"Avoidable and unjust": Lancashire's higher-than-average Covid death rate
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That was the reaction of Lancashire’s public health boss to a study which found that the county had a nine percent higher Covid-related death rate than the England average in the 12 months after the virus struck.
The Northern Health Science Alliance (NHSA) report also estimated that just over half of the increased level of Covid fatalities across the whole of the North of England could be attributed to either pre-existing poor health or deprivation - meaning that they were “potentially preventable”.
That would equate to 15 possibly avoidable Covid deaths per 100,000 people across the 77 northern local authority areas that were examined for the “A Year of Covid in the North” document.
The disproportionate effect of the pandemic on Lancashire and other parts of the North West was "avoidable, unnecessary and unjust”, according Lancashire County Council's director of public health, Dr. Sakthi Karunanithi. He had been spearheading work on how to tackle health inequalities before the pandemic struck and says that their real-world impact - already felt by those who were experiencing them - has been brought into sharp focus for society as a whole by the experience of the last 18 months.
“It’s sad but not surprising - and a reminder that the places where we live, work and go out with our families and friends do matter in determining our health and wellbeing. That's why investing in our NHS alone will not really address this - and we need to invest in our places and communities [in order for them] to thrive.
“Health inequalities have been compounded by the pandemic - and we need a fully-resourced long-term plan to turn it around that can live beyond electrical cycles.
“We need to start thinking about prevention - we need to invest in the causes of the causes [of health disparities] and support people in having better life chances. That means
investing in child development and reducing the number of children living in households in absolute poverty.
“We also need to embed health and wellbeing in all policies that we develop - whether that is on the environment, the economy, housing, transport or education. We need to invest in communities with higher health needs - [be that] deprived or ethnic minority communities, or wherever vulnerable communities exist,” Dr. Karunanithi said.
The NHSA report recommends a raft of short and long-term responses to its findings.
As an immediate action, the authors suggest targeted vaccination programmes focused on those areas and populations where take-up is low. However, the study did find that the North West had the second-highest Covid vaccine rate in the country over the first six months of the rollout.
The document also proposes the creation of ‘Health for Life’ centres across the North, offering life-long programmes of health and wellbeing advice and providing support services from pre-natal schemes to healthy ageing programmes. It recommends targeting the facilities in the most deprived areas as a way of preventing ill-health from becoming entrenched in less well-off communities.
Locally-focused pandemic preparedness plans should also be developed to safeguard vulnerable groups, such as those in care homes, people with disabilities and those suffering chronic ill health in the event of a similar crisis occurring in the future, the report says.
A £1bn ring-fenced fund to tackle health inequalities at a regional level - as well as increased funding for local public health teams - is also proposed.
The call came just 24 hours after the government announced £36bn in new funding over three years to be split between the NHS, social care and the ongoing response to Covid.
Health Inequalities lead for the NHSA, Hannah Davies, said of the partnership’s report : “As we approach autumn with uncertainty around an expected increase in COVID-19 cases and with increasing questions about what ‘Levelling Up’ will mean for the North of England it is clear significant action must be taken in tackling health inequalities.
“The Government has made clear its commitment to level up and to tackle health inequalities, this report shows the importance of making that a reality with significant funding to tackle ill health through significant investment into public health and the NHS in the North of England.”
Although Lancashire's Covid mortality rate across the first year of the pandemic was higher than the England average, it did not exceed it by as much as some other parts of the North West, such as Greater Manchester - where it was 35 percent higher - and Merseyside, which registered a 28 percent higher Covid-related death rate than the national average. However, Lancashire did perform more poorly than Cumbria, whose rate was one percent lower than that across England.
The NHSA study also assesses the economic impact of Covid on northern communities, where weekly gross pay fell slightly in the year to March 2022, in comparison to a fractional rise in England as a whole. Wages by that measure were already far lower in the North before the pandemic - £543 compared to £600.
COVID IN NUMBERS
17 - number of Covid-related deaths per 100,000 people in Lancashire
9 percent - higher Covid mortality rate in Lancashire than the England average
51 percent - of increased Covid mortality across the North of England was due to deprivation or poor health
15 - number of Covid-related deaths per 100,000 people in the North of England that were potentially preventable
Source: "A Year of Covid in the North" report by the Northern Health Science Alliance (all figures cover March 2020 to March 2021)