Titled ‘Healthy places, prosperous lives’, the third interim report for the cross-party commission says that the UK now has among the largest health inequalities of any advanced economy, with one in every four people in England and Wales who are economically inactive living in the unhealthiest 50 local authorities.

These problems are seeing ‘bad health blackspots’ emerge throughout the country that are sicker and poorer than their neighbours, says the report. People living in the most deprived local authorities in England are nearly one and a half times more likely to experience economic inactivity and are twice as likely to be in poor health than those in the least deprived authorities.

Almost one in every ten people in Liverpool (North West), Manchester (North West) and Nottingham (East Midlands) report that they are in bad health, compared with around just one in 33 in Hart (South East), West Oxfordshire (South East) and South Oxfordshire (South East).

These areas correlate with areas of high and low economic inactivity; 33.9 per cent of working aged people in Liverpool are economically inactive, 34.2 per cent in Manchester, and 38.5 per cent in Nottingham, compared with 17.4 per cent in Hart, 17.1 per cent in West Oxfordshire, and 17.8 per cent in South Oxfordshire.

Areas suffering high levels of sickness and low levels of economic activity are exacerbated by also being more likely to experience worse levels of productivity, material deprivation, child poverty, unemployment, and household income. Moreover, these areas also have some of the lowest levels of life expectancy in the country. In Liverpool, for example, the healthy life expectancy is just 58 years. In Wokingham, the healthy life expectancy is over 70 years.

Across the UK, the healthy life expectancy gap between the healthiest and unhealthiest local authority is 23.5 years for women and 21.2 years for men.

Lead author of the report Efua Poku-Amanfo, a research fellow at the IPPR, argued that increased government spending and action on health is not just morally right but also “the economically sensible thing to do”.

She said: “Bad health blackspots, especially in the North East and North West of England and the South of Wales, are stifling national economic growth and holding back the wealth and health of the nation.”

“Sick man of Europe”

The report depicts the UK as the “sick man of Europe” and attributes this to related crises engulfing the NHS and the workforce.

The proposal for the establishment of new Health and Prosperity Improvement (HAPI) Zones came out of a series of multi-day workshops, which the IPPR held with people from across the UK to discuss how to tackle the declining health and wealth of certain areas. The HAPI zones would be modelled on Clean Air Zones and focus on seven key areas, including physical and mental health, housing quality, and addiction. HAPI zones would also go hand-in-hand with a series of sweeping reforms, such as:

• devolving fiscal powers to mayors so they can introduce local taxes on things like alcohol, junk food and tobacco;
• funding new good health schemes to the tune of £3 billion and allocated to local authorities through formular rather than competitive funding; and
• a recruitment drive for expert public health specialists, alongside the creation of new local apprenticeship opportunities and establishing a National Health Volunteering Service.

The IPPR Commission on Health and Prosperity – with commissioners including Lord Ara Darzi, Dame Sally Davies, Mayor Andy Burnham, Lord Bethell and Dr Halima Begum – will publish its final report and recommendations in the spring.

Poku-Amanfo insisted that local leaders are “ready and willing to take ownership of public health, collaborating with their communities to work out the best solutions – but they need the powers and funding from central government to turn things around”.

Former health minister Lord Bethell said: “If everywhere in the UK was as healthy as Wokingham, Windsor or Maidenhead, we would be the healthiest country in the world – and much wealthier too. Not just because they have a better NHS, but because they have the right foundations for a healthy life: healthier food choices, less takeaways and betting shops, fewer mouldy houses, cleaner air, and more green spaces.

“Sick Britain is something we just cannot afford. We urgently need a plan to give people and communities real power over their health.”

Professor Donna Hall CBE, IPPR commissioner and former chief executive of Wigan Council, said: “People working within local government and health services are trapped by a lack of resources, support and agency to serve their local population. People feel unheard and their health is suffering.

“The new HAPI zones would serve as an innovative response to growing poverty and ill health, put power into the hands of local leaders, and ignite local ownership over the future of public health.”