Widening health inequalities match UK poverty patterns

By Joe Mount
16 July 2011

Detailed health profiles for each English local authority were published on June 28 by the Association of Public Health Observatories (APHO).

The Department of Health-run programme aims to gather useful public heath information from government statistics. The profiles highlight large health inequalities and the underlying poverty in Britain’s major towns and cities.

Key indicators of poverty, such as the rate of early death from heart attack and stroke, are double the national average in former industrial cities in northwest England such as Manchester and Liverpool and impoverished boroughs of London such as Tower Hamlets.

The statistics paint a picture of a society riven by inequality, with poverty, gutted social programmes and long-term unemployment taking a toll on health and quality of life of working people and their families.

In central Manchester, the gap in life expectancy between the poorest and richest people is 10.1 years for men and 6.4 years for women. Women in this area have the lowest life expectancy in England. The rate of smoking-related deaths is the worst in the country and is two-thirds higher than the national average.

The area is also bottom of the table for the number of people dying from heart disease, cancer and stroke under the age of 75. Drug misuse and alcohol-related health problems are also widespread, with a higher than average number of people addicted to opiates and admitted to hospital for harm caused by alcohol.

In this city centre area, which contains some of England’s most deprived areas, APHO reports that 41,610 children (41 percent of the total, compared to 20 percent nationally) are living in poverty and 24 percent of 11-year-olds are obese. Reports from previous years show that child poverty has increased since pre-2008 levels, damaging health and having an adverse effect on the well-being of the young.

In Manchester, youth are affected by higher than average rates of tooth decay. Teenage pregnancy is more common in central Manchester than any other local authority in England, with a rate 4.5 times higher than the area with the lowest rate, signifying enormous social inequality.

Bolton, a former mill town in the county of Greater Manchester with a population of 265,000, has over 104,000 people living in the most deprived fifth of areas in England, as measured by a combination of economic, social and housing indicators. Since before the 2008 financial crisis, an additional 1,719 children live in poverty, bringing the total of children in low-income houses or receiving means-tested benefits to 15,540 this year.

Educational attainment is also poor in Bolton, where only half of school pupils attain five General Certificates of Secondary Education (GCSEs.) Tellingly, this rate is only slightly lower than the national average because many local authorities, such as the ex-industrial town Burnley, have pass rates less than four in 10. This compares with the highest pass rate, eight in 10, in England’s more prosperous regions.

On the east coast, the metropolitan borough of South Tyneside, which borders the city of Newcastle, has one of the lowest proportions of adults with a healthy diet in the country, at 19.8 percent, according to its APHO profile. The national average is 28 percent and the healthiest areas have up to 48 percent of adults eating healthily. Other problems include a high percentage of mothers smoking during pregnancy (27 percent) and over a fifth of 11-year-olds being obese.

In London, boroughs such as Tower Hamlets (population 235,000), poor health results from general deprivation, evinced by an average life expectancy that is 12 years shorter than those in more well-off areas.

The area has a greater proportion of children living in poverty than anywhere else in England, with 30,745 children, 57 percent, living in low-income households. As in Manchester, one in four children are obese, and the proportion of school pupils who spend more than three hours per week playing sport or in physical education (PE) lessons is less than half, which is below the national average and falls far short of the national best of 80 percent.

The Marmot Review, published last year by the same organisation, found that well-off sections of society live, on average, seven years longer than those of the poorest—which also suffer higher rates of sickness and disease.


British society today is characterised above all by its vast social polarisation. As the majority of the population faces a day to day struggle to get by, the nation’s super-rich enjoy more privilege than ever before, with their wealth rising by £77 billion to £336 billion in 2010, their biggest gains in 22 years, according to the Sunday Times’ “Rich List”.

Health inequality is set to worsen, as cuts and privatisation are applied to the National Health Service (NHS) as part of the austerity plans of the coalition government, which seeks to shift the cost of the more than £1 trillion bank bailouts onto the backs of the population.

Royal College of Nurses (RCN) union General Secretary Dr. Peter Carter is throwing his weight behind the government’s plan to cut NHS funding by £20 billion by 2014. The Telegraph reported Carter’s remarks that politicians would “have to be brave to make these decisions” to close hospitals that are a “drain on the system”.

A series of Freedom of Information (FOI) requests carried out by the Trades Union Congress’s “False Economy” campaign revealed that the plan will in fact cost 53,150 jobs. Of these, 24,000 are in hospitals, 10,000 in primary care trusts and 6,000 in mental health trusts. These numbers are themselves underestimates, because over a dozen hospitals refused to respond to FOI requests.