Increased death rates in the most deprived areas of cities in England and Scotland

Death rates in the most deprived areas of cities in England and Scotland have been increasing since the start of the last decade, widening inequalities between the richest and poorest in society.

The important new study, led by researchers at the University of Glasgow in collaboration with colleagues from Public Health Scotland, is the first of its kind to compare mortality rates in cities across the U.K. and paints a concerning picture of worsening health in the most deprived areas.

Until now evidence of mortality inequalities in the U.K.—the difference in death rates between the wealthiest and poorest areas—has been shown at a country-wide level, with only Scottish cities analyzed more closely. This study, published in the European Journal of Public Health, marks the first time mortality rates in English cities have been looked at in greater detail, offering a fuller picture of death inequalities across the U.K. in the 21st century.

The data showed significant changes to mortality inequalities between the early 2010s and 2020 in all U.K. cities included in the study: Birmingham, Bristol, Leeds, Liverpool, Manchester and Sheffield in England, and Aberdeen, Dundee, Edinburgh and Glasgow in Scotland. Researchers excluded London from the study due to its vastly different size.

Researchers found that in each city the death rates in the most deprived areas started to increase from around 2012, with some cities—Leeds, Liverpool, Edinburgh, Dundee and Glasgow—showing stark inequalities between the least and most deprived areas. In the same period, premature mortality (death before the age of 65 years-old) also notably increased in the Scottish cities included in the study.

The data also showed that mortality rates were particularly increasing among women living in the most deprived areas, particularly notable in Leeds, Liverpool and Edinburgh.

The study adds to the now considerable evidence base that shows the harmful impact of U.K. Government austerity policies—cuts to social security and funding of vital public services—that were first introduced in 2010, and which have had devastating effects on the health, and death rates, of the poorest in society across different parts of the U.K.

The final year included in the study, 2020, showed a further increase in mortality rates, once again particularly in deprived areas, attributed to the impact of the COVID-19 pandemic.

Study lead Dr. David Walsh said, “Our analysis provides a hugely concerning picture of worsening mortality and widening inequalities across England and Scotland. When viewed in the context of the evidence for the impact of U.K. Government austerity policies on population health, they must be a wake-up call for the current U.K. Government. We cannot continue to fail the poorest and most vulnerable in our society.”

Co-author Professor Gerry McCartney said, “The scale of the changes mean that the U.K. has now entered a new era of health inequality. As the U.K. Government debates future economic choices, they need to understand the evidence of the harm that cuts to social security and vital services have had on communities up and down the land.”

Health Inequalities research at the University of Glasgow is focused on the persistent and unfair gaps in health and well-being between different groups in society. Our researchers seek to understand what causes health inequalities and how we can best tackle them, together.