COVID-19 And The Northern Powerhouse
COVID-19 and the Northern Powerhouse:Tackling inequalities for UK health and productivityLuke Munford, Lecturer in Health Economics, University of Manchester(On behalf on NHSA Report teams)
20182020
Regional health inequalities before COVID-19
Variations in life expectancySource: PHE Fingertips4
Life expectancy over timeConsider the ‘NorthernPowerhouse’ vs. the restof EnglandSource: ONS5
Other health outcomesData from 2018/19. Source: ONS; PHE Fingertips6
% of adults (aged 18 ) who are obese or overweightWest eand65.4NorthNorth EastEast64.9NorthWestWestNorth64.9East Midlands64.2East of England63.3England62.3South West61.3South East61.0London50.055.952.054.056.058.060.062.0% of population64.066.068.0Data from 2018/19. Source: PHE Fingertips7
% of children who are obese or overweight25.2North WestWest37.4North East24.8West Midlands24.637.538.224.1Yorkshire and the Humber35.823.0England35.222.7South West31.8East Midlands22.0South East21.9East of eption(aged 4/5)15.020.025.0% of population30.035.040.045.0Year 6 (aged 9/10)Data from 2019/20. Source: PHE Fingertips8
Regional economic inequalities before COVID-19
1.02LondonSouth WestSouth EastEastNorth WestYorkshire and The HumberWest Midlands0.86 0.88 0.890.840.80 0.81 0.81East Midlands0.73North East0.79Northern 0.100.00Wages (2019)Median gross annual pay, 2019 ( )Job Density ,70325,77218,268 18,95020,00020,20515,00010,0005,0000TotalNorthern PowerhouseRest of England (inc. Lon)MaleFemaleRest of England (exc. Lon)Source: ONS10
Gross Value Added (GVA; productivity)Growth: 2010 to 2018 44bn per-yearNorthernPowerhouseRest of Englandexcluding LondonRest of Englandincluding LondonSource: ONS11
Decomposing the difference in productivity 44bn per-year 13.2bn per-year17.1%60.0%29.9%12.8%10.1%UnexplainedOther factorsMortalityMorbidity12
Regional health inequalities during COVID-19
Was there variation in mortality rates (March to July)?COVID-19All-causeSource: ONS14
COVID-19 mortality rates; March to July 2020South West45.4South East78.5East Mids.79.6East of England80.3Yorks. & Humber82.6West Mids.94.9North West104.4North East106London144.4020406080100120140160Mortality rate per 100,000 (age adjusted)Source: ONS15
COVID-19 mortality rates; monthlyLondoninitiallyhardest hit,but then theNorth afterApril16
All-cause mortality rates; March to July 2020South West388.2South East412.7East of England429.2East Mids.445.6Yorks. & Humber458.7London469West Mids.477.2North West502.8North East513.60100200300400Mortality rate per 100,000 (age adjusted)500600Source: ONS17
All-cause mortality rates; monthlyLondoninitiallyhardest hit,but then theNorth afterApril18
Highest and lowest mortality rates (LADs)COVID-19 (March to July)Hastings (SE)All-cause (March to July)9.7East Devon (SW)308.1Teignbridge (SW)17.7South Hams (SW)313.0Mid Devon (SW)18.1Camden (Lon)315.1Mendip (SW)19.5Eden 541.1Harrow (Lon)184.2Tameside (NW)599.5Haringey (Lon)186.0Blackpool (NW)602.0Hackney (Lon)186.8Sandwell (WM)610.3Liverpool (NW)618.3Newham (Lon)203.4Brent (Lon)218.30.050.0100.0150.0200.0250.0Middlesbrough (NE)677.30.0100.0 200.0 300.0 400.0 500.0 600.0 700.0 800.019
Regression analysis We used data at LAD level (subscript l) to estimate a series of models: Model 1:Outcomel β(Northern Powerhousel) εl Model 2:Outcomel β(Northern Powerhousel) γ(Age structurel) λ(Ethnicstructurel) εl Model 3:Outcome β(Northern Powerhousel) γ(Age structurel) λ(Ethnicstructurel) δ(IMD quintilel) εl20
COVID-19 mortality rate (March to July) 12.4(2.2to 22.6) 12.4(2.2to 22.6) 21.4(13.7to 30.2) 21.4(13.7to30.2) 20.4(12.7to 28.0) 20.4(12.7to28.0) 23.7(15.4to 31.9) 23.7(15.4to31.9) 19.2(11.2to 27.2) 19.2(11.2to27.2) 21.5(13.1to 29.9) 21.5(13.1to29.9)21
All-cause mortality rate (March to July) 57.7 (41.3 to 74.2) 63.2 (46.8 to 79.5) 46.9 (32.6 to 61.3) 45.8 (30.4 to 61.1) 29.4 (16.0 to 42.9) 30.5 (16.8 to 44.1)22
Reductions in mental healthSouth West-1.01East of England-1.07East Mids.-1.11-1.17West Mids.-1.17North WestSouth East-1.24North East-1.37Yorks. & .4-0.20Reduction in GHQ scores; 2019 to May 2020Source: UKHLS23
Regional economic inequalities during COVID-19
Mental health affects productivityThese reductions inmental health in theNorth could cost theUK economy around 5bn in lostproductivity25
Unemployment during COVID-19 Unemployment ishighly predictive ofreduction in mentalhealth Pre-COVID levelsalready well aboveaverage in theNorth, and they rosemuch faster here too26
Other outcomes We also considered a range of other outcomes reported at an individuallevel, including: Loneliness Furlough Number of hours worked (given job was retained) New Universal Credit claims Almost all of these were worst affected in the North We have not, as yet, considered dietary outcome or weight/obesity, butplan to when we have data27
Recommendations from the reports
Recommendations29
Thank youThe two reports where the majority of this material was sourced from are available online:Health for Wealth (2018): -REPORT-FINAL.pdfCOVID-19 and the Northern Powerhouse(2020): OVID-REPORT-101120-.pdfFeel free to contact me:Email: luke.munford@manchester.ac.ukTwitter: @dukester2430
COVID-19 and the Northern Powerhouse: Tackling inequalities for UK health and productivity . (On behalf on NHSA Report teams) 2018 2020 . Regional health inequalities before COVID-19. 4 Variations in life expectancy Source: PHE Fingertips. 5 Life expectancy over time Consider the ‘Northern Powerhouse’ vs. the rest
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