Cambridge researchers find major health inequalities—as well as a geographic divide—between the most and least deprived English towns. They say that life expectancy in cities is now overtaking towns for the first time.
Populations in England’s poorest towns have on average 12 fewer years of good health than those in the country’s richest towns, according to new research from the University of Cambridge’s Bennett Institute.
The study shows that the number of hospital admissions for self-harm in the most deprived towns is—on average—almost double that of the most affluent, with alcohol-related admissions over 75% higher than in the least deprived towns.
Lung cancer is twice as prevalent in the most deprived towns, and child obesity in the poorest towns stands at an average of 23% by the end of primary school, compared to around 12% in the wealthiest.
In fact, researchers say the overall life expectancy of town-based populations is “moving in a worse direction” compared to cities—with female life expectancy now higher in English cities than towns for the first time this century.
“The previous pattern of rising life expectancy has stalled or gone into reverse in many English towns,” said Prof Mike Kenny, report coauthor and Director of the Bennett Institute for Public Policy. “Declining fortunes and debates over Brexit have highlighted the chasm that divides many town inhabitants from those in cities.
“However, on some key health measures, inequalities between towns are much greater than the average difference between towns and cities. People in England’s most deprived towns lose over a decade of good health compared to the populations of wealthy towns.”
“There is an overriding need for policies to address the large and widening gaps in the health and opportunities of many towns. These policies should be integral to post-pandemic economic recovery agendas,” Kenny said.
The team found a “strong geographical context”: most of the healthiest towns are in the South East, while most of the unhealthiest towns are situated in former industrial areas of Northern England.
Towns with the longest life expectancy include Frimley in Surrey and Filton, near Bristol. Populations with the shortest lives, on average, were found in Thurnscoe, near Barnsley, and Oldham.
Two seaside towns at either end of the country, Blackpool in the Northwest and Jaywick in East Anglia, had the highest levels of self-harm. Another coastal town, Newbiggin-by-the-sea, near the former collieries north of Newcastle, had the highest child obesity rates. Eccles and Salford on the outskirts of Manchester are the towns with most alcohol-related hospital admissions.
Hertforshire contains a number of England’s healthiest and wealthiest towns, such as Radlett and Harpenden, while many of the country’s unhealthiest towns—scattered across the north—are also those with the largest populations.
The provision of public green spaces—so important for physical and mental health, and never more so than during the recent coronavirus lockdown—was another dividing line between wealthy and unhealthy towns.
The most affluent towns are on average twice as likely as the most deprived towns to have a common or municipal park within their “built-up area boundary”, according to researchers.
They also found that the most deprived towns had—on average, per capita—50% more fast food shops than the most affluent towns.
“More deprived towns are much less likely to have a green town centre and much more likely to have high numbers of fast food outlets than their wealthier counterparts,” said Ben Goodair, the report’s lead researcher. “Both these factors contribute significantly to the widening of geographic health inequalities in England.”
“There is every chance that the coronavirus pandemic will make the inequalities we see in our research even worse,” said Goodair. “Many deprived towns have an older age profile, and are more susceptible to the worst effects of the virus, as well as low employment prospects that will be reduced even further by the economic consequences of lockdown.”
The report only looked at COVID-19 data up to mid-April, but found a slightly higher death rate was already visible in the more deprived towns during the early phase of the pandemic.
Added Kenny: “The current government has said it is committed to ‘levelling up’ England’s regions. Tackling the factors damaging the health of the poorest towns will have to go much further than the hospital walls, including boosting skill levels, promoting local employment and building community resilience.”