Mortality inequalities are increasing in cities across the UK with ‘deeply concerning’ changes to UK health trends since the 2010s, a study shows.
Death rates in the most deprived areas of cities in England and Scotland have been increasing since the start of the last decade, and researchers report that the UK has now entered ‘a new era of health inequality’ with worsening health in the most deprived areas.
In collaboration with Public Health Scotland, researchers at the University of Glasgow examined intra-city mortality rates across UK cities to provide an up-to-date, detailed picture of UK health trends, including the impact of the Covid-19 pandemic. Previous studies examining long-term UK health trends used country-wide mortality data.
The findings, which the researchers call a ‘wake-up call’ for current and future UK governments, are published in the European Journal of Public Health.
The researchers analysed data from the Office of National Statistics (ONS) for England and from the National Records of Scotland (NRS) for Scotland between 1981 and 2020, examining death records, sex, age, and levels of socioeconomic deprivation across ten UK cities. The cities were chosen because they were the largest in their respective counties.
They included Birmingham, Bristol, Leeds, Liverpool, Manchester, and Sheffield in England and Aberdeen, Dundee, Edinburgh, and Glasgow in Scotland. The study excluded London to allow for more meaningful comparisons between cities.
Manchester, Birmingham and Liverpool
All cities showed high levels of inequality in terms of available income. The highest levels of deprivation were found in Manchester, Birmingham and Liverpool, with between 22 and 23 per cent of the population classed as ‘income deprived’, compared with 14 to 16 per cent in Bristol, Leeds, and Sheffield and between 9 and 19 per cent in Scottish cities.
The data showed significant changes in mortality inequalities over the last few decades. Between the early 2010s and 2020, in all UK cities included in the study, the death rates in the most deprived areas began to increase around 2012. In the same period, premature mortality, defined as death before the age of 65, significantly increased.
Women living in the most deprived areas faced a higher risk of dying earlier, and the data showed notable increases in female mortality rates in Leeds, Liverpool, and Edinburgh.
Worsening mortality and widening inequalities
Study lead Dr David Walsh from the University of Glasgow said: ‘Our analysis provides a hugely concerning picture of worsening mortality and widening inequalities across England and Scotland. When viewed in the context of the evidence for the impact of UK Government austerity policies on population health, they must be a wake-up call for the current UK Government. We cannot continue to fail the poorest and most vulnerable in our society.’
The researchers suggest that the study provides evidence that the UK Government’s austerity policies, including cuts to social security and public services introduced in 2010, are having devasting effects on the health and death rates of the most deprived populations across the UK. The final year of the study, 2020, which coincided with the first year of the Covid-19 pandemic, showed further increases in mortality rates, with the most significant impacts seen in the poorest communities.
Co-author Professor Gerry McCartney, also from the University of Glasgow, added: ‘The scale of the changes mean that the UK has now entered a new era of health inequality. As the UK Government debates future economic choices, they need to understand the evidence of the harm that cuts to social security and vital services have had on communities up and down the land.’
