The scale of health inequalities across Merseyside have been revealed.
The Marmot report, produced by the Institute of Health Equity for a consortium of local councils, compares the situation for residents across the region, looking at links between deprivation and health inequality.
For Knowsley, the second most deprived borough in the country, where one in four residents are classed as income deprived, the starkness of the situation is revealed.
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Set against the backdrop of huge government cuts and a lack of 'levelling up' investment, the borough has also suffered more than most since austerity was introduced in 2010.
The borough has the lowest life expectancy levels in the greater Merseyside area, with Liverpool lagging only marginally behind. Compared to more affluent areas in Cheshire, which track above the national average, life expectancy in Knowsley is on average between nine and 11 years lower.
Within Knowsley itself, this gap is just as stark between the most and least deprived areas in the borough, with a gap of over 10 years in life expectancy depending on where people live.
The gap is even starker in the neighbouring borough of Sefton, where people in the least deprived areas live between 12 and 13 years longer on average than those in the most deprived parts of the borough.
For Wirral, the life expectancy gap for men between most and least deprived areas is nearly 14 years.
The report adds that the pandemic has "revealed and amplified entrenched health inequalities" across Merseyside and beyond.
Most Merseyside boroughs had much higher covid mortality rates than the national average. The figures were starkest in Liverpool where over 350 men per 100,000 died of covid compared to the national average of around 250 per 100,000.
Across the north west as a whole, the mortality rate was raised compared to the national average.
The report also looked at school achievement and attendance as part of its analysis, noting that Knowsley had the highest levels of pupil absences across Merseyside for secondary school children, close to twice the national average.
Knowsley also has the largest amount of children aged 16 and 17 not in education, employment or training out of all the Merseyside boroughs, affecting just under 7% of children in that age group compared with around 2% for the more affluent Cheshire East.
The borough also has the second highest rate of long term job seekers, with four out of every 1,000 people having been unemployed long term. This figure is lower than Liverpool, which had the highest rate of the Merseyside boroughs, coming in at nearly twice the national average.
The 164-page report looked at a range of other factors, bringing together a picture of the ways in which deprivation and long and short term health outcomes are linked.
Discussing the report at a meeting of Knowsley's health and wellbeing board earlier this week, the borough's public health specialist Richard Halford who noted that while on the one hand it was encouraging because the council's existing 2030 strategy appears to link with areas identified in the report, yet "for the vast majority, Knowsley could look at strengthening its approach and whether it is doing all it can to address these areas."
Mr Halford added: "Knowsley alone cannot address health inequalities."
He spoke of the development of a specific 'Marmot' board to bring together a more collaborative approach and of work already being done already across the region, for example around exposure to gambling.
Knowsley's director of Public Health Sarah McNulty referred to the "importance" of the review as she praised the work carried out by the Institute for Health Equity and "everyone who engage with this piece of work."
She added: "I really do welcome moving forward and starting to do the work the report recommends."
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