This case study is part of a Local Democracy Research Centre paper on global health inequalities. Read Still unequal: dealing with health inequalities through the pandemic and beyond
In 2019 the Greater Manchester (GM) system – GM Health and Social Care Partnership and GM Combined Authority – invited UCL Institute of Health Equity (IHE) to work with them to establish a Marmot City Region to reduce health inequalities and inequalities in the social determinants of health. With the onset of Covid-19, the work was reoriented to consider the challenges facing the city region during and post-pandemic and to make recommendations to reduce inequalities. Their report, written by the UCL Institute of Health Equity, Build Back Fairer in Greater Manchester: Health Equity and Dignified Lives was published in June 2021.
The health of the GM population was relatively poor before Covid-19 struck with worsening health inequalities and some deteriorations in social and economic conditions in the ten years up to 2020.
GM is slightly more ethnically diverse than the national average, household incomes are lower, and there are higher levels of deprivation.
There was a high Covid infection rate in GM and a 25 per cent higher covid death rate than England in the 13 months to March 2021. The IHE report says that this contributed to a decline in life expectancy in the North West region larger than the average for England – in 2020 it fell by 1.6 years for men and 1.2 for women compared with 1.3 and 0.9 years respectively across England. (Life expectancy per local authority area was not available when the report was written.)
The work of the IHE helped provide an in-depth analysis to track the spread and impact of the virus in the city region. While deprivation is associated with higher levels of infection and death, analysis showed that levels of income, education and skills, type of employment and health are more strongly connected than other factors such as crime, housing and living environment. Also, the timing of the Covid restrictions did not align with the trajectory of the pandemic in the city region.
See also this LGIU briefing Build Back Fairer in Greater Manchester: health equity and dignified lives.