Health inequalities are widening between children in the North and the rest of the country - Hannah Davies & Dr Luke Munford

That’s why the Government’s Levelling Up white paper published two years ago was welcomed by those working in the public health space.

Today however, in a post-Covid, cost-of-living crisis era with the worst child poverty rates in the OECD group of countries, the white paper’s 2030 health mission - to narrow healthy life expectancy between the highest and lowest areas, and for health life expectancy to rise by five years overall - seems a pipe dream.

Recent data shows things are getting worse, not better. Healthy life expectancy (HLE) is trending downwards almost everywhere but much faster in the most deprived areas – many of which are in the North of England.

Since the Levelling Up White Paper was published we’ve seen in our Health Equity North reports that Children in the North are more likely to be in care than anywhere else in England, that funding for welfare support has been slashed, that people in the North of England are more likely to die from “Deaths of Despair” than elsewhere in the country, that they are increasingly poorer and the factors that see people pushed into ill health are increasing. In addition, there is an ever-growing body of evidence of trends getting worse in other aspects of health. The North has higher rates of bad health, disability, economic inactivity due to ill health or disability, and unpaid care provision.

The frustrating thing for those of us working, researching and advocating for improved public health is that we know that the Levelling Up mission on health was, and still is, achievable – perhaps not now by 2030 but with the right policies people can live longer lives and in much better health.

Investing in health has a far-reaching impact both in terms of improving people’s health, wellbeing and life chances but also a knock-on effect on productivity. The shocking increase in the number of people of working age who are signed off sick doesn’t come from nowhere – it’s driven by poverty, and in the North, there has been a shocking lack of investment compared to the South of the country.

Our seven Health Equity North missions, to create a national strategy to reduce health inequalities, tackle poverty through evidence-based policies, to give children in the North enough food of good quality, to give people warm homes of a good standard, to support communities and families to access health and social care easily, to fund schools in the North of England fairly and give people in communities that are not often consulted a voice, offer steps to take us out of the mess of ill health, low productivity and poverty.

Not taking action when NHS waiting lists climb and more and more people drop out of work should not be an option.

Our reports have found over the last decade, the regional life expectancy gap increased for both males and females. The three northern regions – Yorkshire and The Humber, the North East, and North West - have amongst the highest rates of infant mortality. Across the North there is an average of four deaths per 1,000 live births compared to three deaths per 1,000 live births in London and the South East. This equates to an extra 144 infant deaths in the North in 2021, above what would be expected if we had the same rates as in the best performing regions.

Children in the North are also more likely to live in poverty than the rest of England and are amongst the least protected from the cost of living crisis. We know that poverty is the lead driver of inequalities between children in the North and the rest of England, so why aren’t those with the power to change the state of play listening to the myriad of warning signs?

The levelling up agenda has failed to deliver the necessary action on poverty and livelihoods to address the wider determinants of health inequalities. Recent child poverty figures suggest that, far from reducing health inequalities, Government actions over the past decade will cast a long shadow, with inequalities in child health and development setting children living in deprived areas on trajectories of compromised educational attainment, lower labour market participation and productivity, and physical and mental health problems.

Our research shows that improving health in the North would reduce the regional gap in productivity by 30 per cent or £1.20 per person per-hour, generating an additional £13.2bn in UK GDP per year.

The evidence is clear. It has been for years. What’s not clear is why the Government has failed to make meaningful inroads in tackling these entrenched inequalities.

Hannah Davies is Health Equity North executive director and Dr Luke Munford is academic co-director at Health Equity North.