Adults living in the most deprived areas of England are more than twice as likely to die before age 75 as those in the least deprived areas, a Health Foundation analysis has found. The risk was 2.3 times higher for both men and women in the most deprived areas, with 815 premature deaths per 100,000 people compared with 353 per 100,000 in the least deprived areas.
The analysis used demographic data from the 2021 census and deaths recorded from March 2021 to December 2023. It defined premature mortality as any adult death before the person’s 75th birthday and examined differences by deprivation, education, employment, region and ethnicity.
Educational and occupational gaps were pronounced. Women with no qualifications had a premature mortality rate 2.5 times higher than women with a degree or higher qualification. Men who were long-term unemployed or had never worked had a rate 3.5 times as high as men in higher managerial, administrative and professional occupations.
The inequalities were widest in the northeast, the northwest and Yorkshire and the Humber, and narrowest in London. Among women who had never worked or were long-term unemployed, the rate in the northwest was 796 deaths per 100,000 people, 72% higher than London’s 462 deaths per 100,000.
The research also points to a decline in healthy life expectancy. Previous analysis has indicated that the UK population’s health is poor, getting worse and not improving at the steady pace seen in countries such as Japan, Norway and Spain.
“These findings lay bare the scale of the inequalities that continue to shape people’s chances of living a long and healthy life,” said Freya Tracey, principal data analyst at the Health Foundation. “Where you live, the opportunities available to you, and the circumstances you are born into should not determine your risk of dying early. A cross-government approach is needed to reduce inequalities in the building blocks of health – including education, employment and local economic conditions.
“The government’s approach to devolution must include supporting local areas to deliver prevention to reduce health inequalities. Without sustained action, inequalities will continue to cut lives short.”
Ethnicity patterns varied. Black Caribbean men had the highest male premature mortality rate, at 573 deaths per 100,000, closely followed by White British men at 537. Chinese men had the lowest rate, at 284 deaths per 100,000. Among women, White British and Black Caribbean women had the highest rates, at 370 and 367 deaths per 100,000 respectively, while Chinese women had the lowest observed rate, at 181 deaths per 100,000.
Jabeer Butt, chief executive of the Race Equality Foundation, said the figures appeared to challenge much of what is known about racism and health inequalities. He said lower premature mortality in some ethnic groups did not mean those groups experienced better health or that racism was unimportant.
“What our analysis shows is that we need to look beyond ethnicity alone, to understand how migration, poverty, employment, housing and discrimination interact to shape people’s chances of living a long and healthy life,” Butt said.
The Department of Health and Social Care was approached for comment.