Health divide in County Durham and Tees Valley shortening lives, reducing life chances and costing billions in lost productivity

25 July 2023

Click here to read the full report

The stark extent of inequalities in one of the poorest regions of the country has been laid bare in a new report.

People in County Durham and Tees Valley, in the North East of England, experience extreme levels of deprivation with much higher child poverty rates, much lower life expectancy and healthy life expectancy, worse health across a wide range of conditions from strokes to cancer and much higher unemployment rates than the national average.

County Durham and Tees Valley: Health, Wealth and (Unequal) Opportunities to Thrive exposes a growing health gap between County Durham and Tees Valley and the rest of the country and explores the impact this has on the economy.

Commissioned by County Durham Community Foundation and written by academics at Health Equity North, the report paints a bleak picture of the wide-ranging health challenges faced within the area, covering social and economic inequalities, COVID-19 and the cost of living crisis, health and wellbeing, historic factors, and the impact of national policies.

It demonstrates how, if the health of people in County Durham and Tees Valley was brought up to the national average, an additional £4bn per year would be added to national productivity.

The key findings include:

Children

Child poverty rates in the region are extremely high with 38.7% of children in County Durham and Tees Valley in poverty compared to 27% nationally.
Between 2015 and 2021, child poverty rates increased by 13.0 percentage points in Redcar and Cleveland; 12.4 in County Durham; 12.2 in Middlesbrough; 12.0 in Darlington; 11.8 in Stockton on Tees; and 11.6 percentage points in Hartlepool.
The rate of emergency admissions for children under 5 years in County Durham is 35.6% higher than the national average – and 74.4% higher in Darlington.

Life expectancy

The health gap between County Durham and Tees Valley and other parts of the country grew in the last five years: male life expectancy in County Durham fell by six months between 2015-17 to 2018-20 and female life expectancy in Darlington fell by over a year in this period, whereas life expectancies increased by around a year in already high performing areas (such as Westminster, Kensington and Chelsea).
People live shorter lives in the region. The average life expectancy in England for men is 79.8 years. In County Durham it is 78.3 years and 77.7 years in the Tees Valley.
The average life expectancy in England for women is 83.4 years. In County Durham it is 81.8 years and 81.4 years in the Tees Valley.
There is a 10-year life expectancy at birth gap between men in the most deprived neighbourhoods and men in the least deprived neighbourhoods in the region – the gap is highest in Stockton-on-Tees at 14.5 years, and lowest in Durham at 10.3 years. For women this gap is over 8 years (ranging from 8.2 years in County Durham to 13.9 years in Stockton-on-Tees).
All-cause mortality rates in County Durham and Tees Valley are between 10% and 35% higher than the national average.
The COVID-19 mortality rate was 18.3% higher in County Durham and 18% higher in the Tees Valley than the English average.

Health habits

The percentage of physically inactive adults, who do less than 2.5 hours a week of moderate exercise, is at least 10% higher than the English average in five of the six local authorities in County Durham and Tees Valley.
16% of adults in County Durham and Tees Valley smoke, compared to 13.9% in the rest of England
Hospital admissions from alcohol-related causes are higher at 598 per 1000,000, compared to 456 per 1000,000 in England.
Deaths from drug misuse are higher, with 11.7 per 100,000 dying, compared to 5.0 per 100,000 in England, and are more than three times the English average in Hartlepool and Middlesbrough.
Emergency hospital admissions in County Durham and Tees Valley are well above the English average.
- County Durham – 8.1% higher
- Redcar and Cleveland – 10.0% higher
- Darlington – 10.1% higher
- Stockton-on-Tees – 29.8% higher
- Middlesbrough – 32.1% higher
- Hartlepool – 33.5% higher

Health conditions

The amount of people with major health conditions such as depression, stroke, hypertension, diabetes, respiratory conditions, heart disease, cancer and dementia, is at least 10% higher in County Durham and Tees Valley.
The number of people living with a limiting long-term illness is higher than the national average of 17.6%:
- Stockton-on-Tees 19%
- Darlington 19.6%
- Middlesbrough 20.9%
- Redcar and Cleveland 22.8%
- Hartlepool 23.2%
- County Durham it is 23.7%

