Newsroom University of Manchester

Living in the North of England increases risk of death from alcohol, drugs and suicide

Fri, 15 Mar 2024 09:00:00 +0000

People living in the North of England and in coastal areas are more likely to die from ‘death of despair’, according to new University of Manchester-led research.

The new analysis shows that between 2019 and 2021, 46,200 people lost their lives due to Death of Despair in England – the equivalent of 42 people every day.

However, in the North East of England more than twice as many people lost their lives due to Deaths of Despair compared to London.

Deaths of Despair is a collective term for deaths from alcohol, drugs and suicide, which tend to occur much more frequently in socially deprived communities.

The study, led by academics from Health Equity North (HEN), The University of Manchester and the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater 91ֱ�� (ARC-GM) examined local authority data to identify geographical trends and risk factors that contribute to these kind of deaths.

The analysis found that northern regions and coastal areas of England are experiencing a much higher burden of mortality from these avoidable causes.

Out of the 20 local authority areas that experience the highest rates of Deaths of Despair, 16 are in the North, and all of the top 10 areas are in the North.

Conversely, none of the 20 local authorities with the lowest rates of Deaths of Despair are in the North.

The analysis also looked at associated factors that predict the risk of these kinds of deaths; living in the North was the strongest predictor. Local authorities with higher proportions of unemployment, white British ethnicity, people living alone, economic inactivity, employment in elementary occupations, and people living in urban areas had higher rates of Deaths of Despair.

The study found that:

On average, 14.8 per 100,000 more people die from Deaths of Despair in the North compared to the rest of England
Even after accounting for multiple social and economic factors, living in the North of England was associated with a 5.8 per 100,000 increase in Deaths of Despair rate
More than twice as many people died from Deaths of Despair in the North East of England than they did in London (54.7 per 100,000 and 25.1 per 100,000 respectively)
The highest rate of Deaths of Despair in England (at local authority level) is in Blackpool – almost 2.5 times the national average
Three areas in England, all in the North, experienced more than double the average Deaths of Despair – Blackpool (83.8 in 100,000 deaths), Middlesbrough (71.6 per 100,000 deaths) and Hartlepool (70.5 per 100,000 deaths)
Alcohol-specific deaths made up almost half of Deaths of Despair in England, accounting for 44.1% of all such deaths
Deaths of Despair accounted for 2.9% of all deaths in England
Deaths of Despair were highest among people aged 45-54 (55 per 100,000)
Deaths of Despair accounted for 2 in 5 deaths in people aged 25-29 (41.1% of all deaths)
Coastal local authorities had a significantly higher average Deaths of Despair rate than inland local authorities (41.6 per 100,000 compared to 31.5 per 100,000)

The study is believed to be the first of its kind to explore geographical patterning and contributing causes of deaths of despair in England.

The researchers are calling on government to prioritise preventative policies which address the longstanding inequalities across England, with fair funding allocation distributed according to need.

Christine Camacho, lead author and PhD Fellow NIHR ARC-GM, said: “Our study shows that some of the risk factors of deaths of despair have a more pronounced impact in the North of England, where inequalities in health and wealth are persistent and have widened during recent decades.

“As well as specific public health interventions to prevent deaths from drugs, alcohol and suicide, we need to move further and faster with Levelling Up in England to tackle the underlying inequalities which are leading people to die from despair.”

, Co-Academic Director at Health Equity North, and Senior Lecturer in Health Economics at The University of Manchester, said: “Time and time again, we see research exposing regional inequity with the North of England often being hit the hardest. Unsurprisingly, the findings of this study further highlight the persistent health inequalities in northern regions. This can’t be ignored – it is not acceptable that more than twice as many people in some deprived communities in the North are dying due to deaths of this nature.

“This research provides policymakers with a novel insight into the associated social factors of deaths of despair, which can help when developing comprehensive strategies that not only target specific risk factors but also consider the intricate relationships among these causes, contributing to more effective prevention and intervention efforts.”

Global COVID-19 study finds higher infection risk was main driver of ethnic inequality

Mon, 06 Mar 2023 07:00:00 +0000

In the most comprehensive analysis of ethnic inequalities in COVID-19 health outcomes to date, a major new global study has found that ethnic minority groups experienced higher rates of severe illness and death during the pandemic because of their greater risk of infection.

The research, published in , analysed results from 77 research studies, covering 200 million people from around the world. Earlier research showed a higher risk of severe illness or death for people from ethnic minority groups, but it was not clear if this was due to higher infection risk, poorer prognosis once infected, or both.

