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
Photo by Tim Mossholder on Unsplash