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Death rates among adults ages 25–49 were 42% higher in the North than in the South of England in 2024, compared with 13% higher in 1981, according to research published today in The Lancet Public Health.

The relative North–South gap in this age group has therefore more than tripled over four decades. These comparisons take account of differences in age and sex between the populations.

In the 1980s, northern women in their late 20s and 30s had no excess mortality compared with the South; today, every five-year age group of women ages 25–49 shows a 35%–60% excess, and the gap for women has grown 3.5-fold overall, from around 12% to 41%.

In this study, "northern excess mortality" means how much higher death rates are in the North than in the South of England in the same year.

The study, led by researchers from the University of Liverpool, the University of Manchester and Health Equity North, analyzed national death registrations and population estimates from 1981 to 2024. It examined how the divide varied by age and sex, and whether trends changed during and after the COVID-19 pandemic.

Mortality rates fell overall during the four decades studied, although improvements were interrupted by the pandemic. The North–South gap persisted, and the widening among adults ages 25–49 began well before COVID-19.

During 2010–19, the relative North–South mortality gap among 25–49-year-olds widened for both women and men, with a faster increase among women.

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