North-South divide in young adult mortality

Given the strong associations between unemployment, (relative) poverty, social welfare and health, we examined the role of the 2008-9 Great Recession and of the subsequent policy response on regional disparities in mortality in England.

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Examining data from 1965 to 2015, we found that in the context of overall declines in mortality rates, northern excess mortality remained consistent for most age groups between 1965 and 2010, but for adults aged 25–44 excess mortality increased sharply from the mid-1990s onwards due to the long-term declines in mortality stalling in the North. In absolute terms, the total number of northern excess premature deaths (aged under 75) throughout the study period was estimated at 986,434. In addition, following the 2008–09 Great Recession, premature mortality in both North and South England stopped declining (plateaued). This worrying pattern had never been observed before to follow earlier recessions, and we hypothesised that the austerity and public spending restrictions imposed by the 2010 UK government was a major driver behind these finding.[1

A major question that emerged from this work was the reasons behind this northern excess mortality and its increase in later years. In follow-up work we found that the excess northern mortality for adults aged 25-44, between 2014 and 2016 translated into 627 female and 1,177 males deaths. The major contributors to this disparity were accidents, drug-poisoning, alcohol and cardiovascular disease. Important contributions were also made by suicide among males, especially at ages 30-34, and by cancer among females. Only two thirds of overall excess mortality in the North were explained by deprivation. A regional analysis showed that much of the North-South divide is attributable to substantially lower mortality in the capital. Although mortality rates in most northern regions were higher than in southern regions, rates in all regions – including those in the South – were at least 13% higher than rates in London.[2]

The findings from this work were also summarised in The Conversation for lay audiences. Numerous media appearances resulted from this work, highlighting its importance, including a Sky news exclusive documentary and an exclusive in The Guardian with the work reported on the first page.  

Project team


  1. Buchan IE, Kontopantelis E, Sperrin M, Chandola T, Doran T: 'North-South disparities in English mortality1965-2015: longitudinal population study'. J Epidemiol Community Health 2017, 71(9):928-936.
  2. Kontopantelis E, Buchan I, Webb RT, Ashcroft DM, Mamas MA, Doran T: 'Disparities in mortality among 25-44-year-olds in England: a longitudinal, population-based study'. Lancet Public Health 2018, 3(12):e567-e575.