Rates of premature death are significantly higher in the most deprived areas of England than in the least deprived, researchers have found.
The study from the University of East Anglia (UEA) revealed rates of premature mortality from all causes were more than two times higher in Blackpool compared to the most affluent areas of Wokingham, Surrey, Windsor and Maidenhead, and West Berkshire.
Half of all premature deaths in the UK are linked to risk factors including tobacco, diet, alcohol and drug use, obesity and high blood pressure.
But the study also reveals the huge burden of disability linked to long-term conditions such as low back and neck pain, anxiety and depression.
Heart disease was the leading cause of premature death in the UK in 2016, and rates were two times higher in men than in women. Self-harm was the third leading cause of premature death for men.
In England, Wales and Northern Ireland (but not Scotland), the years lived with disability exceeded the years of life lost.
Low back and neck pain, skin and subcutaneous diseases, migraine, depressive disorders, sense organ disorders and anxiety disorders were the leading causes of disability.
Lead author Prof Nicholas Steel, from UEA’s Norwich Medical School, said as death rates decrease people continue to live with long-term, often multiple, conditions.
“Our findings show a significant shift from mortality to morbidity, yet our health services are still designed to deal with the big killers. Today, conditions such as back and neck pain and anxiety and depression are huge causes of disability in the UK,” he added.
In England, some areas performed better than expected for their level of deprivation. For instance, Birmingham and some London boroughs, such as Tower Hamlets and Hackney, performed better than those with similar levels of deprivation in Liverpool and Manchester.
The authors suggested that the relatively better health seen in London may be because of lower levels of risk factors such as smoking and poor diet; better access to health care; higher educational performance; or the selective movement of sicker people outside London and of healthier people to London for work.
Northern Ireland had particularly high rates of anxiety disorders, which have been attributed to the social and economic legacy of civil conflict.
Premature mortality remains higher in Scotland than in England, with higher rates of cardiovascular disease, cancer and cirrhosis.
The authors said the long-standing differences between the countries of the UK are likely to be due to variations in risk factors and socioeconomic deprivation, rather than differences in health service organisation and spending.
The research also found that between 1990 and 2016, life expectancy has improved in all four countries of the UK, but the rate of improvement has slowed since 2010. Nine out of 150 areas had worse rates of premature death in 2016 than in 2010.
The national slowdown in improvements since 2010 was mainly driven by the gradual disappearance of improvements in heart disease, cerebrovascular disease, and to a lesser extent colorectal cancer, lung cancer and breast cancer.