Health gap grows in North after years of low spending
■ Government urged to make good on pledges ■ Alliance tells of hidden burden on top of virus
THE MOST vulnerable communities in Yorkshire are facing widening health inequalities due to a lack of sustained long-term investment in the North, senior health leaders have warned.
The Government has been urged to make good on its “levelling-up” commitment as an already-stretched NHS and social care system is set to face further pressure from a hidden burden of future disease and early deaths.
New analysis for The Yorkshire Post from the Northern Health Science Alliance (NHSA) has revealed that life expectancy for women fell in the region over the last three years, while the English average rose.
While life expectancy among men has risen since 2015, it has done so by roughly half of the equivalent figure for England. At the same time, obesity and diabetes rates have risen higher than in the country as a whole.
Lead author Dr Luke Munford, a lecturer in health economics at the University of Manchester, said mortality rates in May which take into account Covid-19 and noncoronavirus deaths were “some of the highest in the country”.
Unless “urgent action” was taken, Yorkshire’s health inequalities will only get worse, he warned.
“Coupled with this, Yorkshire and Humber has some of the highest unemployment rates in the country and these are rising much faster than average,” Dr Munford said.
“We know the North suffers as a result of health and economic inequalities and this data suggests that things are getting worse and that urgent action needs to be taken.”
Since 2001, life expectancy for women in Yorkshire rose by just 2.1 years to 82.4 for women, whereas the English average is now 83.2. Over the same period, life expectancy for men rose 3.1 years to 78.7, compared to an English average of 79.6.
The NHSA, which brings together leading universities, NHS trusts and Academic Health Science Networks, said poor health accounts for a third of the productivity gap between the North and the rest of the UK at a cost of £13.2bn a year. Long-term investment for health technology research could begin to tackle the issue by benefitting local patients first, and creating new jobs to boost the northern economy,
The NHSA’s chief executive, Dr Séamus O’Neill, said: “For years, there has been rhetoric in government about tackling health inequalities. It is time that the action matches the rhetoric. This has been 50 or 60 years in creation, it is going to take at least that long to address these issues.”
The mayor of the Sheffield City Region, Dan Jarvis, said devolved powers could be used to combat generations of health inequalities in the North.
STARK disparities in poor health in the North have been brought to the fore in “devastating fashion” due to coronavirus, a leading researcher has said. The Northern Health Science Alliance’s (NHSA) chief executive Dr Séamus O’Neill said there is a risk that if lessons are not learned, then those who currently face the most disadvantage will eventually pay the highest price.
He told The Yorkshire Post:
“Covid has hit the North harder and the North is less well able to sustain that kind of blow.
“The effects of Covid-19 are disproportionately felt in the North and equally in Yorkshire because it disproportionately affects areas of deprivation. It is unfairness on top of unfairness.”
Official data revealed in May that the Covid-19 mortality rate in Yorkshire and the Humber was 26.3 deaths per 100,000 people – 31.5 per cent higher than the English average, prompting the British Medical Association to call on MPs in the North to take “urgent, concerted action” to tackle health inequalities.
The call for action comes as five areas in Yorkshire were included in a list of 20 councils facing the worst coronavirus outbreaks in England, with Bradford, Sheffield and Kirklees identified in the region as needing “enhanced support”, and Rotherham and Barnsley marked as a “concern” according to a classified document leaked to The Observer and
The Guardian newspapers.
Dr O’Neill said a lack of longterm investment in tackling poor health in the North is exacerbating generational inequalities and helping to widen the North-South health divide.
New analysis from the organisation shows that since 2001, life expectancy for women has increased at a slower rate in Yorkshire than the English averages.
Areas with the consistently low life expectancy for women include Hull, Barnsley, Doncaster, Rotherham, Bradford, Calderdale, Kirklees, Leeds and Wakefield.
Over the same period, life expectancy for men has increased, but the rate is slower than the English average, and the gap appears to be getting bigger – especially for West Yorkshire.
The NHSA’s analysis also showed the prevalence of obesity in the region since 2015 is rising much faster than the English average, with the much higher rates of obesity in Barnsley,
Bradford, Doncaster, North-East Lincolnshire, North Kirklees, Rotherham, Scarborough and Ryedale and Wakefield.
Dr O’Neill stressed that the Covid-19 pandemic should serve as a watershed moment in creating the social and political will to build a society that values the nation’s health now and in the long term.
“If people continue to see sustained inequality, it is not a matter of what party they vote for – people will just stop participating,” he said.
“I think there is a real risk of having a very disillusioned and disengaged population who don’t see the value of government.” Dr O’Neill said using the strengths of Yorkshire’s hospitals and other NHS assets to attract industry investment over a sustained period should be a priority, adding: “There is no shortage of passion and ideas or innovation in the North – what we need is the space to work and the resource to work which has been disproportionately based in Whitehall so far. “There are 16 million people in the North, and we are talking about a few high-profile investments, but we should be talking about many, many more of those large-scale investments. The fact that there are not that many big government initiatives or investments in the North is telling.”
The NHSA is calling on the Government to “over-invest” in the pockets of excellence to give the North the opportunity to “compete” after under-investment for decades.
