Cities in the North have higher shares of inactivity due to poor health, as shown in Cities Outlook 2023.
Amid talks on rising economic inactivity, and the causes of it – from the ‘great resignation’ to the ‘great retirement’ – one element has received a lot of attention lately: worsening health. The debate has been largely blind to how this plays out across the country, and how it interacts with other factors. This blog draws on Cities Outlook 2023, published last week, to explore these issues in greater detail.
Long-term sickness is now the main reason why people are outside the labour market and not looking for a job. It accounts for 28 per cent of inactivity levels in the UK by the end of 2022 – that’s around 2.5 million people, the highest level since records began. It goes to 4.8 million when including those who are inactive with health issues but do not cite health as their primary reason.
Poor health is particularly prevalent in urban areas in the North of England and in Wales (Figure 1). In Newport and Sunderland, for example, more than 40 per cent of all inactive people are not seeking work primarily because of poor health. That’s nearly three times higher than in cities like Aldershot and Norwich.
Source: ONS, 2022.
Worsening health has been widely discussed in the context of the large increases in inactivity levels seen since Covid-19. Nationally, the number of people reporting being inactive for health issues has gone up by about 360,000 since the start of the pandemic.
A few factors might explain this jump – long-Covid, mental health issues or long waitlists for treatment could all have played a role – but the extent to which poor health has driven recent changes in inactivity is unclear: part of the increase in health-related inactivity could also be due to compositional changes – for instance, if already inactive people became sick.
One thing is for sure though: sickness-related inactivity is far from being a new problem, particularly in the North of England (Figure 2). In the 1980s and 1990s, it was especially acute among former coal miners, steelworkers, and other industrial workers. Exposure to industrial injury led many to become inactive, often claiming incapacity benefits, when their industries shut down.
Source: ONS 2022. Note: the 1981 values only include men.
Yet few of those ex-minors or factory workers are still of working age. What Figure 2 shows, instead, is the prevalence of poor health among their children and grandchildren. And while health outcomes are determined by a wide range of factors, the lasting predominance of low-skilled, routine occupations in former industrial areas certainly plays a role: by mid-2022, sickness-related inactivity was far more common among former workers in sectors like transportation, construction, and manufacturing, which are more prevalent in ex-industrial areas. This could be because many of those routine, manual jobs are more likely to impair health, and are harder to carry out while managing a long-term illness, than most white-collar jobs.
The priority for policy, as identified by the Levelling Up White Paper, is to address inequalities in health. Bridging the life expectancy gap between different parts of the country by 2030 was identified as one of the 12 central ‘missions’ of the agenda. Yet little has been done so far to turn those pledges into action. The Government now needs to press on with tackling the prevalence of long-term illness in the most deprived parts of the country, understanding its causes and the reasons why health has worsened in recent years.
Addressing health-related inactivity specifically will require both supply and demand side measures. Interventions which aim at improving physical and mental health, and helping those with a health condition return to the labour market are important and necessary. But as Cities Outlook 2023 showed, they will not be enough to bring down high inactivity rates because health isn’t the only problem driving them up in northern and Welsh cities. In cities like Blackburn, Sunderland, and Newport, even if the Government had a magic wand to improve the health of those people and help them get back into work, there just aren’t enough jobs out there for them to get back to.
This is why delivering on the economic growth element of the levelling up agenda is so important. If we are to turn around the struggles of many places outside the Greater South East, the focus should also be on bringing good, high-value jobs to weaker economies to help them prosper.
As well as providing a deep dive into the latest economic data on the UK’s cities and largest towns, Cities Outlook 2023 shines a light on the UK's growing economic inactivity crisis.
As well as providing a deep dive into the latest economic data on the UK’s cities and largest towns, this year our flagship publication focuses on the scale and geography of economic inactivity across the country.
One year after the publication of the white paper, and three years after a general election, the Government has very little to show on levelling up. This is what should happen now.
What does the UK's growing inactivity crisis say about the state of the labour market and how should policy tackle this urban problem?
While many cities perform poorly against the national average, they still play an important role in their regions despite this underperformance.
Chief Executive Andrew Carter and members of Centre for Cities’ research team explore the findings and implications of Cities Outlook 2023.
The UK’s seemingly record-low unemployment figures mask a hidden army of more than three million working-aged people that are involuntarily economically inactive.
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