We use cookies to ensure that we give you the best experience on our website. You can change your cookie settings at any time. Otherwise, we'll assume you're OK to continue.

Durham University

Department of Geography

Staff Profile

Publication details

Bambra, C, Barr, B & Milne, E North and South addressing the English health divide. Journal of Public Health. 2014;36:183-186.

Author(s) from Durham


The North South divide in England has been a popular trope from the mid-19th century novels of Charles Dickens (Hard Times, 1854) and Elizabeth Gaskell (North and South, 1855) through to TV and radio documentaries of 2014.1,2 These often focus on culture and the economy, but it is also well known that there are large and longstanding geographical inequalities in health in England.3 Between 2009 and 2011 people in Manchester were more than twice as likely to die early (455 deaths per 100 000) as people living in Wokingham (200 deaths per 100 000).3 This sort of finding is not new; for the past four decades, the North of England (commonly defined as the North East, North West and Yorkshire and Humber regions) has persistently had higher all-cause mortality rates than the South of England, and the gap has widened over time.4 This dates back to at least the early 19th century when, for example, Chadwick5 found that life expectancy for all social classes was higher in Bath than in Liverpool.

The extent of the current spatial health divide in England is extreme by contemporary comparative standards. England has some of the largest regional inequalities in health …