Sir Michael Marmot, whose report a few weeks before Covid-19 warned that health was already ‘bankrupt’ in England and regional divisions are widening after a decade of uneven austerity, also finds that almost four more months have been erased the life expectancy of men in the Northwest last year from the national average.
Its report, examining the impact of the pandemic in Greater Manchester and proposing measures to ‘rebuild fairer’, also finds that the closures were not timed to match the pandemic pattern here, while the measures did. they already have “particularly damaging” social, health and economic impacts.
Sir Michael told MEN that the extent of the uneven trend has been “preventable,” highlighting long-term trends spanning more than a decade that have led this part of the country to be more prone to the pandemic.
“The pandemic, Covid, is not just a virus,” he said. “It’s about the nature of society.
Sir Michael’s report echoes his review of health inequalities at the end of February 2020, which found life expectancy was falling for the poorest people in all parts of England outside London, a trend particularly pronounced in parts of the North and a sign, he says, that society was indeed retreating.
Its latest review examines how Covid then ‘exposed and amplified’ this inequality for Greater Manchester and seeks solutions, echoing warnings from officials and politicians previously reported by the MEN.
Perhaps most striking are his conclusions on the deadliest impacts of the pandemic.
“While England has experienced high Covid-19 death rates compared to other countries, the rate in Greater Manchester has been even higher than the average in England,” the report finds.
“Analysis shows Covid-19 death rates in Greater Manchester are 25% higher than in England as a whole.
“Life expectancy in the North West of England has also declined more in 2020 than in England as a whole. “
This fell by 0.9 years for women and 1.3 years for men nationally, according to provisional figures from last year, but in the Northwest the figures were 1.2 years respectively. and 1.6 years.
These are “breathtaking” falls, said Sir Michael, but noted that they were “even bigger” in this part of the country.
“It’s huge,” he said of declining life expectancy in the Northwest, adding that there is also a “remarkable” correlation with poverty.
Every borough of Greater Manchester has experienced above-average death rates, with the exception of Stockport and Trafford, highlighting inequalities within the metropolitan area 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 the impact of Covid here, he says, but he also finds that the timing of the lock does not match the pattern of how the virus was playing here.
“The timing of the containment measures implemented in England did not fit well with the trajectory of the pandemic in the city region,” he notes, echoing criticism from other health experts that the first lockdown ended too early for the pandemic model here.
“The city region also suffered particularly damaging long-term economic, social and health effects from a combination of local and national blockages during the fall of 2020 and through the first half of 2021.
“The impacts include the deterioration of community and environmental conditions as public funds are stretched further, the worsening of inequalities during the early years of children and in school engagement and achievement, the increase in poverty and income inequality, rising unemployment, especially among young people, and deteriorating mental health for all ages. groups but again especially for young people.
“All of these negative impacts will harm health and worsen health inequalities in Greater Manchester. This report assesses these uneven impacts and makes proposals on how to take urgent corrective action. “
Sir Michael and his team at University College London, who worked on the report with the Greater Manchester system, point out a range of ways the metropolitan area was already more vulnerable to a health crisis such as Covid-19, making it clear correlation between levels of poverty and those most likely to catch the virus, to suffer from a serious illness and potentially to die from it.
Almost half of Manchester’s neighborhoods are among the poorest 10% in the country, he points out, while nearly one in 20 people in the metropolitan area live in overcrowded housing.
This rises to more than one in ten people from ethnic minorities in the Northwest. All over Greater Manchester, with the exception of Trafford and Stockport – again – there were already an above-average number of low-income people. Trafford and Stockport were the only boroughs to start 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 directly impacted the increased likelihood that people in most parts of Greater Manchester will catch Covid and become ill.
“When you have something like a pandemic, it builds on existing inequalities,” he said. “For example, if you are part of a low income household, you are more likely to work in a frontline occupation, which means you get more exposure, which means poorer people are more at risk of contracting Covid and severe Covid and deadly Covid.
“And likewise, if you are in a crowded household, you are at a greater risk of transmission of infection and severe Covid and potentially Covid. “
The report highlights – like its predecessor in February 2020 – how unevenly the cuts have unfolded across the country since 2010 and warns that the pandemic has unfolded.
Cuts in public health funding have seen the Northwest lose more per capita than the national eight-year average, while the Northeast has lost twice as much per person as the Southeast. Urban councils in the north have been consistently hit by larger budget cuts than those in the south of the county.
“Funding cuts have been regressive – poorer areas and areas outside London and the south have suffered proportionately larger cuts,” the latest report says.
“The resulting damage to the more disadvantaged local authorities affected the course of the pandemic and, above all, the resilience of the areas to face the economic and social impacts of the pandemic containment measures. “
When asked whether the scale of the uneven patterns seen during the pandemic was preventable, Sir Michael pointed to these uneven cuts.
“It was government policy,” he said. “So, was it preventable? Yes, of course, it was preventable.
“Different policies could have produced different results. “
Its latest review is now calling on the government to urgently take its findings into account in any “race to the top” agenda.
It presents a list of practical recommendations, many of which are aimed at local leaders, including working with employers to introduce a Greater Manchester salary that matches the income needed for a healthy life here and a goal of providing training or education. to all schools. outgoing.
But many will demand that the government spend more and differently, such as doubling Greater Manchester’s health prevention budget in five years.
Sir Michael said it had been “inspiring” to work with Greater Manchester on the research.
“I didn’t get the impression that people were looking at this and thinking ‘this is too awful, there is 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 thrive. But neither can they do it without government funding. “
Local government organizations across the country – including in the North East – had been in contact to work to mitigate the pandemic’s uneven health impact, he said, but so far he had ” no response ”to the ministers’ report.
Nonetheless, the findings are not limited to this part of the country, but should be absorbed into the whole of the government’s outlook, placing health equality at the “heart” of its policies, he said.
“I like to think that what we are reporting in Greater Manchester will be very important for Greater Manchester, but also potentially provide a model for the rest of the country,” he said.
“If we really want to level up, this is the way to do it. And if the government does not activate, they will find that local governments across the country are. Now is the time to do it.
Number 10 has been approached for comment.
Greater Manchester Mayor Andy Burnham said: “The pandemic has brutally revealed how unequal England is. People have been living parallel lives for the past 18 months.
“People in low-paid and insecure work often have had little choice as to their level of exposure to Covid; and the risk of getting it and taking it home to those they live with.
“The upgrade needs to start in the communities that have been hit hardest by the pandemic.
“To improve the physical and mental health of the nation, we must start by giving all of our citizens a good job and a good place to call 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 support us with the resources and the powers to put better health at the heart of our recovery. “