‘Jaw-dropping’ falls in life expectancy as Greater Manchester sees a quarter more Covid deaths than the English average
Greater Manchester #GreaterManchester
Greater Manchester’s pandemic death rate has been 25 per cent higher than the national average, new research reveals – warning the scale of England’s pandemic divide was ‘avoidable’ and that its causes must finally be urgently addressed by ministers.
Sir Michael Marmot, whose report weeks before Covid-19 warned health was already ‘faltering’ in England and regional divides widening after a decade of uneven austerity, also finds nearly four months more was wiped off male life expectancy in the North West last year than the national average.
His report, looking at the impact of the pandemic in Greater Manchester and proposing steps to ‘build back fairer’, also finds that lockdowns were not timed to chime with the pattern of the pandemic here, while the measures themselves have already ‘particularly damaging’ social, health and economic impacts.
Sir Michael told the M.E.N. the extent of the uneven pattern had been ‘avoidable’, pointing to long-term trends over more than a decade that resulted in this part of the country being more exposed to the pandemic.
“The pandemic, Covid, is not just about a virus,” he said. “It’s about the nature of society.”
Sir Michael’s report has strong echoes of his review of health inequality in late February 2020, which found that life expectancy was falling for the poorest people in every part of England outside London, a pattern particularly pronounced in parts of the North and a sign, he said, that society was effectively moving backwards.
His latest review looks at the way Covid then ‘exposed and amplified’ that inequality for Greater Manchester and seeks solutions, echoing warnings from officials and politicians reported by the M.E.N. previously.
Arguably most stark is its findings on the pandemic’s deadliest impacts.
“While England has experienced high Covid-19 mortality rates compared with other countries, the rate in Greater Manchester has been even higher than the average in England,” finds the report.
“Analysis shows that rates of mortality from Covid-19 in Greater Manchester are 25pc higher than in England as a whole.
“Life expectancy in the North West of England also declined more during 2020 than in England overall.”
That fell by 0.9 years for women and 1.3 years for men nationally, according to provisional figures for last year, but in the North West the figures were 1.2 years and 1.6 years respectively.
These are ‘jaw dropping’ falls, said Sir Michael, but noted they were ‘even bigger’ in this part of the country.
“That’s enormous,” he said of the North West’s fall in life expectancy, adding that there is also a ‘remarkable’ correlation with poverty.
Every borough within Greater Manchester has seen higher than average death rates, apart from Stockport and Trafford, highlighting inequalities within the conurbation as well as with the rest of the country.
Poverty, working and living conditions, types of employment and the ‘interconnected’ nature of Greater Manchester all partly explain Covid’s impact here, it says, but it also finds that the timings of lockdown measures did not marry up with the pattern of the way the virus was playing out here.
“The timing of the containment measures implemented in England did not align well with the trajectory of the pandemic in the city region,” it finds, echoing criticisms from other health experts that the first lockdown ended too soon for the pandemic’s pattern here.
“The city region has also experienced particularly damaging longer-term economic, social and health effects from a combination of local and national lockdowns during the autumn of 2020 and through the first half of 2021.
“Impacts include deteriorating community and environmental conditions as the public purse is further strained, widening inequalities during children’s early years and in educational engagement and attainment, increasing poverty and income inequality, rising unemployment, particularly for young people, and deteriorating mental health for all age groups but again particularly for young people.
“All of these negative impacts will damage health and widen health inequalities in Greater Manchester. This report assesses these unequal impacts and makes proposals about how to take urgent, remedial action.”
Sir Michael and his team from University College London, who have been working on the report with the Greater Manchester system, specify a range of ways in which the conurbation was already more vulnerable to a health crisis such as Covid-19, pointing to the clear correlation between degrees of poverty and those most likely to catch the virus, suffer serious illness and potentially die from it.
Nearly half of Manchester’s neighbourhoods are in the poorest 10pc nationally, it points out, while nearly one in 20 people across the conurbation live in overcrowded housing.
