North-South health divide 'kills thousands every year'

The health divide between the North and South of the country is at its widest for 40 years and is claiming the lives of tens of thousands of people before their time, a study has found.

Every year 37,000 people – enough to fill a football stadium – die in the North earlier than their counterparts in the South. But all efforts to narrow the gap have failed. Premature deaths before the age of 75 are a fifth higher in the North, and the gap has changed little since the 1960s. It even widened between 2000 and 2008 despite government expenditure of £20bn on initiatives supposed to close it.

The divide has persisted despite large improvements in health in all regions of the country over the past 40 years. Death rates have fallen by 50 per cent in men and 40 per cent in women since 1965, with both the North and South seeing similar reductions. But the North has never caught up with the South and, in the last decade, seems to be slipping further behind.

Researchers warned yesterday that the excess toll of ill health and disability in the North was "decimating [the region] at the rate of one major city every decade". It is certain to get worse as the effects of the recession are felt disproportionately in the North.

Iain Buchan, professor of public health informatics at the University of Manchester, who led the study, which was published online in the British Medical Journal, said that genetic, climatic and environmental differences could "in no way" account for the gap.

Rather than pinning the blame on differences in lifestyle such as smoking and drinking, the key factor behind the gap was money, he said. "The counter-intuitive fact is that the behavioural differences we can measure account for just one fifth of the gap. The difference in smoking, for example, accounts for only 14 per cent [of the northern excess deaths]. But there is a large body of evidence that shows that the amount of disposable income has a much greater effect.

"Social and economic factors are extremely reliable predictors of health. If you put more resources into an area, or take them out, its health will improve or decline. It would be unheard of for economic growth not to translate into better health."

The health divide mirrors the income disparity between North and South, the researchers say. The "gross value added per head" – a measure of the state of the local economy – was 40 per cent higher in the South than the North in 2008, having risen from 25 per cent in 1989.

The cash people had to spend – their "disposable income" – was more than 26 per cent higher in the South, up from 21 per cent in 1995, even after allowing for the higher cost of living. Professor Buchan said the North-South divide had persisted since 1066 and reflected a London-centric nation with power and money concentrated in the South for the last 1,000 years. Benjamin Disraeli wrote that England was a tale of two countries and William Farr, the 19th-century epidemiologist and founder of medical statistics, blamed the divide on the habit of healthier people in the North migrating to better-off areas in the South, leaving their sickly peers behind.

Migration may still be a factor maintaining the divide but is unlikely to be a major one, the researchers say. Spending on the NHS is inadequate in the North, relative to the high health needs. The Commons Public Accounts Committee accused the Government of failing to address the shortage of GPs in the North in its report on health inequalities last October. Two-thirds of the areas with the highest deprivation were failing to get the money they were due for dealing with excess ill health, it said.

Professor Buchan said the failure of the huge injection of funds by the previous Labour government to close the health gap demonstrated the difficulty of overcoming the social and economic forces driving North and South apart.

"We have to target business development in the North – the South is overworked. The challenge is to have an investment strategy to make the country less London-centric. If we want better health in the North it has to go hand in hand with social and economic change."

The North-South divide in numbers

House prices

The value of homes in the South rose last year, led by a 6.3 per cent increase in London. Average prices dipped in the North, with the North-east experiencing a 3.3 per cent fall, according to the Land Registry.


In 2008, average disposable household income was £19,038 in London and £16,792 in the South-east, according to the Office for National Statistics. This was against £12,543 in the North-east. London households earned more than 28 per cent over the national average in 2008.


In the 12 months ending June 2010, the highest unemployment rate in Britain was in Kingston-upon-Hull, East Yorkshire, at 14 .1 per cent, followed by Blaenau Gwent in Wales at 13.8 per cent. The region with the narrowest spread of unemployment rates was the South-west, where the highest rate of unemployment was found in Torbay, at 8.8 per cent.

Shops lying vacant

The Local Data Company described a "large and growing" divide. In 2010, 90 per cent of the top 25 large towns with the highest vacancies were in the Midlands or North, with 28 per cent of stores in Rotherham vacant. Big shopping centres in London and the South-east were said to be "holding up well".

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