New analysis shows how inequalities cut lives short

New Health Foundation analysis has revealed stark inequalities in the risk of dying early, depending on people’s education, occupation and where they live.

The analysis, using Office for National Statistics (ONS) data and modelling, explores the links between socioeconomic circumstances and premature mortality (deaths before age 75), finding substantial differences in the risk of dying early related to people’s education, occupation and the level of deprivation of the area they live in.

The analysis finds that men and women living in the most deprived areas have a risk of an early death 2.3 times as high as peers in the least deprived areas. Women with no qualifications have a premature mortality rate 2.5 times as high as those with a degree or higher. Men who are long-term unemployed or have never worked have a rate 3.5 times as high as those in higher managerial, administrative and professional occupations.

However, higher qualifications and certain occupation types do not fully protect people from the effect of living in deprived areas. While higher education or occupation mitigates the impact of deprivation on the risks of an early death, men with a degree or higher and men in higher managerial and professional occupations who live in the most deprived areas of England have a risk of dying early still about twice as high as their peers in the least deprived areas.

While the impacts of deprivation on health outcomes are well established, these findings highlight how deprivation may interact with education and occupation to shape the risk of premature mortality. Higher qualifications often lead to higher-quality jobs, higher incomes and lifetime earnings. These all enable a good standard of living, and greater ability to afford essential goods and services that support good health. Unemployment often brings stress and uncertainty which can weigh heavily on mental wellbeing and spill over into physical health problems. Job quality – which includes things such as adequate pay, secure work and reliable working patterns – has also been shown to have an impact on mental and physical health.

The size of socioeconomic inequalities also differs between regions and is less pronounced within London than within most other areas. In the North West, the inequality divide between different groups is substantially higher than in London. This highlights the need for the government’s devolution drive to focus on reducing health inequalities.

Freya Tracey, Principal Data Analyst at the Health Foundation said: 

‘These findings lay bare the scale of the inequalities that continue to shape people’s chances of living a long and healthy life. Where you live, the opportunities available to you, and the circumstances you are born into should not determine your risk of dying early. A cross-government approach is needed to reduce inequalities in the building blocks of health - including education, employment and local economic conditions. The government’s approach to devolution must include supporting local areas to deliver prevention to reduce health inequalities. Without sustained action, inequalities will continue to cut lives short.’

Note: This analysis did not look at premature mortality rates by ethnicity. This will be covered in a separate report published by the Race Equality Foundation and funded by the Health Foundation.

Notes to editors

1. Office for National Statistics (ONS) data source.

2. The Health Foundation carried out this analysis underpinned by data and modelling by the Office for National Statistics.

• This analysis uses data from the 2021 census to look at differences in premature mortality rates (that is, deaths occurring below the age of 75 years old). The analysis includes people living in England who are aged 18 to 74 years and included in the 2021 census. Results are also available for Wales in the ONS publication. The study period included deaths from March 2021 to December 2023. Any adult who died from any cause before their 75th birthday within this timeframe was classified as a premature death.
• *For men, the mortality rate in the most deprived areas is 815 deaths per 100,000, compared with 353 in the least deprived. For women, the rate is 556 deaths per 100,000 in the most deprived areas, compared with 243 in the least deprived.
• Women without any qualifications have a premature mortality rate of 564 premature deaths per 100,000 people, compared with 225 for women with a degree or higher.
• Men who are long-term unemployed or who have never worked have a premature mortality rate of 1,069 deaths per 100,000 people, compared with 306 for men who are in in higher managerial, administrative and professional occupations.
• Men with a degree or higher who live in the most deprived areas have a premature mortality rate of 556 deaths per 100,000, compared with 269 for men with the same level of education in the least deprived areas.
• Men working in higher managerial, administrative and professional occupations in the most deprived areas have a rate of 492 deaths per 100,000, compared with 255 for men working in the same type of occupations in the least deprived areas.

Media contact

Jessica Clinkett
jessica.clinkett@health.org.uk
020 7664 4647