For the first time, city-specific mortality inequalities - that is the difference in death rates between the wealthiest and poorest areas - have been analysed across ten major British cities.

Profound changes to mortality trends and inequalities were seen across both nations and all cities in the decade up to 2020, including unprecedented increases in death rates among those living in the 20% most deprived neighbourhoods of almost every city.

Researchers say these changes predate the COVID-19 pandemic but have been exacerbated by it.

The study was led by Dr David Walsh, Senior Lecturer in Health Inequalities at the University of Glasgow, in collaboration with Public Health Scotland.

For deaths at all ages, the rise was particularly evident in Leeds, Liverpool, Edinburgh, Dundee and Glasgow, while for those aged under 65 years, Scottish cities stood out.

The data also showed that mortality rates were increasing among women living in the most deprived areas, particularly notable in Leeds, Liverpool and Edinburgh.

The study adds to the now considerable evidence base that shows the harmful impact of UK Government austerity policies i.e. cuts to social security and vital public services. A new book by two of the study authors, ‘Social Murder? Austerity and Life Expectancy in the UK’, sets out the evidence of how austerity policies have led to a decline in life expectancy and widening mortality inequalities, with more people dying younger and in larger numbers since 2010.

Dr David Walsh said: “Our analysis provides a hugely concerning picture of worsening mortality and widening inequalities across England and Scotland. When viewed in the context of the evidence for the impact of UK Government austerity policies on population health, they must be a wake-up call for the current UK Government. We cannot continue to fail the poorest and most vulnerable in our society.”

Co-author Professor Gerry McCartney said: “The scale of the changes mean that the UK has now entered a new era of health inequality. As the UK Government debates future economic choices, they need to understand the evidence of the harm that cuts to social security and vital services have had on communities up and down the land”.

The ten cities included in the study were: Birmingham, Bristol, Leeds, Liverpool, Manchester, Sheffield, Aberdeen, Edinburgh, Dundee and Glasgow.

The paper, A new era of inequality: profound changes to mortality in England, Scotland and 10 major British cities, is published in the European Journal of Public Health.

First published: 19 February 2025

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