Death rates among working-age people in the North of England have tripled compared to the South since 1981, with 25 to 49-year-olds now facing a 42% higher mortality risk, according to a study published in The Lancet Public Health.
The gap, which stood at 13% in 1981, widened sharply by 2024, with experts describing the findings as "deeply worrying" and warning that this is just the "tip of the iceberg" of regional health inequalities.
Women in the North face higher mortality risk
In the 1980s, northern women in their late twenties and thirties were no more likely to die than their southern counterparts. Today, a woman of working age is between a third and two thirds more likely to die, the research shows.
Professor Iain Buchan, public health physician and data scientist from the University of Liverpool, said: "These findings are deeply concerning," and warned it "is the tip of the iceberg of rising regional inequalities in the health of working-age adults..."
Speaking to The Mirror, Professor Buchan said: "That's more than a tripling of the gap in my working lifetime. It worries me enormously that we have been asleep at the wheel as a country. We are not doing enough to fix the problem."
Deaths stopped falling in the North around 2012
England's death rates among working-age people had been falling for decades, but around 2012 they stopped falling in the North and have risen about 12% since, while in the South rates have barely moved.
Professor Buchan highlighted the economic impact, saying: "Health Equity North estimates that if people in the North were as healthy as the rest of England, the UK economy would be about £18 billion a year bigger. That's not charity for the North, that's the health and wealth of the whole country."
He attributed the "big differences" between North and South to income, housing and access to fulfilling work, adding: "Prevention is key for both public health and the economy. In the years after 2010 the cuts fell hardest on the services women in the poorest areas rely on."
Study calls for targeted government action
The study, led by researchers from the University of Liverpool, the University of Manchester and Health Equity North, analysed national death registrations and population estimates from 1981 to 2024. The authors describe the widening divide among working-age adults and women in early to mid-life as "major challenges for government".
Professor Evangelos Kontopantelis, Professor in Data Science and Health Services Research at the University of Manchester, said the study "paints a picture of persistent regional inequalities and exposes a concerning trajectory for the North. It also provides robust evidence for the need for sustained policy action in the North that extends beyond healthcare and tackles the wider factors that shape health outcomes, such as deprivation, multimorbidity, poor housing and adverse employment conditions."
Hannah Davies, Chief Executive of the Northern Health Science Alliance and Executive Director of Health Equity North, said: "Targeted action is needed in the hardest-hit communities, informed by robust research and combining prevention and healthcare with action on the wider social and economic determinants of health."
The report concludes: "Reducing premature mortality and its regional inequalities in England will require sustained action on the social determinants of health - a daunting challenge, especially given the current economic climate and unemployment pressures, but one that is essential if the UK is to meet its commitments to growth, opportunity, and a healthier population."
A Department of Health and Social Care spokesperson said: "Someone's postcode should never dictate how long they live, and this government is determined to tackle the stark inequalities that still exist in our country, and halving the gap in healthy life expectancy between the richest and poorest regions. We're already taking action, including delivering pioneering new Neighbourhood Health Centres in the areas that need them most, but we will now go further in devolving power to local communities, putting decision-making into the hands of those who know their areas best, and driving lasting change across the country."
