Preventable deaths grow as health gap widens than any time

THE HEALTH gap between rich and poor in Britain is the widest on record and is continuing to grow, researchers report today.

Increasing inequality in income, lifestyle, educational opportunities and jobs is resulting in thousands of extra deaths in the most deprived inner cities. The death rate among people under 65 is now more than two and a half times higher in the worst parts of Glasgow than in the prosperous southern communities of Esher and Wokingham.

Despite ministerial pledges to narrow the gap, experts from the Townsend Centre for International Poverty Research, at the University of Bristol, say the Government's policies are doomed to fail because they focus on getting people into work or increasing the incomes of those already in work. Most of those living in poverty do not have jobs and could not take them even if they were available because they are looking after children or the sick, or are elderly themselves.

Instead, the authors advocate redistribution, claiming "widespread public support" for measures to reduce poverty in Britain. "It is our firm belief that if health inequalities ... are to be reduced, as is the stated aim of the Government, then policies which actively address the reduction of poverty and of inequality through redistribution [of income and wealth] must be pursued." They add: "The costs would be borne by the rich."

The study, published as a book, The Widening Gap, is the most comprehensive since the Black report of 1980, which was updated last year by the Independent Inquiry into Inequalities in Health, chaired by Sir Donald Acheson. The authors criticise the Acheson report for failing to highlight the fundamental role of poverty in creating and maintaining the health gap. It was "lost in a sea of recommendations from traffic curbing to the fluoridation of the water supply", they say.

For the first time, the report compares geographical areas to find the "worst health" and "best health" parts of Britain and reveals a clear north/south divide. If people in the worst areas had enjoyed the same health as those in the best, 71 per cent of the deaths under 65 would not have occurred between 1991 and 1995, a saving of more than 10,000 lives.

The most embarrassing finding for ministers is that those suffering the most sickness and the highest death rates are Labour voters. Of the 100 constituencies with the worst health, 97 are Labour. Of the 100 constituencies with the best health, 81 are Conservative.

The geographical comparisons show the infant mortality rate is twice as high in Salford, one of the worst areas, as in south Suffolk, one of the best, and that 7,500 infants might have been saved between 1991 and 1995 if every area had matched the rate in Suffolk.

The health gap mirrors gaps in income, education and employment levels. The average household income in Glasgow Springburn, one of the worst areas, is pounds 13,697 compared with pounds 24,490 in Wokingham, Berkshire. Average incomes in the worst areas are 30 per cent less than those in the best areas.

The researchers say the gap between rich and poor has widened faster in Britain and that levels of poverty are higher than in much of Europe. The report shows that life expectancy for professional men is now 9.5 years more than for male unskilled manual workers. For women it is 6.4 years more.

Yet in the 1960s and 1970s the gap narrowed. "Just as a gap can widen so it can narrow ... the trends of growing inequality show no sign of abating and the consequences of such a widening gap are dire," the authors say.

DEADLY EFFECTS OF THE POVERTY DIVIDE

SPRINGBURN, GLASGOW

Chronic illness 155 sufferers per 1,000 population

Infant mortality 67.9 deaths per 10,000 live births

Unemployment* 53.8 per cent

Cars 7,214 (among 30,000 households)

GCSE failures+ 7 per cent

Poverty 41 per cent of households

*men, aged 16-64, includes sick, early retired and those on government schemes +defined as not achieving 5 GCSE's at grades A to C

WOKINGHAM, BERKSHIRE

Chronic illness 36 sufferers per 1,000 population

Infant mortality 53.2 deaths per 10,000 live births

Unemployment* 27.9 per cent

Cars 46,195 (among 32,000 households)

GCSE failures+ 46 per cent

Poverty 10 per cent of households