Press Story

  • One in every four people who are economically inactive live in just 50 local authorities
  • People in Liverpool are 2.8x more likely to be in poor health than those in Oxfordshire, and twice as likely to be economically inactive – see map to find out data for your area
  • Areas of sickness associate with areas of low productivity, high poverty and persistent unemployment
  • IPPR proposes new health zones - with sweeping new powers to invest, raise local taxes, and set missions

A stark divide in health and wealth throughout the UK is leaving many ‘bad health blackspots’ sicker and poorer than their neighbours, according to the third interim report for the cross-party IPPR Commission on Health and Prosperity.

The report 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.

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 10 people in places like Liverpool (North West), Manchester (North West) and Nottingham (East Midlands) report that they are in bad health, compared to 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 to 17.4 per cent in Hart, 17.1 per cent in West Oxfordshire and 17.8 per cent in South Oxfordshire.

The concerning ‘double injustice’ of 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.

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.

Lives and livelihoods are being cost by poor health in the UK – which has now become the sick man of Europe. As a result, the UK is experiencing related crises in the NHS and the workforce.

IPPR held a series of multi-day workshops with people from across the UK to develop bold new proposals to tackle the declining health and wealth of certain areas. They recommend a new network of good health zones across the country. Health and Prosperity Improvement Zones (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 go hand-in-hand with a sweeping series of 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
  • 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 Spring 2024.

Lord James Bethell, former health minister and IPPR commissioner said:

"If everywhere in the UK was as healthy as Wokingham, Windsor or Maidenhead, we'd 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.”

Efua Poku-Amanfo, research fellow at IPPR and lead author of the report, said:

“The case for government spending and action on health is clear. It’s not just the morally right thing to do, it’s the economically sensible thing to do.

“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.

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.”


Efua Poku-Amanfo, the report’s lead author, is available for interview. Commissioners may be available upon request.


David Wastell, Director of News and Communications: 07921 403651

Liam Evans, Senior Digital and Media Officer: 07419 365334


  • The IPPR paper, Healthy places, prosperous lives by Efua Poku-Amanfo, Jamie O’Halloran and Chris Thomas, will be published at 19:00 on 18 January 2024.
  • Advance copies of the report are available under embargo on request
  • TABLE: Ten best and worst local authorities in England and Wales for bad health and economic inactivity


Local authority

Per cent in bad health

Per cent economically inactive

Ten best


Hart (South East)

2.8 per cent

17.4 per cent


West Oxfordshire (South East)

3.3 per cent

17.1 per cent


South Ofordshire (South East)

3.2 per cent

17.8 per cent


Wokingham (South East)

2.8 per cent

18.7 per cent


Mid Sussex (South East)

3.3 per cent

17.8 per cent


Vale of White Horse (South East)

3.3 per cent

18.0 per cent


Uttlesford (East of England)

3.1 per cent

18.9 per cent


Horsham (South East)

3.2 per cent

18.8 per cent


West Berkshire (South East)

3.4 per cent

18.2 per cent


Surrey Heath (South East)

3.1 per cent

19.2 per cent

Ten worst


Liverpool (North West)

9.2 per cent

33.9 per cent


Manchester (North West)

8.8 per cent

34.2 per cent


Nottingham (East Midlands)

8 per cent

38.5 per cent


Middlesborough (North East)

8.1 per cent

32.9 per cent


Neath Port Talbot (Wales)

8.5 per cent

31.0 per cent


Newcastle upon Tyne (North East)

7.5 per cent

34.8 per cent


Blackburn with Darwen (North West)

7.8 per cent

31.9 per cent


Birmingham (West Midlands)

7.4 per cent

35.1 per cent


Blackpool (North West)

8.8 per cent

29.4 per cent


Blaenau Gwent (Wales)

9.3 per cent)

29.0 per cent