of “lock her up” and “bad hombres”, a key part of his presidential election campaign was a promise to ramp up infrastructure investment. Trump was fed up that other countries “look at our infrastructure as being sad”. As someone who has tried to use Amtrak, the US domestic rail service, I’ve got to say I agree with him.

But it’s easy to complain; it’s following through with a solution that’s the real problem. Only 13 per cent of the $1.5trn Trump hopes to raise is going to come from federal purse, with the rest funded by… erm… something else. It’s in this delivery that this went from being a realistic promise of change to just saying what people want to hear.


On this side of the pond, we have a similar problem: Boris Johnson. A politician who regardless of the issue in question will suggest the answer is an absurd, massive infrastructure project in thinly veiled efforts to grab headlines and deflect from any helpful debate.

His stint as London mayor was dominated by such ill-thought out infrastructure projects. The new Routemaster buses and the Emirates Cable Car were a big waste of money. Aborted suggestions include the Garden Bridge Project, which managed to waste another £46m in public money without even being built, and the Thames Estuary Airport.

More recently, on the prospect of a hard Brexit and lorries queuing up the M20, Johnson proposed a road bridge between England and France. To solve the issue of a hard border between the Republic of Ireland and Northern Ireland, he called for another sea-crossing bridge. You get the idea.

So for Johnson, big projects are a cure-all for difficult problems, which can catch the headlines and allow any reasoned criticism to be easily be framed as not “believing in Britain”. 

Unlike Johnson and Trump, the Hungarian President, Victor Orban, has managed to follow through with his big projects. Unfortunately, they have nothing to do with infrastructure. He has instead spent hundreds of millions of Euros on building football stadiums around the country all to the delight of football-mad Hungarians. This, in a country with one of the worst poverty rates in Europe.

In his 2006 study on the future of high-speed rail in the UK, the director of News Corporation and former CEO of British Airways, Sir Rod Eddington, warned against being “seduced by ‘grands projets’ with speculative returns.” His message was intended for politicians but, in a world of Trumps, Johnsons and Orbans, is surely a lesson that should be learnt by everyone.

 
 
 
 

What’s killing northerners?

The Angel of the North. Image: Getty.

There is a stark disparity in wealth and health between people in the north and south of England, commonly referred to as England’s “north-south divide”. The causes of this inequality are complex; it’s influenced by the environment, jobs, migration and lifestyle factors – as well as the long-term political power imbalances, which have concentrated resources and investment in the south, especially in and around London.

Life expectancy is also lower in the north, mainly because the region is more deprived. But new analysis of national mortality data highlights a shockingly large mortality gap between young adults, aged 25 to 44, living in the north and south of England. This gap first emerged in the late 1990s, and seems to have been growing ever since.

In 1995, there were 2% more deaths among northerners aged 25 to 34 than southerners (in other words, 2% “excess mortality”). But by 2015, northerners in this age group were 29% more likely to die than their southern counterparts. Likewise, in the 35 to 44 age group, there was 3% difference in mortality between northerners and southerners in 1995. But by 2015, there were 49% more deaths among northerners than southerners in this age group.

Excess mortality in the north compared with south of England by age groups, from 1965 to 2015. Follow the lines to see that people born around 1980 are the ones most affected around 2015.

While mortality increased among northerners aged 25 to 34, and plateaued among 35 to 44-year-olds, southern mortality mainly declined across both age groups. Overall, between 2014 and 2016, northerners aged 25 to 44 were 41% more likely to die than southerners in the same age group. In real terms, this means that between 2014 and 2016, 1,881 more women and 3,530 more men aged between 25 and 44 years died in the north, than in the south.

What’s killing northerners?

To understand what’s driving this mortality gap among young adults, our team of researchers looked at the causes of death from 2014 to 2016, and sorted them into eight groups: accidents, alcohol related, cardiovascular related (heart conditions, diabetes, obesity and so on), suicide, drug related, breast cancer, other cancers and other causes.

Controlling for the age and sex of the population in the north and the south, we found that it was mostly the deaths of northern men contributing to the difference in mortality – and these deaths were caused mainly by cardiovascular conditions, alcohol and drug misuse. Accidents (for men) and cancer (for women) also played important roles.

From 2014 to 2016, northerners were 47% more likely to die for cardiovascular reasons, 109% for alcohol misuse and 60% for drug misuse, across both men and women aged 25 to 44 years old. Although the national rate of death from cardiovascular reasons has dropped since 1981, the longstanding gap between north and south remains.

Death and deprivation

The gap in life expectancy between north and south is usually put down to socioeconomic deprivation. We considered further data for 2016, to find out if this held true for deaths among young people. We found that, while two thirds of the gap were explained by the fact that people lived in deprived areas, the remaining one third could be caused by some unmeasured form of deprivation, or by differences in culture, infrastructure, migration or extreme weather.

Mortality for people aged 25 to 44 years in 2016, at small area geographical level for the whole of England.

Northern men faced a higher risk of dying young than northern women – partly because overall mortality rates are higher for men than for women, pretty much at every age, but also because men tend to be more susceptible to socioeconomic pressures. Although anachronistic, the expectation to have a job and be able to sustain a family weighs more on men. Accidents, alcohol misuse, drug misuse and suicide are all strongly associated with low socioeconomic status.

Suicide risk is twice as high among the most deprived men, compared to the most affluent. Suicide risk has also been associated with unemployment, and substantial increases in suicide have been observed during periods of recession – especially among men. Further evidence tells us that unskilled men between ages 25 and 39 are between ten and 20 times more likely to die from alcohol-related causes, compared to professionals.

Alcohol underpins the steep increase in liver cirrhosis deaths in Britain from the 1990s – which is when the north-south divide in mortality between people aged 25 to 44 also started to emerge. Previous research has shown that men in this age group, who live in the most deprived areas, are five times more likely to die from alcohol-related diseases than those in the most affluent areas. For women in deprived areas, the risk is four times greater.


It’s also widely known that mortality rates for cancer are higher in more deprived areas, and people have worse survival rates in places where smoking and alcohol abuse is more prevalent. Heroin and crack cocaine addiction and deaths from drug overdoses are also strongly associated with deprivation.

The greater number of deaths from accidents in the north should be considered in the context of transport infrastructure investment, which is heavily skewed towards the south – especially London, which enjoys the lowest mortality in the country. What’s more, if reliable and affordable public transport is not available, people will drive more and expose themselves to higher risk of an accident.

Deaths for young adults in the north of England have been increasing compared to those in the south since the late 1990s, creating new health divides between England’s regions. It seems that persistent social, economic and health inequalities are responsible for a growing trend of psychological distress, despair and risk taking among young northerners. Without major changes, the extreme concentration of power, wealth and opportunity in the south will continue to damage people’s health, and worsen the north-south divide.

The Conversation

Evangelos Kontopantelis, Professor in Data Science and Health Services Research, University of Manchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.