Study links devolution in Greater Manchester to modest improvement in life expectancy

The devolution deal which granted Greater Manchester increased control over a range of public services, including  health and social care, has been linked to a positive impact on life expectancy in a study by University of Manchester researchers.

The Health Foundation funded study also showed the benefits linked to devolution on life expectancy were felt in the most deprived local authorities where there was poorer health, suggesting a narrowing of inequality.

The study, published in The Lancet Public Health  (showed that between 2014/16 and 2017/19:

  • Life expectancy was 0.2 years higher in Greater Manchester compared to a comparable control group from the rest of England. The change in Greater Manchester  was 2·2 times larger than the average change in life expectancy over the same period.
  • The change persisted throughout the period after the devolution deal  and was larger for men (0.34 years) than for women (0·06 years).
  • Statistically significant increases in life expectancy were observed in eight out of the ten local authorities in Greater Manchester, with the exceptions of Rochdale (decrease) and Oldham (no change).
  • In the short-term, life expectancy remained constant in Greater Manchester but declined in comparable areas in England. In the longer-term, life expectancy increased at a faster rate in Greater Manchester than in the rest of the country.
  • Improvements in life expectancy were larger in the local authorities with the worst levels of income deprivation and lowest life expectancy prior to devolution, when compared to areas with equally high deprivation and low life expectancy in the rest of England.

The improvements, say the researchers, may have been a result of a combination of changes in response to the devolution deals in the region, including the health and social care devolution agreement, the devolution of powers over wider determinants of health (such as housing, employment, transport, adult education, policing, and economic development), and the election of a Greater Manchester mayor.

The study, which is the first of first kind, estimated the impact of devolution on the population stratified by sex, local authority, income deprivation, and life expectancy compared to the rest of England, excluding London.

The researchers used local authority data on life expectancy at birth published by the Office for National Statistics between 2006 and 2019 to calculate the relationship.

Lead author Dr Philip Britteon Research Fellow at The University of Manchester said: “We provide the first robust evidence on the impact of devolution in England on population health, focusing on changes occurring in Greater Manchester.

“The study shows modest improvements in life expectancy in Greater Manchester compared to comparable areas in the rest of the country from the introduction of devolution until the start of the COVID-19 pandemic in 2020, using a robust statistical method.

“This finding may have been driven by combination of changes in response to the health and social care devolution agreement, the devolution of powers over wider public services, the election of a new mayor, or earlier steps to improve population health prior to devolution.

“The findings support the suggestion that devolved systems are able to more closely identify and address the needs of local populations. However, further research is required to understand the mechanisms behind the estimated effect.”

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