Study finds North-south divide in early deaths deepening

Liverpool at night

A new study of mortality rates across England, published in The Lancet Public Health this week (Wednesday, 31 October 2018), highlights socioeconomic deprivation as the cause for the sharp rises in deaths among 22 to 44-year-olds living in the North of England.

Since the mid-1990s, excess mortality has increased markedly for adults aged 25–44 years in the North compared with the South of England.

The study, conducted by researchers from the universities of Manchester, Liverpool, Keele and York, aimed to identify the underlying causes of this excess mortality and the contribution of socioeconomic deprivation.

North verses South

Mortality data from the Office of National Statistics for adults aged 25–44 years were aggregated and compared between England’s five most northern (North East, North West, Yorkshire and the Humber, East Midlands, and West Midlands) versus five most southern government office regions (East of England, South Central, South West, South East, and London) between Jan 1, 1981, and Dec 31, 2016.

The researchers found that deaths during this time period from accidents, alcohol and drug poisoning increased nationwide. However, in the North, where deprivation tends to be greater and more widespread, these deaths increased more quickly.

Between 2014 and 2016, 3530 more men and 1881, more women aged between 25 and 44 died in the North than in the South from 2014 to 2016, when population and age are taken into account.

Important factors

The study found that:

• Accounting for age and sex, northerners aged 25-44 were 47% more likely to die from cardiovascular reasons, 109% more likely to die from alcohol misuse and 60% more likely from drug misuse, compared to southerners.

• London had the lowest mortality rates, with the North East having the highest, even after adjusting for age, sex and socio-economic deprivation.

• Suicide among men, especially at ages 30-34, and cancer deaths among women were also important factors.

• National cardiovascular death rates declined over the study period, though the North – South gap persists.

The study also revealed that, although there was little difference between early deaths in the North and the South in the 1990s, by 2016 a gap had opened up nonetheless.

New health divisions

Professor Evan Kontopantelis, University of Manchester, lead author of the study states the data reveals a profoundly concerning gap in mortality between the North and the South, especially in men.

Professor Kontopantelis, said: “Sharp rises in deaths from accidents, suicide, alcohol misuse, smoking, cancer and drug addiction appear to have created new health divisions between England’s regions and are profoundly concerning.

“These causes of death are all strongly associated with socioeconomic deprivation and in our models two-thirds of the excess mortality in the north was explained by that.”

Professor Iain Buchan

Professor Iain Buchan, who recently took up the position of Public Health & Informatics Professor at the University’s Department of Public Health and Policy, was a co-author on the study. Of the research he said: “Socioeconomic inequalities are the stubborn engine room of England’s North–South divide in mortality.

“Major regional investment and empowerment are needed to counter England’s centralist tradition around London, which drives public health inequalities, now with alarming rises in excess Northern deaths of people aged 25–44 years, especially men.”

The research was funded by the Wellcome Trust and the Health eResearch Centre, which is supported by a consortium of 10 funders including the Medical Research Council.

The full study, entitled ‘Explaining North-South disparities in mortality rates among 25-44 year olds in England: a longitudinal population study’, can be found here.


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