The UK has some of the largest place-based health inequalities of any advanced economy. We are getting poorer and sicker and the places already faring worst are falling behind the fastest. Healthy life expectancy is like an alarm bell for how well our economy and society are doing, and right now, the alarm is sounding loudly. The government must change course, or we will remain a fundamentally divided country.
New research by my colleagues at the Institute for Public Policy Research (IPPR) has found a gap of more than 20 years of healthy life expectancy between our best and worst performing local authorities in the UK. On average, people in Wokingham can expect 70 years in good health, but those living in Liverpool can expect only 58 years of the same conditions. Places with poorer health also experience lower household income, higher poverty and lower wealth.
This chasm between places chimes with what I’ve seen. I’m lucky enough to spend time working across the country with determined communities – one week in Redcar, the next in Wigan – but it’s becoming harder and harder to ignore the escalation in issues people are facing day-to-day: social isolation, destitution, poor mental health, dilapidated homes, all coupled with the grim expectation that nothing will change.
We need to correct course to tackle these place-based inequalities. The latest report from the director of public health for Liverpool City Council, Professor Matt Ashton, makes for stark reading. The key health issues that will face children and young people in Liverpool in the next two decades are poor mental health, obesity and child poverty. Regions like that face the double disadvantage of poor health and poor economic and social conditions.
This gets to the core of why levelling up, or its next iteration, can’t be separated from health. They are two sides of the same coin. One proposal made by IPPR to address place-based health disparities is to introduce what we have called health and prosperity improvement zones across the country. The zones would provide local leaders in the areas with the lowest healthy life expectancy with additional funding, paid for with a health-harming industry levy, to combat the drivers of poor health, as well as the option to make junk food, alcohol and tobacco less attractive through local taxes.
Good health is not only needed to make life worthwhile – sustaining relationships with friends and family, being active in your community, and engaging in passions and hobbies – but it also enables us to keep financially afloat. Our health and our wealth are inextricably linked. If our economy and society fail to provide the conditions for a long and healthy life, then what and who are they serving? If we use that as our guiding principle, then poverty and housing will need to be prioritised as part of our approach, connecting all of these strands to a plan for regional growth. If we level up the right way, health outcomes will improve, helping productivity, lowering economic inactivity, and relieving pressure on the NHS.
The adage “prevention is better than cure” couldn’t be true enough.