The Health Divide: Why the North East Lives Shorter, Sicker Lives

Where you are born and live should not determine how long and how well you live, yet in modern Britain it very often does. The North East carries some of the starkest health inequalities in the country, with people here, on average, living shorter lives and spending more years in poor health than those in more prosperous parts of the country.

The Lowest Life Expectancy.

The figures lay the divide bare. The North East has the lowest life expectancy at birth of any region in England, for both men and women, followed closely by the North West, while the highest life expectancies are found in the south.

Just as important is healthy life expectancy, the number of years a person can expect to live in good health, which is also lowest in the North East. People here not only tend to live shorter lives but spend more of those lives in poor health.

A Gap That Is Widening.

These inequalities are not narrowing but, in many respects, growing. The North East has seen among the largest increases in life-expectancy inequality of any region over recent years, with the gap between the most and least deprived areas widening.

This reflects a wider national picture in which the difference in life expectancy between rich and poor has been increasing. Nationally, men in the least deprived areas can expect to live around a decade longer than those in the most deprived, and for the North East these inequalities are especially pronounced.

The Role of Deprivation.

At the heart of these inequalities lies deprivation. The North East has many times as many residents living in the most deprived circumstances as the most prosperous regions, and deprivation is powerfully linked to poorer health and shorter lives.

But the picture is more than a simple matter of recorded illness. In more deprived areas, people often report worse health even where the recorded levels of disease are similar, reflecting how much harder it is to manage health problems amid financial insecurity, poor housing and limited support.

The Causes of the Causes.

Understanding health inequalities means looking beyond the health service itself to what are sometimes called the causes of the causes: the conditions in which people are born, grow, live, work and age. Secure, well-paid work, good-quality housing, education and supportive local environments all profoundly shape health, often more than healthcare does.

This is why tackling health inequalities cannot be left to the health service alone, but depends on action across housing, employment, education and the wider economy. The roots of the health divide lie in the social and economic circumstances of people's lives.

What Drives the Gap.

Certain conditions account for much of the gap in life expectancy between richer and poorer areas. Higher death rates in more deprived areas from heart disease, lung cancer and chronic respiratory conditions explain a large share of the difference, and these conditions are strongly linked to risk factors that are themselves shaped by circumstance.

Population-level factors such as smoking remain significant drivers of these diseases and of the inequalities they produce. Addressing them is a public health challenge that goes far beyond individual choices, rooted as it is in the conditions in which people live.

A Question of Fairness.

Health inequalities of this kind are widely regarded as avoidable, unfair and systematic differences in health between groups of people. They are not an inevitable fact of life but the product of circumstances and choices that could be different.

That the place a person is born can take years off their life, and add years of ill health, offends against basic fairness. Tackling these inequalities is therefore not only a matter of public health but of social justice, of ensuring that everyone, wherever they live, has a fair chance of a long and healthy life.

The Cost to the Region.

The consequences of poor health reach far beyond individuals to the wider region. Ill health limits people's ability to work and to participate fully in life, contributing to economic inactivity and placing greater demand on health and care services.

A region burdened by poor health faces a drag on its economy and its potential, while the human cost, in lives cut short and years lost to illness, is immense. Improving the health of the North East is therefore central to its prosperity as well as its wellbeing.

Closing the Divide.

The health divide that sees the North East live shorter, sicker lives than more prosperous regions is one of the great injustices of modern Britain, rooted in deprivation and the wider circumstances of people's lives. Closing it will require sustained action not just within the health service but across housing, work, education and the economy, addressing the deep causes of poor health.

This is a long-term challenge, but a vital one, for a region that deserves the same chance of a long and healthy life as anywhere else. Narrowing the gap would transform not only the health but the prospects of the North East and its people.

The Power of Place.

One of the most important lessons of health inequalities is the profound influence that place has on health, an influence that operates largely independently of individual choices and behaviours. Two people of similar circumstances can have very different health prospects depending on where they live, shaped by the quality of the housing available, the security and quality of local jobs, the state of the local environment, access to green space and amenities, and the strength of local services and support.

In more deprived places, a whole range of factors combines to make staying healthy harder and managing illness more difficult, from poorer housing and fewer good jobs to greater exposure to stress and a thinner safety net of services. This is why health inequalities are so closely tied to geography, and why a region like the North East, with its particular history and economic challenges, carries such a heavy burden of poor health.

Recognising the power of place means understanding that improving health is not simply a matter of encouraging individuals to make different choices, but of changing the conditions in which people live so that the healthy choice becomes the easier one and the circumstances that damage health are addressed. It means investing in good housing, secure and well-paid work, strong local services and healthy environments, as well as in healthcare itself.

It also means recognising that the places that have been left behind economically have often been left behind in health too, and that addressing one requires addressing the other. For the North East, this points to the importance of the region's wider economic renewal, its housing, its jobs and its services, as a foundation for better health.

The power of place to shape health is a reminder that health is made not only in clinics and hospitals but in the everyday conditions of people's lives, and that building a healthier region means building a fairer and more prosperous one.

Share your thoughts.

The North East has the lowest life expectancy of any English region, and the gap with wealthier areas is widening.

What do you think would do most to improve health in our region?