Jobs, labour market and poverty

Unemployment rates in the region are at 6.1% of the workforce, compared to 4.1% nationally.
The number of available jobs in the region is lower than the national average with 0.69 jobs per worker aged 16-64 available, compared to 0.84 on average in England.
There are higher than average rates of Universal Credit Claims in County Durham and Tees Valley.
Wages are below the English average, despite people in the region working the same amount of hours: in 2019, median annual gross pay was £2,533 less than the English average (£22,617 compared with £25,150).
There was a £12,265 gap in GVA per-head (in 2020 prices) between County Durham and Tees Valley and the national average in 2019 (the last pre-pandemic full year of data. This is equivalent to £4bn per year in lost productivity.
Worse health accounts for 27% of lost productivity, bringing up the health of people living in County Durham and Tees Valley to the national average could generate an additional £4bn in increased productivity per year

The report sets out a number of policies, strategies and solutions that are needed to overcome the divide in health, wealth and opportunities for people living in County Durham and Tees Valley.

The County Durham Community Foundation and Health Equity North (HEN) are now calling on government to act by:

Giving families with children enough money and security of income to meet their basic needs
Making sure children have enough healthy food to eat
Ensuring that there is a joined-up and place-based community approach by national and local government to address poverty, health inequalities and the cost-of-living crisis
Giving community foundations a role in the proposed Community Wealth Funds

Dr Michelle Cooper MBE, Chief Executive of County Durham Community Foundation, said: “As a Community Foundation, we’ve been working with charities and community groups on the frontline in County Durham and the Tees Valley for nearly 30 years. We know all too well the hardships and the entrenched poverty. But the question is, what are we going to do about it?

“This report sets out a series of recommendations that will give our region and communities a fighting chance to get out of the vicious cycle of poverty and make a brighter tomorrow a reality. We’re advocating for a common sense but urgent approach to give more resources and more funds to those local experts on the ground, who know what their communities need and can make it happen.

“There simply is no time to waste if we are to reduce inequalities and create opportunities for a sustainable future. If we want County Durham and the Tees Valley to be a place where people can expect to grow up with a good education, secure a good job and live a full, healthy life, then the recommendations in this report must be actioned and implemented.”

Hannah Davies, Executive Director of Health Equity North, said: “The inequalities faced by people living in County Durham and the Tees Valley today are laid bare by this report. People in the region do not have the same opportunities to thrive as those elsewhere in the country. They may live in the same geographical country, but their experiences, opportunities and health are foreign to those living in different parts of England.

“And this report shows that their lives are on the precipice of getting much worse. Deprivation is one of the leading causes of ill-health and the current economic chaos is deepening already enduring crises of austerity, the pandemic and long-term economic downturn.

“This report and its recommendations must be taken seriously by policymakers. To build a successful 21^st century Britain we cannot let down such a large proportion of its population.”

Dr Luke Munford, HEN Academic Director, Health Economist from the University of Manchester, and co-author of the report, said: “County Durham and Tees Valley has a rich history, but it has faced many challenges over the years, from industrial decline to austerity-driven cuts, and more recently the impact of the pandemic and the current cost of living crisis. All this has resulted in people living in the area experiencing worse physical and mental health, lower life expectancy, and poorer life chances.

“The case studies in the report show the realities of what life is like for some people in the area. People who often rely on support from organisations like the County Durham Community Foundation to help make ends meet. We hope that the recommendations in the report, if actioned and implemented, will help to bridge the growing divide and give communities the opportunity to recover from decades of disadvantage.”

Professor Clare Bambra, HEN Academic Director, Professor of Public Health at Newcastle University, and co-author of the report, said: “This report should act as a warning to government that urgent action is required to help communities like those in County Durham and Tees Valley. There needs to be targeted place-based approaches implemented to address poverty, health inequalities and the cost-of-living crisis – all of which are hitting people in deprived areas much more severely.”

The Rt Revd Paul Butler, Bishop of Durham, said: “People living in County Durham and Tees Valley deserve the same opportunities as those elsewhere in the country. But this report clearly shows that this is not the case. It makes for shocking reading and exposes the harsh realities of inequality within the region. It is imperative it acts as a wake-up call for action for all across our society. I urge all policy makers, local and national, to read and implement the recommendations carefully.”