'Health gap widens between rich and poor'

Forty years of progress in public health have failed to make any impact on the poorest people in northern England, who are dying at the same rate as people did in the late 1940s and early 1950s, according to a report.

The study says the gap between the health of the rich and the poor is widening, with the health of the poor worsening significantly between 1981- 1991. Death rates in the most affluent areas fell substantially, but rates in the poorest areas actually increased, particularly among men aged 15-44.

Dr Peter Phillimore, from the Department of Social Policy at Newcastle University, one of the authors of the report, said: 'For the first time since the 1930s the death rate is rising (in these groups).'

According to the report published in tomorrow's British Medical Journal, inequalities in death rates increased for both sexes in all ages under 75 'primarily because the health of people in the poorest areas worsened relative to the rest of the population'.

The study looked at 678 electoral wards in Cleveland, Cumbria, Durham, Northumberland and Tyne and Wear, comparing factors linked to socio-economic status: unemployment, car ownership, housing tenure, and household overcrowding. Death rates from all causes were assessed for different age categories between 1981-1991.

The research suggested that unemployment and deregulation at work are 'at least as influential' as HIV and Aids on national changes in death rates of men aged between 15-44.

The report says that in the poorest 10 per cent of wards, death in 1989-1991 among men aged 45-54 and women aged 55-64 was equivalent to national levels last experienced in the late 1940s, while among women aged 45-54 and men 55- 64 the equivalent rates occurred in the early 1950s. It concludes that 'public health is strongly linked with material conditions rather than individual behaviour'. Critics of the Government say that its failure to acknowledge this undermines its Health of the Nation strategy. Average life expectancy in Britain slipped from 12th position in 1970, to 17th in 1990 among 24 countries of the OECD.

Health spending will be tilted towards the underprivileged areas in the North and the inner cities under plans being prepared by Labour.

The shift in grants to NHS regions is being planned as a solution to a widening gap in health between North and South, and rich and poor, David Blunkett, the Labour spokesman, said in a speech to a public health conference at Birmingham University.