The rising north–south divide in health in the UK

Abstract

The north–south divide in the UK, and in England in particular, is made up of economic and health-related disparities, among other socioeconomic factors. An article by Iain Buchan and colleagues, published on Aug 7 in the Journal of Epidemiology and Community Health, reported that in the past 20 years, age- and sex-adjusted excess mortality has increased by as much as 46 percentage points in people aged 35–44 years in the north of England compared with the south, and by 27 percentage points in people aged 25–34 years. However, overall mortality plateaued at a low of 35 per 10 000 people from 2012—20% higher than in the south. One cause of this higher mortality is an increase in suicide in young people since the 2008 recession, mostly in the north of England. This has been linked to increases in unemployment, associated with poverty, inferior social welfare, educational attainment, and poorer health outcomes. Rates of drinking, smoking, and obesity are also comparatively higher in the north and are at least partly driven by more fast food shops on northern high streets. Clearly, reports commissioned by the UK Government have not been an incentive for hard action. The 2010 Fair Society, Healthy Lives review identified six policy actions that could be implemented from central and local governments and the National Health Service (NHS) to reduce health inequality. These include creating fair employment and ensuring healthy living standards. Although this report states what changes need to be made—and in which sectors expenditure should be increased—how these changes can be brought about is less certain. The UK Naylor review published in March on NHS property and estates earmarked 117 active clinical or medical sites of the 543 NHS plots of land recommended for sale throughout the country, and highlighted that there were more superfluous sites in the north of the country. The question is now whether the increase in funds and the potential decrease in resources from the sale of these sites will reduce—or increase—the gap in health care between the north and south of England. For the Buchan et al article see http://press.psprings.co.uk/jech/august/jech209195.pdfFor the Fair Society, Healthy Lives review see http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review/fair-society-healthy-lives-exec-summary-pdf.pdf For the Buchan et al article see http://press.psprings.co.uk/jech/august/jech209195.pdf For the Fair Society, Healthy Lives review see http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review/fair-society-healthy-lives-exec-summary-pdf.pdf