There is a “clear association” between where you live and your risk of dying prematurely, with factors such as deprivation and ethnicity accounting for much of the difference across local areas, a new study has found.
Education, occupation and whether someone was born in the UK are also likely to contribute to the sharp contrasts that are evident around the country.
The research is the first of its kind to explore the impact of such characteristics on premature mortality at a local level.
It has been carried out by the Office for National Statistics (ONS) on behalf of independent charity The Health Foundation, which said the findings can be used “to support co-ordinated action to address health inequalities”.
Premature mortality is defined as someone who dies from any cause before they reach the age of 75.
The study focused on adults in England and Wales in the period March 2021 to December 2023.
In partnership with The Health Foundation, we've published insights into premature mortality rates for adults in upper tier local authorities in England and Wales, accounting for differences in sex, age, ethnicity, whether born in the UK, and socioeconomic characteristics. pic.twitter.com/aVoPxszdrG
— Office for National Statistics (ONS) (@ONS) July 8, 2025
It found that levels of premature death in Blackpool, the local authority with the highest rate at 696 per 100,000 people, were nearly 2.5 times above those in the London borough of Richmond upon Thames, which had the lowest rate of 285 per 100,000.
While these figures took into account differences in age and sex among the local population, they did not reflect ethnicity, nationality of birth and socio-economic factors such as deprivation and education.
But after further adjustment for ethnicity and being born outside the UK, Blackpool’s mortality rate was found to be 2.3 times higher than Richmond upon Thames – and with additional adjustment for socio-economic status, it fell to 1.1 times higher.
By contrasting the mortality rates before and after these factors were taken into account, the ONS was able to see the influence such characteristics have on levels of premature death.
Socio-economic status has “the greatest impact on variation in premature mortality rates, suggesting that it accounts for a considerable proportion of these geographical inequalities”, the ONS said.
This trend was evident not only when considering levels of premature mortality from all causes but also for premature deaths due to cancer, cardiovascular disease, diabetes and respiratory conditions.
Daniel Ayoubkhani, head of the ONS health research group, said: “This analysis shows a clear association between where you live and your risk of dying prematurely.
“When accounting for differences in age and sex, we see that there are substantial differences in premature mortality rates across local authorities in England and Wales.
“For the first time, we have explored the role of socioeconomic characteristics, ethnicity, and whether someone was born in the UK in geographic variations in premature mortality, revealing that these factors explain much, but not all, of the differences in premature mortality rates between local authorities.”
Charles Tallack, Health Foundation director of research and analysis, said: “The opportunity of living a long and healthy life is dependent on the socio-economic conditions people live in.
“This analysis can be used to support co-ordinated, cross-sector action to address health inequalities.”
The study found that rates of premature death due to cancer were more than two times higher (just over 100%) in Blackpool at 208 per 100,000 people, the highest area in England and Wales, compared with the London borough of Harrow at 104 per 100,000, the lowest area.
But once ethnicity, being born in the UK and socioeconomic status are taken into the account, the rate for the new highest local area, Wrexham in north Wales, is only 50% above the lowest, Kensington & Chelsea in London.
A similar pattern was found when looking at three other specific causes of premature death:
– For diabetes, the London borough of Newham had the highest rate (115 per 100,000 people), more than 4.5 times higher than the lowest rate, for Cheshire East (25 per 100,000; once the other factors are taken into account, the range narrows and the highest rate (West Northamptonshire) is around 2.7 times above the lowest (Bournemouth, Christchurch and Poole).
– For premature deaths due to respiratory conditions, Blackpool had the highest rate (113 per 100,000 people), more than four times higher than the area with the lowest rate, Richmond upon Thames (27 per 100,000); once the other factors are taken into account, the range narrows and the highest rate (Wrexham) is just over two times higher than the lowest (Suffolk).
– For deaths due to cardiovascular disease, Blackpool again had the highest rate (146 per 100,000), nearly three times higher than Richmond Upon Thames with the lowest rate (50 per 100,000); once the other factors are accounted for, the range narrows and the highest rate (Swansea in south Wales) is 2.3 times above the lowest (Isle of Wight).
Geographical inequalities still exist even after accounting for differences in age, sex, ethnicity, being born outside the UK, and socioeconomic factors, the ONS added.
These remaining differences are likely to be linked to factors not accounted for in the new analysis, such as access to and provision of healthcare, environmental factors, and health-related behaviours.