The study found that the biggest driver of ethnic inequalities was in infection rates. Compared with the White majority group, South Asian people were 3 times more likely to test positive for infection, Black people were 1.8 times more likely, and Mixed and Other ethnic groups were each 1.3 times more likely.

Among studies that looked at the risk of severe illness or death from COVID-19 in the whole population, Black people were 1.5 times more likely to be admitted to hospital than the White majority, Indigenous people were 1.9 times more likely and Hispanic people were 1.3 times more likely. The risk of needing intensive care was also higher: South Asian, East Asian, Indigenous, Hispanic and Black groups all had more than triple the risk than White majority groups. Indigenous people had twice the risk of dying than White majority people, with the Mixed ethnic group at 1.4 times the risk and the Hispanic group at 1.3 times the risk.

The fact that more people from ethnic minority groups were admitted to hospital and more of them died seems to be due to a greater proportion of people being exposed to the virus and becoming infected – when looking at studies that only include people infected with COVID-19, the risks of severe illness and death are similar for ethnic minority groups and the White majority group.

However, after being admitted to hospital with COVID-19, ethnic minority people were more likely to be admitted to ICU compared to White people. These higher rates may be a reflection of poorer health before infection with COVID-19, or inequalities in access to healthcare or service quality - all of which are a result of structural and institutional racism.

Higher infection rates can be driven by socioeconomic inequalities experienced by ethnic minority groups, that were exacerbated by the pandemic, and occupational risks. Different patterns of employment, income and housing impacted the level of risk faced by people from different ethnicities - people from ethnic minority groups are more likely to have public-facing jobs, less likely to be able to self-isolate or work from home, more likely to live in overcrowded housing and less likely to have access to open spaces. These factors all increase the risk of COVID-19 infection.

Data was also shaped by inequalities in policy and service provision. While positive test rates for White majority and Hispanic people were similar, antibody tests - the best indicator of previous infection - showed that Hispanic people were twice as likely to have previously been infected with COVID-19. This suggests that Hispanic people may not have had adequate access to tests.

The researchers emphasise the importance of using disaggregated ethnic categories, as the use of broad groups can mask differences in health outcomes. The study found that South Asian people had a higher risk of infection, whereas East Asian people did not, and these differences may not have been found if a broad ‘Asian’ group was used.

“The COVID-19 pandemic disproportionately impacted ethnic minority people, with the present findings demonstrating that the health inequalities earlier in the pandemic were largely driven by differences in exposure,” said the study’s lead author, Dr Patsy Irizar from The University of Manchester.

“Our study examines COVID-19 outcomes from ethnic minority groups globally,” said Dr Daniel Pan, joint lead author and NIHR Doctoral Research Fellow from the University of Leicester. “Although now there are reductions in mortality amongst ethnic minority groups in the UK, our work is of relevance to policy makers internationally, where ethnic minority groups continue to suffer disproportionatey worse outcomes from COVID-19.”

“This latest study, now of over 200 million individuals from around the world, confirms and builds on our earlier work highlighting the disproportionate risk of COVID-19 in ethnic minority groups,” said Professor Manish Pareek, Chair in Infectious Diseases at the University of Leicester. “This work will be of relevance to UK’s independent public inequiry into the pandemic, which has committed to examining the impact of inequalities at the forefront of its investigations. Going forward it is critical that policy-makers address health inequalities to improve health outcomes for ethnic minority groups.

“The COVID-19 pandemic shone a spotlight on the health inequalities experienced by ethnic minority groups,” said Professor Vittal Katikireddi, Professor of Public Health and Health Inequalities at the University of Glasgow. “Monitoring these inequalities in the future will be important to ensure policy responses are helping create a fairer society.”

This work was supported by the Economic and Social Research Council [grant number ES/W000849/1].

Tackling the lack of diversity in energy research

Mon, 28 Mar 2022 15:06:40 +0100

The University of Manchester is part of a new £1.25M project working to develop a more diverse energy research community, ensuring energy research draws upon the expertise of academics from all backgrounds.

Funded by an EDI Network+ grant from the (EPSRC), the (IGNITE+ Network) research project will bring together eight University partners to critically evaluate stages in the career pathways of energy researchers, identifying and challenging systemic inequities.

Dr Jessica Gagnon, Lecturer in the 91ֱ�� Institute of Education, will lead on the ‘See Yourself in Energy’ initiative, designed to inspire the next generation of researchers in STEM. Working with Education partners across Greater 91ֱ��, Dr Gagnon will be recruiting energy researchers at a variety of career stages to share their area of energy research expertise to pupils in Key Stages 2 and 3.

