The North East’s ‘Left Behind’ Neighbourhoods

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A devastating new report by the All-Parliamentary Party Group (APPG) for ‘left behind’ neighbourhoods and the Northern Health Science Alliance (NHSA) explores the health inequalities of our most deprived neighbourhoods and how these could be overcome.

This summary will highlight the North East stats and impact on work, the economy, and businesses.

 

What are ‘left behind’ neighbourhoods?

‘Left behind’ neighbourhoods are identified as being within the top 10% most deprived of the Index of Multiple Deprivation and the top 10% of areas most in need as measured by the Community Needs Index. They lack the transport, digital connectivity, and social infrastructure that would transform a place into a community where people would want to live and businesses would want to trade.

Of England’s 225 ‘left behind’ neighbourhoods, nine of the 20 most vulnerable are in the North East, with six of them being in County Durham specifically.

Areas that are identified as ‘left behind’ have among the worst health outcomes in England, and these disparities between them and the rest of the country are continuing to grow. People who live in these areas are more likely to self-report their health to be ‘bad’ or ‘very bad’ (9.1%) than other deprived areas (8.1%) and England as a whole (5.5%). As a result of these worse health outcomes, people in ‘left behind’ neighbourhoods also live shorter lives and live 7.5 fewer years in good health.

The report has also shown that those living in ‘left behind’ neighbourhoods have been particularly vulnerable to COVID-19, with them being a devastating 46% more likely to die from it when compared to the national average. These COVID-19 mortality rates were particularly high in ‘left behind’ neighbourhoods in the North East. Seven of the 10 areas with the highest mortality rates are in this region, with the highest recorded rate in Hemlington in Middlesbrough.

 

Work and the Economy

It is apparent that these health inequalities have an impact on work. ‘Left behind’ neighbourhoods have nearly twice the proportion of people out of work due to sickness than the England average. Residents are also more likely to be out of employment due to mental health conditions. Despite this, people in these neighbourhoods also work more hours on average than those in the rest of England, but the nature of the jobs in these areas means that average wages are lower, as is productivity, which is falling even further behind the rest of England.

This poor health therefore also translates into poor economic outcomes. However, reducing health inequalities and bringing ‘left behind’ neighbourhoods up to England’s average would add an extra £29.8 billion to the country’s economy each year.

 

Policy Recommendations

The report emphasises that investment in the social infrastructure that ‘left behind’ neighbourhoods lack is a key policy solution. This would transform the physical and social environment in these neighbourhoods and strengthen residents’ capacity to address the health disparities and other poor outcomes that they experience. To achieve this would require consistent and longterm financial support.

The report also suggests that the government’s national ‘levelling up’ strategy must include reducing regional health disparities trough targeting multiple neighbourhood, community and healthcare factors. The authors stress that levelling up cannot be done without working together with these communities and their residents. Residents must be listened to and be able to take an active role in safeguarding their health and improving the quality of their lives and their community.

Community public health budgets must also be safeguarded and more longterm funding is needed for effective delivery of resources and for targeted heath inequalities programmes, such as Healthy New Towns.

Healthy New Towns was a three-year NHS England initiative that took place between 2016 and 2019 in ten housing development sites across England. One of these sites was Darlington. The initiative provided resources to these housing development sites with the aim to shape the health of communities and rethink how healthcare services could be planned more effectively and from a more integrated approach, which could, in turn, promote health and wellbeing and prevent illness.

Despite challenges which included a delayed implementation and funding uncertainty, Darlington’s Healthy New Towns programme was successfully piloted. It resulted in a cultural shift among GP practices to work in more integrated ways, a successful delivery of e-consulting across the area, and more suitable serviced being accessed by patients, which led to an estimated 985 GP appointments being saved in 2019 and reduced incidences of non-attendance.

 

Overall, the report shows the severity of regional health inequalities in this country (which has been further exposed by the Covid-19 pandemic) and the importance of taking an ultra-local approach to solving health issues and engaging the local community in these efforts. If these inequalities can be addressed, not only will the lives of millions of citizens be improved, but entire communities and the economy as a whole.

 

Read the whole Overcoming Health Inequalities in ‘Left Behind’ Neighbourhoods report here, and their summary here.

Read my summary of a previous NHSA report, Child of the North, here.

