A year of COVID-19 in the North: Regional inequalities in health and economic outcomes

Abstract

Key findingsThe COVID-19 pandemic has hit the country unevenly with a disproportionate effect on the North of England -increasing regional health and economic divides.The Northern Health Science Alliance commissioned this report to understand the impact of the first year of the COVID-19 pandemic on health and productivity in the North and identify the opportunities for 'levelling up' regional health and productivity.The report shows the unequal health and economic impacts of COVID-19 on the North with higher rates of COVID-19 related mortality and unemployment.As it develops its post-COVID-19 'levelling up' strategy, central government should pay particular attention to the importance of supporting the physical and mental health and development of the North as a route to increased prosperity.n On average, the rates of mortality attributable to COVID-19 during the first 13 months of the pandemic (March 2020 to March 2021) were higher in the North than in the rest of the country:n 29.4 more people per 100,000 (95% CI: 10.7 to 48.0) died of COVID-19 in the North (204.1 per 100,000) compared to the rest of England (174.4 per 100,000).n This represents a 17% higher mortality rate in the North compared to the rest of England.n On average, the rates of mortality attributable to all-causes during the first 13 months of the pandemic (March 2020 to March 2021) were higher in the North than in the rest of the country:n 145.8 more people per 100,000 (95% CI: 106.8 to 184.9) died of all-causes in the North (1190.2 per 100,000) compared to the rest of England (1044.4 per 100,000).n This represents a 14% higher mortality rate in the North compared to the rest of England.n About half of the increased COVID-19 mortality in the North (or 15 deaths per 100,000) and two-thirds of the increased all-cause mortality (or 99 deaths per 100,000) were explained by higher deprivation and worse pre-pandemic health in the North, which are potentially preventable.n On average in care homes, the rates of mortality attributable to COVID-19 during the pandemic (March 2020 to March 2021) were higher in the North than in the rest of the country:n 1.2 more people per 1,000 care home beds (95% CI: 0.7 to 1.8) died of COVID-19 in the North (5.9 per 1,000 beds) compared to the rest of England (4.7 per 1,000 beds).n The North's care home COVID-19 mortality was therefore 26% higher than the rest of England.n On average in care homes, the rates of mortality attributable to allcauses were also higher in the North than in the rest of the country:n 2.1 more people per 1,000 care home beds (95% CI: 0.6 to 3.5) died of all-causes in the North (22.4 per 1,000 beds) compared to the rest of England (20.3 per 1,000 beds).n The North's care home all-cause mortality was therefore 10% higher than the rest of England. Mortality204.1 per 100,000 174.4 per 100,000of COVID-19 in the North compared to in the rest of England 1 1 1 2 2 2 3 3 3 4 4 4 5 Regional differences in mortality ratesWe start by presenting information on unadjusted age standardised mortality rates by government office region ('region' here-on-in).England is broken down into nine regions: North East, North West, Yorkshire and the Humber, East Midlands, West Midlands, East of England, London, South West, and South East.We further present information on differences between the North and the rest of England.We obtained the local authority mortality rates attributable to COVID-19 and all causes from the Office for National Statistics (ONS) for the period March 2020 to March 2021.Each local authority was then mapped to its region using look-up tables. 10 COVID-19 mortality ratesRegionally during the pandemic, the North West (233.7 per 100,000) and North East (212.8per 100,000) had the second and fourth highest COVID-19 mortality rates, respectively (Figure 1.2).Yorkshire and The Humber had the fifth COVID-19 mortality rate (194.9 per 100,000).London had the highest COVID-19 mortality rate (264.8 per 100,000).The South West (100.0 per 100,000) and the South East (171.8per 100,000) have the lowest and second lowest COVID-19 mortality rates, respectively.The North Rest of England