Read: Paying the economic price of health inequality
Health inequality comes at a high price. It costs those individuals who experience more ill-health during the course of their lives and who have an overall shorter life expectancy and it costs the country in lost productivity as a result.
New research from the Northern Health Science Alliance (NHSA) and the All-Party Parliamentary Group (APPG) for left behind neighbourhoods has estimated that persistent ill-health in England’s most left behind communities costs the country almost £30 billion a year in lost productivity.
The 225 left behind areas considered in the report have been identified by combining data from the Community Needs Index with that from the Index of Multiple Deprivation. Mainly post-industrial areas of the Midlands and the north of England as well as coastal towns, they have poor physical and digital connectivity, low community engagement and a lack of community spaces, as well as high levels of social and economic deprivation.
We know that life expectancy rates can vary significantly in different parts of the country and that they can also vary markedly even within smaller areas. The same social and economic factors behind poor life expectancy also have a similar impact on the number of years that people can live in good health. In the 225 left behind areas in the report, there is a higher prevalence of 15 of the 21 most common health conditions including high blood pressure, cardiovascular diseases, obesity, lung conditions and mental health problems. Over 9% of people in these areas say their health is bad or very bad compared with 5.5% in England as a whole.
It’s no surprise that poor health and wellbeing translates into poor economic outcomes. Alongside shorter lives, the reduction in healthy life expectancy means that they are also less productive over their lifetime. Only 47% of people with a health condition or disability that limits their ability to work are in employment, compared with 81% of those without. That is reflected even more acutely in left behind areas – for example, 21% of working-age people in Hartlepool in the north east have a work limiting disability compared to 11% in Hillingdon in London. Even though left behind areas have nearly twice the proportion of people out of work due to sickness than the England average, people living in them still work more hours on average than elsewhere.
In 2018 productivity, measured by Gross Value Added (GVA), in local authorities with left behind neighbourhoods was £20,400 per person. That was £1,400 lower per person than in local authorities that contained other deprived areas and £6,386 lower per person than in the rest of England. With over 15 million people living in the 225 left behind areas, the gap in productivity between local authorities with left behind neighbourhoods and the rest of the country was £124.1bn a year.
Analysis in the report shows that the national economy would be boosted by an extra £29.8bn each year if people in the most deprived regions were as healthy as those in more advantaged areas. Just improving the health of residents in local authorities that contain ‘left behind’ neighbourhoods to the level of residents in local authorities with other deprived areas could add £2bn per year to the national economy.
These figures are a stark reminder of why we need to level up the country, and where we need to concentrate our efforts. They clearly show how deeply it impacts our social and economic wellbeing, as individuals and as a country. In the context of a recovering economy with increased productivity, it is an imperative. As we await the publication of the Government’s White Paper on Levelling Up, it is becoming ever clearer that what should be delivered is a long-term strategy with adequate investment, developed in collaboration with those left behind neighbourhoods which need the most help. Local NHS Trusts, charities and third sector organisations are already working hard to address the issues, backed by local knowledge and expertise which understands the needs of the communities they serve.
The Purpose Coalition – a group of the most committed purpose-led leaders in the country measuring social impact - is working with many of these organisations across the country. Working in local partnerships, they recognise that long lasting success is dependent on the engagement and participation of the community. They are already tackling the fallout from existing health inequality and working to promote the improved health outcomes that will help to boost productivity and prosperity.
Everyone deserves to live a long life in good health. For those left behind neighbourhoods, reducing health inequality and boosting productivity is key to ensuring they can share in the opportunities that will improve their lives for the better. It is also essential for the country as we rebuild the economy post-pandemic.
By Rt Hon Anne Milton