That rises to more than one in ten people from ethnic minority backgrounds across the North West. Everywhere in Greater Manchester apart from Trafford and Stockport – again – already had higher than average numbers of people on low incomes. Trafford and Stockport were the only boroughs to begin the pandemic with above-average life expectancy and the only ones not to see above-average death rates from Covid.
Speaking yesterday, Sir Michael explained how poverty, types of work and housing have all had a direct bearing on higher the likelihood of people in most parts of Greater Manchester catching Covid and becoming sick.
“When you’ve got something like a pandemic it builds on the existing inequalities,” he said. “So, for example, if you’re in a low income household you’re more likely to be working in a frontline occupation which means you get greater exposure which means that poorer people are more at risk of getting Covid and severe Covid and fatal Covid.
“And similarly if you’re in an overcrowded household, you’re at greater risk of transmission of infection and getting severe Covid and potentially Covid.”
The report points – like its predecessor in February 2020 – to the uneven way in which cuts have played out across the country since 2010 and warns that had a bearing on how the pandemic played out.
Cuts to public health funding saw the North West lose more per head than the national average over eight years, while the North East lost twice as much per person as much as the South East. Northern urban councils were consistently hit with bigger budget cuts than southern shire ones.
“The cuts to funding were regressive – poorer areas and those areas outside London and the South experienced proportionately larger cuts,” says the latest report.
“The resulting damage to local authorities with greater deprivation have affected the course of the pandemic and, crucially, the resilience of areas to cope with the economic and social impacts of pandemic containment measures.”
Asked whether the scale of the unequal patterns seen during the pandemic were avoidable, Sir Michael pointed to those uneven cuts.
“That was government policy,” he said. “So was it avoidable? Yeah, of course it was avoidable.
“Different policies might have yielded different outcomes.”
His latest review now calls on government to urgently take heed of its findings as part of any ‘levelling up’ agenda.
It reels off a list of practical recommendations, many of them aimed at the local leadership, including working with employers to introduce a Greater Manchester wage that matches the income needed for a healthy life here and a goal to provide training or education to all school-leavers.
But many will require government to spend more and spend differently – such as a doubling of Greater Manchester’s health prevention budget in five years.
Sir Michael said it had been ‘inspiring’ working with Greater Manchester on the research.
“I didn’t get the sense that people were looking at this and thinking ‘it’s too awful, there’s nothing we can do about it’,” he said.
“They say: we want to make Greater Manchester the best place for children to grow up and for people to flourish. But they can’t do it without government funding as well.”
Local government organisations all over the country – including the North East – had been in touch about working to mitigate the uneven impact of the pandemic on health, he says, but as yet he had ‘not had a response’ to the report from ministers.
Nevertheless the findings are not limited to this part of the country, but should be absorbed into the government’s entire outlook, putting health equality at the ‘heart’ of its policymaking, he said.
“I like to think that what we’re signalling in Greater Manchester will be very important for Greater Manchester, but will also potentially provide a blueprint for the rest of the country,” he said.
“If we’re serious about levelling up, this is the way to do it. And if the government doesn’t get active, what they’ll find is that local governments all round the country are doing it. The time to do it is now.”
Number 10 has been approached for comment.
Mayor of Greater Manchester, Andy Burnham said: “The pandemic has brutally exposed just how unequal England actually is. People have lived parallel lives over the last 18 months.
“People in low-paid, insecure work have often had little choice in their level of exposure to Covid; and the risk of getting it and bringing it back home to those they live with.
“Levelling up needs to start in the communities that have been hit hardest by the pandemic.
“To improve the nation’s physical and mental health, we need to start by giving all of fellow citizens a good job and good home.
“We are grateful to Michael Marmot for showing how Greater Manchester can improve the health of our residents and we hope the government will back us with the resources and powers to put better health at the heart of our recovery.”