Dr O’Neill said: “The time is now to act, we can’t do anything about the missed opportunities over the years that have gone. But the lack of opportunity and the disadvantage is compounded by every year and every generation that goes past.”
The Government insisted it is committed to levelling up – including health inequalities – during and after the pandemic.
A Department of Health and Social Care spokesperson said: “It is clear Covid-19 has disproportionately impacted certain groups and we are determined to take the right steps to protect them and minimise their risk.
“Following the findings of Public Health England reports published last month, the Equalities Minister is taking forward vital work to tackle these disparities and protect our most vulnerable communities from the impact of the virus.”
Well-documented divide
However, a health leader from Yorkshire warned that the North has been “devoid of investment and energy” and the recovery from Covid-19 should be used to place targeted long-term investment into local communities.
Professor Mahendra Patel, from the University of Bradford, said emphasis should be placed on positive early childhood development initiatives to fight against generational health inequalities.
He made the call as new analysis from the NHSA showed the prevalence of diabetes in the region since 2015 is increasing much faster than the English average.
Higher rates of diabetes are found in Barnsley, Bassetlaw, Bradford, Doncaster, North-East Lincolnshire, North Kirklees, Rotherham, Scarborough and Ryedale and Wakefield clinical commissioning group areas.
New NHSA data also revealed that across the Bradford district the prevalence of obesity stands at 13.23 per cent, 30.73 per cent higher than the English average, while the prevalence of diabetes is 8.45 per cent, or 21.93 per cent higher than the national average.
Prof Patel is a member of the Royal Pharmaceutical Society’s English Pharmacy Board, which has worked with ethnic minorities to tackle health inequalities for more than 20 years.
He said: “You cannot say we just accept our health inequalities here. This North-South divide has been well documented.
“People have been trying for decades to make changes in various governments – it is just not happening.”
Prof Patel, who has led outreach work to highlight health messages to ethnic minority communities, stressed early childhood prevention plans need to be expanded to tackle issues such as high rates of obesity and diabetes in both adults and children, and poor oral health, particularly tooth decay in youngsters.
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Poor suffer the most
Deprivation spurred on by a decade of austerity has entrenched health inequalities that have been ruthlessly exposed by Covid-19, a leading York charity has warned.
The Joseph Rowntree Foundation (JRF) said the Government needs to prioritise ending poverty in the region to improve health, as families on Universal Credit and Child Tax Credit struggle to afford food and basic utilities, such as gas and electricity.
Research published last month by the JRF showed two-thirds of families on Universal Credit had slid into debt since the start of the lockdown.
The organisation, alongside Save the Children, has called for a £20-a-week increase to the child element of Universal Credit and Child Tax Credit to help the poorest families. Those on Universal Credit currently receive £235.83 per child per month.
The JRF’s acting director, Helen Barnard, inset, told The
Yorkshire Post: “One group we are worried about are families with children, particularly because there hasn’t been any targeted help.
“We have been calling for an urgent lifeline for children, because we can see families of children are really getting pulled under.”
The head of UK poverty campaigns at Save the Children, Becca Lyon, added: “By taking action now, we can prevent increased child poverty from becoming a damaging legacy of this pandemic, which has already caused too much suffering.”
Some 1.2 million people in the region live below the breadline, with 30,000 more people in Yorkshire living in poverty than five years ago, according to the JRF.
While more than a fifth of people in Yorkshire live in poverty, what is particularly concerning, the charity said, is that most of this rise was among children – with nearly a third of all youngsters in the region, a total of 350,000, now living in poverty.
Ms Barnard, who is also a member of the West Yorkshire Economic Recovery Board, warned this figure will grow disproportionately for those most vulnerable in the region with a detrimental effect on their health as a result of the pandemic.
She said: “Across Yorkshire, people in poverty are spread over quite a lot of areas, and people in poverty have higher mortality rates from Covid-19.
“Living in poverty means you are much more likely to have underlying health conditions because of the ongoing pressure that poverty puts on your mental and physical health. So people are going into this pandemic much more vulnerable.”
Plea for sporting chance
Meanwhile, a leading Yorkshire sports organisation has called for extra support to push exercise and fitness in areas hit by a “double-whammy” of deprivation and low activity levels to help the recovery from coronavirus.
Yorkshire Sport Foundation chief executive Nigel Harrison said there was a need for a government drive in some of Yorkshire’s most deprived areas where high rates of inactivity could see inequalities rise for the most vulnerable in future.
“We have concerns that there could be greater inequalities and greater health reductions for people who we aren’t then able to support in the way we would like to,” he said.
The charity, which contributes to the Government’s agenda to increase the number of people participating in sport and physical activity nationally, works across 15 priority areas in South and West Yorkshire with the highest rates of health inequalities identified through analysis of income deprivation domain data (IMD). In West Yorkshire, areas include Seacroft in Leeds, Birkby and Fartown in Huddersfield and Airedale in Castleford, while Maltby in Rotherham, Burngreave in Sheffield, Kendray in Barnsley and the Dearne Valley are covered in South Yorkshire.
Mr Harrison said: “Our main concerns as we go forward are those health inequalities could increase, with a reduction in the economy which is looking highly likely in the future.”
He added that if inequalities continued to widen in the North, it would have a detrimental effect on the health and wealth of the region.