Dr Gagnon will evaluate how young people’s interactions with energy researcher role models affects their aspirations of becoming future energy scientists and engineers and the impact the project has on the role models and partners involved.

The initiative will build on the successful pilot intervention that was funded by and organised by STEM Equals, in collaboration with Glasgow Life/Glasgow public libraries, three local secondary schools and the Glasgow Science Centre.

Alongside the evaluation work, the IGNITE Network+ team will be working to support energy researchers from disadvantaged and underrepresented backgrounds through organisational interventions, mentorship, advice and advocacy.

Initiatives arising from consultation with the research community will be a key component of the network, with 40% of the funding allocated to flexible funding calls to address energy research challenges, and fund initiatives in support of Equality, Diversity and Inclusion.

Principal Investigator, Professor Rebecca Lunn from the Department of Civil and Environmental Engineering at Strathclyde said: “There is a real lack of diversity in energy research which stems not from a lack of interest, talent or ambition in underrepresented individuals, but from systemic inequalities in UK systems and institutions.

“IGNITE Network+ will focus on transforming diversity by critically evaluating systemic inequalities at each stage in the career pathways of energy researchers. We will design and implement initiatives to remove barriers to success for underrepresented individuals and monitor the performance of these initiatives.”

The project work will be complemented by separate research carried out by Professor Simone Abram at Durham University, a Director in the , also funded by EPSRC. The EDI+ national fellowship scheme will address key challenges and equip a cohort of researchers and their organisations to make lasting changes towards a diverse, equitable, inclusive and accessible research community.

Review highlights stark ethnic healthcare inequalities in the UK

Mon, 14 Feb 2022 14:07:25 +0000

A major new review into ethnic inequalities in healthcare has revealed vast inequalities across a range of health services in the UK.

The review, funded by the NHS Race and Health Observatory and led by experts from The University of Manchester in conjunction with the University of Sheffield and the University of Sussex, explored differences in mental healthcare, maternal & neonatal healthcare, digital access to healthcare, genetic testing & genomic medicine, and the NHS workforce.

While ethnic inequalities were found across each area studied and there were differences between ethnic minority groups, some communities were found to have particularly poor access, experiences and outcomes.

Some of the largest inequalities were found in mental healthcare, where treatment for Black groups was particularly poor. The review also found a lack of research into specific areas including how outcomes may differ for ethnic minority babies in neonatal healthcare settings, where just one study was found to investigate health disparities in the care of ethnic minority new-born babies.

It found GPs were less likely to refer ethnic minority patients to the Improving Access to Psychological Therapies (IAPT) programme compared to White patients. Barriers were also faced by patients who delayed or avoided seeking help for health problems due to their fear of racist treatment from NHS healthcare professionals.

Strikingly, there was evidence that ethnic inequalities in adult mental healthcare is being reproduced in younger people, with one study in the review showing that Black children were 10 times more likely to be referred to Child and Adolescent Mental Health Services (CAMHS) via social services rather than their GP service, in comparison to White British children.

In maternal care, there were some positive relationships with midwives – however, this was limited by poor communication between women and health providers, and women who did not speak English as a first language often lacked access to quality interpreting services. The one study researchers found that focused on ethnic inequalities in care for new-born babies, showed Asian babies were over-represented in admissions to neonatal units for jaundice.

Overall, the review of maternal healthcare found evidence of negative interactions, stereotyping, disrespect, discrimination and cultural insensitivity, leading to some ethnic minority women feeling ‘othered’, unwelcome, and poorly cared-for.

With respect to the NHS workforce, the impact of racism on careers and professional development was also explored in the review, and there was evidence of an ethnic pay gap affecting Black, Asian, Mixed and Other groups, and to a lesser extent, Chinese staff.

The review urges ‘critical action’ to be undertaken by organisations including NHS England, NHS Improvement and NHS Digital, with recommendations outlined by topic area.

“For too many years, the health of ethnic minority people has been negatively impacted by a lack of high-quality ethnic monitoring data recorded in NHS systems; lack of appropriate interpreting services for people who do not speak English confidently and delays in, or avoidance of, seeking help for health problems due to fear of racist treatment from NHS healthcare professionals,” said lead investigator Dr Dharmi Kapadia, Lecturer in Sociology and member of The University of Manchester’s Centre on Dynamics of Ethnicity. “Our review confirmed that all of these issues are still to be tackled by the NHS.”

“It is clear that existing evidence on the stark health inequalities faced by ethnic minority communities has not led to significant change - this is why the Observatory has been established: to synthesise what already exists, translate it into actionable policy recommendations, and to challenge leaders to act,” said Dr Habib Naqvi, Director of the NHS Race and Health Observatory.

