The impact of Covid is not classless – and a shocking new report proves it

Few will be surprised to learn that the economic impact of Covid-19 has been felt most acutely in the North of England. “Covid-19 and the northern powerhouse”, an extensive piece of research carried out by the Northern Health Science Alliance, explores why this might be the case.

It is an impressive and significant report, which harnesses the skills and knowledge of the country’s leading scientists to analyse the impact of Covid on England’s regions. Their findings are startling and should be a wake-up call to the government, particularly after it promised to “level up” following the last election.

When the North-South divide is discussed, it tends to be framed in economic terms. What is interesting about this research is its focus on the impact of the North-South divide on people’s health and life chances. It is sobering to discover, for example, that men in the worst affected northern regions die five years earlier than their peers in the south; for women, the gap is four years. Some of this is accounted for by stubborn and persistent differences in health and employment (or unemployment). But what is shocking is how these differences have been amplified by the pandemic.

Covid is an infection that is classless, but its impact is not. Infection rates and mortality were found to be significantly elevated in the North. Where you live determines not only the chances of having a health problem – be that heart disease or Covid – but the outcome. 12.4 more people per 100,000 died as a result of contracting Covid in the North compared to the South. This pandemic is destroying communities already all too familiar with lives cut short.

There is a close and persistent relationship between health and social factors that leads to these premature deaths. All the factors that compromise health and therefore lead to mortality are present in these regions. Differences in mental health between the regions, for example, is staggering. Rates of mental illness are up to 74 per cent higher in northern regions over southern ones. The factors leading to this divergence are not difficult to locate: higher rates of substance use, poorer housing, lower employment and more unstable and poorer paid employment are all the necessary ingredients to fracture mental health.

Intelligence and ability are spread equally in the population but not achievement. It is appalling to learn from this report that 69 per cent of children in affluent areas achieve five or more GCSEs, compared to only 52 per cent from the poorest. Covid has compounded this, as access to IT, private tuition and a healthy diet have not been shared out equally.  

Premature death is obviously the final fatal outcome of these structural inequalities that can be traced back to childhood. Where you are born is just as important as any lifestyle factors in determining, not only how long you live, but the years of good health you will enjoy without any life-limiting disability. The well-known saying, “give me a child until the age of seven and I will give you the man”, sums up the crucial impact of these early years. This is why the “Sure Start” programme was set up in the late 90s with the aim of reducing the health and educational inequalities rampant in many regions. The decision in 2010 to cut the budget of these initiatives has no doubt contributed to the acceleration in inequalities found in this report.

Debt and poverty share one thing in common with wealth: they are both intergenerational. In the same way that assets are passed from one generation to another, so is lack of resource and all that accompanies it. If you are born into poverty, it is getting harder to escape. It is this intergenerational inheritance of poverty or affluence that needs to be fixed and this can only be done by taking an equally long-term view of the potential plan and solution.

One of many recommendations made is to substantially improve the social safety net by increasing child benefit and Universal Credit; these are the more immediate proposed fixes. Longer term, the authors call for the cuts made to public services in the name of austerity to be reversed. These cuts to services were paradoxically most severe in the most deprived, often northern, regions. For every pound cut it is estimated that £3.17 was lost in productivity.

Heath and economics are intertwined; one without the other is futile. The years of underinvestment in the North is costly to the nation. The authors cite the estimated £5bn lost due to poor mental health in northern regions. The £5bn mental health penalty illustrates how, beyond the individual suffering, there is an economic as well as humane imperative to rectify this imbalance.

Bear in mind this report only covers the first wave of the pandemic up to July. There will be further economic costs, which are avoidable if the government chooses to invest in northern mental health services. This is just one way of narrowing the current productivity gap of £4 an hour between the North and South.

All we can do is hope that those in power read and respond to this report in a meaningful way. That is difficult to imagine given how abstract its content will be to many of those in government who have had a completely different life experience from those highlighted in the report. The “fire in the belly” evangelical zeal needed to break these structural inequalities is not demonstrated by politicians but those with lived experience like Marcus Rashford, a man who puts his money where his mouth is.

Responding to this report with warm words will not be enough. It needs a well-sourced and thought-out tactical long-term plan.