ARC GM | Projects

What were we trying to do?
We wanted to find out how much impact COVID-19 had on the physical and mental health and economic outcomes (such as employment) of people in the North of England compared to England as a whole.

Why was this important?
The COVID-19 pandemic had a huge effect on all parts of England, but the North was hit harder than most, both in terms of health and employment. The North already had poorer health and economic outcomes than other parts of England, and the additional challenges of the pandemic only made this worse.

To improve the health and productivity of people in the North, we need to understand COVID-19’s impact on England overall and compare it to the impacts seen in the North. This knowledge will allow policies to be written and funding decisions to be made that support the North in improving its health and economic outcomes, reducing the disadvantages experienced by northern people.

How did we do it?
We used a range of data to find out how COVID-19 affected 8 important factors, and compared the impact on the North with the effects on England as a whole:

Overall mortality rates (the number of deaths)
Mortality in care homes
Hospital pressures
Testing rates
Vaccination rates
Local lockdowns
Mental wellbeing
Economic impact

Findings
We found the following impacts on people in the North during the first 13 months of the pandemic:

Overall mortality rates (the number of deaths)
We split mortality data into ‘deaths caused by COVID-19’ and ‘deaths with any cause’. We found that the North experienced significantly higher mortality rates, from both COVID-19 and all-causes, than the rest of England across the 13 months of the pandemic.

17% more people died of COVID-19 in the North compared to the rest of England including London.
14% more people died of all-causes in the North compared to the rest of England including London.
51% of the increased COVID-19 mortality in the North and 68% of the increased all-cause mortality were due to higher deprivation and worse pre-pandemic health in the North, both of which are potentially preventable.

Mortality in care homes
We looked at the number of deaths in care homes that were caused by COVID-19, as well as deaths from any cause. We found that the North experienced higher mortality rates in care homes during the pandemic, due to COVID-19 and all causes, than the rest of England.

The North’s care home COVID-19 mortality was 26% higher than the rest of England, with rates the highest in the North East.
The North’s care home all-cause mortality was 10% higher than the rest of England.

Hospital pressures
We looked at whether there were regional inequalities in how many people were in hospital due to COVID-19 between March 2020 and April 2021. We found that the North had significantly more beds occupied by people with COVID-19 than the rest of England.

10% more hospital beds were occupied by COVID patients in the North than in the rest of England over a year period.

Testing rates
We looked at how many people had a positive COVID-19 test result in the North compared to the rest of England. On average, the percentage of positive COVID-19 test results was higher in the North than in the rest of the country.

The amount of positive COVID-19 test results in the North was 50% higher than the rest of England.

Vaccination rates
We looked at how many people were vaccinated in the North compared to the rest of England during the first 6 months of the vaccination programme. On average, more people in the North were vaccinated than in other parts of the country.

Overall, an extra 6% of people were vaccinated in the North than in other parts of England.
However, vaccination rates were only higher in the North during 4 of the 6 months. The increased demand during some months could be explained by COVID-19 ‘hotspots’.

Local lockdowns
We examined differences in lockdown regulations, looking at lockdown tiers and how these differed regionally. We found that people in the North experienced more days in higher levels of lockdown, with stricter rules.

People in the North spent 54.6% of the time in the two most restrictive tiers of lockdowns, compared to 46.3% in the rest of the country.
People in the North experienced an average of 41 additional days of the strictest restrictions compared to those in other parts of the country.

Mental wellbeing
We looked at regional inequalities in mental wellbeing and found that people living in the North experienced a large drop in mental wellbeing during the COVID-19 pandemic.

Self-reported mental health fell by, on average, 4.4% in the North (compared to an England-wide reduction of 3.9%).
There was a 55% increase in minor psychiatric disorders in the North compared to a 50% increase in the rest of England.
People in the North experienced more loneliness, particularly in the North East.
A greater number of antidepressants were prescribed in the North before the pandemic, and this continued during the COVID-19 pandemic.

Economic impact
We looked at the impact of COVID-19 on employment, furlough, and wages and found that people in the North experienced higher rates of unemployment but lower rates of furlough than people in other parts of England.

The average unemployment rate in the North was 6.3% compared to 5.3% in the rest of the country.
Furlough rates in the North are similar to the rest of England, but were lowest in the North East.
Wages in the North were lower than the rest of England before the pandemic and these further fell during the COVID-19 pandemic (from £543.90 to £541.30 per week). However, wages slightly increased in the rest of the country.

Read the full report A Year of COVID-19 in the North: Regional inequalities in health and economic outcomes.

Who did we work with?

Funding information
This work was funded by the National Institute for Health and Care Research, the Northern Health Science Alliance, and Policy@Manchester as part of the QR SPF grant monies allocation from Research England.

More information

Senior Programme Lead
Mike Spence
mike.spence@healthinnovationmanchester.com