North–South Mortality Gap in England Widens Sharply for Adults Under 50
A study in The Lancet Public Health compared death rates in northern and southern England from 1981 to 2024. Among adults aged 25–49, the northern excess mortality rose from 13% in 1981 to 42% in 2024, with the gap widening for both sexes and faster for women. The analysis found no narrowing during 2020–24 and noted that the divergence began before the COVID-19 pandemic.
The analysis used national death records and population estimates to track England’s regional mortality divide from 1981 through 2024, adjusting for age and sex. For people aged 25–49, the North’s relative excess rose from 13% to 42%, meaning the gap more than tripled.
Among women, the pattern shifted markedly: in the 1980s, those in their late 20s and 30s showed no excess mortality, but by 2024 every five-year female age band from 25 to 49 had a 35%–60% excess. The study covered all causes and found no narrowing in 2020–24.
The findings may heighten attention on regional health inequalities among working-age adults, especially women in northern England, whose earlier mortality advantage appears to have eroded. Policymakers and regional authorities could face pressure to consider social and economic factors shaping health, while employers and communities may feel effects through workforce health and economic participation. The study cannot show causes, so its societal impact may depend on whether further research and targeted funding follow.