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A new report supported by the NIHR Applied Research Collaboration (ARC) North East and North Cumbria has highlighted that older people in the North of England are more likely to be poorer, less healthy, physically inactive, lonely and in poor housing – resulting in millions of pounds of avoidable NHS costs.

The Ageing in the North report, published by the Northern Health Science Alliance, has catalogued the disadvantages faced by older people living in the North; in health, life expectancy, housing, nutrition, employment, and social isolation.

The authors state that this inequality is mainly driven by economic and social factors, and is ‘totally reversible’ – as long as policymakers are bold enough to act. For example, targeted investment has the potential to reduce or recover as much as £10.9 billion in lost productivity costs, £315 million in NHS costs from falls and hip fractures, and £588 million in NHS costs from treating conditions resulting from poor housing.

The report has been co-authored by Professor Barbara Hanratty, Professor of Primary Care and Public Health at Newcastle University, and ARC NENC lead for research into Multimorbidity, Ageing and Frailty.

ARC NENC Research Fellows Dr Vanessa Davey and Dr Mohi Ziyachi also contributed to the work.

Professor Hanratty said: “For many, it is harder to grow old in the North than in the South. There are some deep-seated and long-term reasons for that. But we must also acknowledge that the situation is being influenced by decisions that are being made today.

“Average earnings in the North amongst those aged 65 and over are the lowest in England, and poverty has increased over the last 10 years. People in the North are more likely than their neighbours to leave the workforce due to ill-health.

“We need real policy changes to tackle the root causes of this inequality, with more targeted initiatives to address the many disadvantages facing older people in the North.”

Researchers analysed existing data through a regional lens to examine the different ways in which ageing is experienced across England. They explored issues such as poverty and employment, health expectancies, long-term chronic conditions, frailty and falls, physical activity, nutrition, dementia and cognitive frailty, social support and unpaid care, social isolation and loneliness, housing and ethnicity.

They found that:

• There are an estimated 904,200 economically inactive 50-64 year olds in the North: 170,100 in the North East, 428,600 in the North West, and 305,500 in Yorkshire and the Humber, contributing to a potential reduction in GDP of £10.9 billion per year
• People from the South are more likely to retire, while those in the North are more likely to leave the job market due to poor health
• Older people living in the North East and North West are 1.61 and 1.33 times, respectively, more likely to be frail, 1.16 and 1.06 times more likely to have a fall that requires hospital treatment, and 1.14 and 1.12 times more likely to have a hip fracture compared to older people living in the South East
• The cost to the NHS of falls and hip fractures in the North is £55.7 million and £258.8 million per year respectively
• 1.47 million northern homes are considered non-decent, with over a third housing over-60s residents. This is costing the NHS approximately £588 million in treatment per year
• In the ten years from 2012 to 2022, the North East and Yorkshire and the Humber have seen the rates of poverty among people aged 65 and over rise by 10%
• People aged 65 or over are 5% more likely to be deprived in the North (68%) than in the South (63%)
• Between 2020-21 and 2022-23, pensioner couples in the North East had an average income 14% lower than the national average and 25% lower than those in the South East
• Men aged 65 and over in the North East are predicted to have the highest number of unhealthy years of life on average, at 20.2 years. Yorkshire and Humber have 19.1, while the South East has 16.6
• The number of unhealthy years of life for older women in the North East is 23.7 years, compared to 19.4 years in the South East
• There is a two-year life expectancy gap between the North and the rest of England, with premature death rates 20% higher for those in the North
• Arthritis is more common amongst 55-64 year olds in the North (28%) than in the South (23%). Just 51% of people in the North East and Yorkshire and the Humber are seen for treatment within the national three-week target, compared to 79% in the South West
• Physical inactivity in the North East among 55-74 year olds is at 31% compared to 22% in the South East
• Northern adults over 65 are 27% more likely to experience food insecurity than those in the South
• Cognitive frailty (cognitive impairment plus physical frailty) in old age is more common in the North than in the South, with 11.8% living with cognitive frailty in the North East compared to 7% in the South East.
• Older adults in the North are 23.3% more likely to experience loneliness compared to the South, with northern women 1.55 times more likely to be lonely than men
• The three northern regions have the highest proportion of people aged 65 and over living in care homes, costing an estimated £4.83 billion in care home fees
• Minoritised ethnic groups consistently report poorer self-rated health than White British peers. Self-rated health is generally poorer in the North than in London and the South.

The report includes evidence-based policy recommendations, which could go a long way to reversing the widening inequality gap between North and South.

Read the full report

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