'Early death map' shows English health inequality

Behind the Headlines

Tuesday June 11 2013

The Longer Lives map pinpoints pockets of health inequality

“North and South health divide: Chilling study reveals premature death is 'postcode lottery',” the Daily Mirror reports.

The news is based on a new interactive map showing the variation in premature death rates across England.

The Longer Lives map, created by the new organisation Public Health England, ranks 150 local authorities by their premature death rates (deaths occurring before age 75).

The interactive map also enables users to compare these areas by five common causes of premature (and potentially preventable) deaths:

Premature deaths and your local NHS

NHS Choices has a similar map of premature deaths broken down into local NHS areas.



These areas are those covered by Clinical Commissioning Groups (CCGs), which organise most of the hospital and community NHS services locally.

The simple, colour-coded map enables users to see the variations between each local authority at a glance, including a measure of socioeconomic deprivation.

Much of the media coverage of the new map was dominated by the striking contrast between large parts of the north, coloured red (poor health), and the affluent south, mostly coloured green (good health). However, there are also pockets of poor health in some southern cities, boroughs of London, and in the Midlands.


What information is this map based on?

The information provided in Longer Lives is from the Public Health Outcomes Framework. This uses records of deaths from the Office of National Statistics.

The death rates are standardised to account for the fact that death rates are higher in older populations and adjusts for differences in the age make-up of different areas.


What factors could explain the variations?

The top five healthiest local authorities in England (in terms of premature deaths) are:

  • Wokingham
  • Richmond upon Thames
  • Dorset County Council
  • Surrey County Council
  • South Gloucestershire

The top five unhealthiest local authorities are:

  • Manchester
  • Blackpool
  • Liverpool
  • Salford
  • City of Kingston upon Hull

There are likely to be a number of reasons for the differences seen. These could include variations in factors such as poverty, obesity, alcohol consumption, and smoking. These four factors are often interlinked.

Historical factors, such as the decline of the manufacturing industry, mean that poverty is more prevalent in some areas of the north of England. The same is likely to be true in the areas of poor health in the south, where port cities such as Southampton and Portsmouth have been affected by Britain’s declining importance as a maritime trading nation.

However, there could be more complex factors at work, including the social, economic and cultural context as well as environment, education, housing and transport.

Hopefully, this data will allow health authorities to target their resources to the areas of greatest public health need.

How you can reduce your risk of an early death

Despite some of the more fanciful reporting – such as the Daily Mail’s headline “Steer clear of Manchester to avoid an early grave” – where you live does not directly determine your life expectancy.

You can reduce your risk of premature death, wherever you live, by:


Analysis by NHS Choices. Follow Behind the Headlines on Twitter.

Analysis by Bazian

Edited by NHS Choices


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