 

Freya Thompson

Knowledge and Research Executive

@NEEChamberFreya

Photo by Tim Mossholder on Unsplash

New Report Reveals Devastating Inequalities Faced by Northern Children

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A major new report, Child of the North, produced by the Northern Health Science Alliance (NHSA) and N8 Research Partnership outlines the inequalities faced by children growing up in the North post-pandemic compared to those in the rest of the country.

Over forty leading academics from across the North of England wrote of the wide range of factors disproportionately impacting our children, including increased chances of poverty, obesity, being in care, and death under the age of one. Children of the North were lonelier throughout the pandemic, and they also missed more schooling throughout this time, which will cost an estimated £24.6 billion in lost wages over lifetime earnings, while the mental health conditions they developed during the pandemic could cost them an additional £13.2 billion. The North also faced more cuts to spending on Sure Start children’s centres — a shocking £412 per eligible child on average, compared to only £283 in the rest of England. In addition, the one in five children who are from an ethnic minority in the North are more likely to live in deprived areas than children from ethnic minorities elsewhere.

The North East stats:

  • The North East has the highest child poverty rate before housing costs at 30% and the 2nd highest after housing costs at 37%
  • Between 2011/12-13/14 and 2017/18-19/20, the child poverty rate increased by 11% in the North East (compared to 3% for the UK as a whole)
  • Almost half of Middlesbrough’s local authorities (48%) are among those with the 10% highest child poverty rates nationally. This is the highest proportion nationally. Hartlepool follows with 43%, which is the 3rd highest nationally
  • By the 2nd half of the autumn 2020 term, pupils in the North East experienced 4.0 months learning loss in primary maths (compared to less than a month in the South West and London) and a 2.0 month loss in reading (the greatest in the country)
  • Children in the North East are most likely to be eligible for Free School Meals (27.5%)
  • Prevalence of low and very low household food security was 11% in the North East (compared to 6% in the South East and 8% in England as a whole) and when marginal food security is considered, the prevalence rises to 18% (compared to 11% in the South East and 14% for England as a whole)
  • The North East is the region with the highest persistent overall rates of children in care
  • The North East has the highest under 18s conception rate
  • The North East has the highest prevalence of obesity at age 17
  • Domestic abuse rates are highest in the North East, where the rate is 19 per 1,000 population (almost double the London rate)

As a result, children growing up in the North “get a bad deal” with worse outcomes “across the board” says David Taylor Robinson, who is co-lead author of the report and Professor of Public Health and Policy at the University of Liverpool, and yet these inequalities are preventable. Kate Pickett, another co-lead author and Professor of Epidemiology at the University of York, states that levelling up the North should be just as much about creating opportunities for children as it is about infrastructure, and that “investment in children creates high returns and benefits for society as a whole.”

This includes “high returns and benefits” for the economy, with the report explaining that the well-known ‘productivity gap’ between the North and the rest of England, which costs the UK around £44bn a year and is predicted to grow, has its origins in poor health care. In essence, the relatively poor health care in the North has a profound impact on child health and development, which then impacts these children’s ability to grow up to be healthy, productive adults in the future, and the pandemic has exacerbated this. Previously, a 2018 ‘Health for Wealth’ report found that improving health in the North would reduce the regional gap in productivity by 30% and generate an additional £13.2 billion in UK GDP.

The authors put forward a large set of recommendations which aim to tackle the inequalities suffered by Northern children over the course of the pandemic, which includes urging the government to invest in early years services and other welfare, health and social care systems that support children’s health, particularly in the most deprived areas and areas most affected by the COIVD-19 pandemic. They state the need for greater support for children’s educational development in the post-pandemic years in order to ‘make-up’ for lost development of both cognitive and non-cognitive skills. The UK is already ranked as one of the lowest (169 out of 182) for its ability to deliver on key areas of children’s rights, prompting the report to advocate for children’s rights to be placed at the heart of COVID-19 recovery plans.

As for what the report says businesses can do to help, they encourage local businesses to pay staff the Living Wage, get involved in multi-component employment interventions to decrease unemployment among young people, and connect with and support educational establishments. The report states that “schools can help businesses to engage and understand places and their people, and help our businesses and enterprise initiatives target investment more effectively, and thereby drive social mobility.”

Read the NHSA and N8 Research Partnership’s full report here and their summary here.

Freya Thompson

Knowledge and Research Executive

@NEEChamberFreya

Photo by Michał Parzuchowski on Unsplash