“This report should be a tool for them; highlighting the best quality evidence and making concrete recommendations for change. By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system.”

Dr Bola Owolabi to give this year's Doubleday Lecture

Mon, 08 Nov 2021 09:00:00 +0000

The 2021 Doubleday Lecture, hosted by , will be delivered online by Dr Bola Owolabi, Director, Health Inequalities at NHS England and NHS Improvement, who is also the recipient of the 2021 Doubleday Award.

Covid-19 has highlighted health inequalities and Dr Owolabi is leading the NHS effort to accelerate progress tackling those identified during and beyond the pandemic.

The widely respected health leader explain why reducing health inequalities is so important in the online lecture which will take place at 2pm on Wednesday, 10 November. Anyone who wants to attend can book

Bola works as a General Practitioner in the Midlands and is particularly interested in reducing health inequalities through Integrated Care Models, Service Transformation and using data and insights for Quality Improvement.

She has held various leadership roles at local, system and national levels. Until recently Bola was National Specialty Advisor for Older People and Integrated Person Centred-Care at NHS England and Improvement where she led the Anticipatory Care Workstream of the National Ageing Well Programme. She has worked with teams across NHS England/Improvement and the Department of Health and Social Care as part of the COVID-19 Pandemic response.

Bola is an alumnus of Ashridge Executive Education/Hult International Business School and holds a Masters degree with distinction in Leadership (Quality Improvement). She holds an NHS Leadership Academy Award in Executive Healthcare Leadership for Clinicians. Bola is a Generation Q Fellow of the Health Foundation, an independent charity committed to bringing about better health and health care for people in the UK.

The Doubleday Centre for Patient Experience was established by the in 2015 as the first centre of its kind in England. The Fund was set up by the parents of Edwin Doubleday, a former medical student at 91ֱ�� who passed away before he could take his final exams.

The annual Doubleday Award and Lecture is granted to an individual of standing who has made a significant contribution to patient care and who, in turn, delivers a lecture at The University of Manchester.

91ֱ�� reveals huge ethnic minority health inequalities

Fri, 29 Jan 2021 00:18:00 +0000

England’s most extensive ever study of ethnic minority health in the over-55s ever has revealed huge inequalities across most groups, compared with white British people.

The University of Manchester study showed people from some ethnic minority groups – particularly those belonging to Asian groups – were more likely to report poor experiences at their GP surgery.

That suggests, say the authors, unfairness within NHS services may be exacerbating health inequalities for some ethnic minority groups.

It found that the average health of 60 year olds belonging to Gypsy or Irish Traveller, Bangladeshi, Pakistani, and Arab groups was similar to that of a typical 80 year old.

People from almost all ethnic groups studied were much more likely to report insufficient support from local services to manage their health conditions and to say they lacked self-confidence in managing their health.

The study, published in Lancet Public Health, used the England-wide GP Patient Survey to analyse responses from almost 1.4 million adults aged over 55 surveyed between 2015 and 2017.

The sample included over 150,000 people who self-identified as belonging to an ethnic minority group – the largest ever sample.

The GP Patient Survey contains information on day-to-day difficulties and factors that can determine overall health.

Other key findings included:

Inequalities tended to be wider for older women
Older people from ethnic minority groups were more likely to report suffering from some common long-term conditions like diabetes and from having 2 or more conditions
Older Bangladeshi women were around 3 times more likely to report poor experiences than compared to older White British women

Lead author Dr Ruth Watkinson from The University of Manchester said: “We found that people from some ethnic minority groups – particularly Asian groups – were more likely to report poor experiences at their GP surgery.

“This suggests the NHS as an institution is failing people from some ethnic groups. Policy action is needed to transform healthcare and wider support services to make sure they meet the needs of all individuals in England’s multi-ethnic population fairly.

“But policy makers also need to address the structural racism that makes it harder for people belonging to ethnic minority groups to access socioeconomic opportunities because poverty is a major cause of poor health.

Co-author Dr Alex Turner, also from The University of Manchester added: “Researchers haven’t been able to research the health outcomes of people over 55 in ethnic minority groups, because they aren’t included in sufficient numbers in most datasets.

“And much official data doesn’t distinguish between groups, which can mask inequalities

“But this study allowed us analyse results for all 18 of the UK census ethnic groups separately, allowing us to see differences between them.

“However more research to better understand exactly what drives these health inequalities. There needs to be more data collection with much better inclusion of people from ethnic minority groups in longitudinal studies.”

Photo by Mohammad Jobaed Adnan from