Northern regions relegated to bottom of child health league table

1 August 2023

Northern regions relegated to bottom of child health league table




A league table ranking child health by football team area has further shown the dramatic health divide between the North and the South.

Ahead of the new football season kicking off later this month, researchers at Health Equity North (HEN) analysed data to create a visual representation of how children from different areas of the country fare across a range of childhood health indicators.

The rankings, based on public health information from the areas local to the clubs, look at: poverty; obesity; infant mortality rate; life expectancy at birth; educational attainment; and the gap in life expectancy.

Presented in the form of a football league table featuring the 20 men’s Premier League teams due to battle it out in the new season, the results – ranked from best to worst – demonstrate the extent of disparities in health across the country.

The top half of the table, showing the best performing regions, is dominated by southern clubs and the ‘relegated clubs’ are from the Midlands and the North West.

Manchester United would win the Child Health and Wellbeing League, followed by Bournemouth, Fulham and Tottenham in the top four European places, with Chelsea in fifth, Brighton in sixth and Brentford in seventh place.

The bottom three in the table, who would all be relegated, are Nottingham Forest, Everton and Liverpool.

The league table also shines a spotlight on the health inequalities that exist within towns and cities. While Manchester United win the league, their neighbours Manchester City are almost relegated. Children are 50% less likely to grow up in poverty (22.3%) on the red side of Greater Manchester than on the blue side (44.7%).

There are also high inequalities in life chances within local authorities – there is an almost 13-year gap in life expectancy for babies born in the most and least deprived areas of Kensington and Chelsea. Similarly in Newcastle, the gap in life expectancy at birth is over 10 years.

Liverpool and Nottingham have some of the worst health and wellbeing outcomes in the country. The infant mortality rate in Nottingham is over three times higher (6 deaths per 1,000 live births) than Trafford’s (1.8 per 1,000 live births).

Life expectancy is almost five years higher for baby boys (80.7 years) and over seven years higher for baby girls (85.9 years) born in Kensington and Chelsea than for baby boys (75.8 years) and baby girls (78.7 years) born in Liverpool.

Professor Clare Bambra, HEN Academic Director, Professor of Public Health at Newcastle University, and co-author of the research, said: “Our League demonstrates the stark inequalities in the life chances of children across England. It is unacceptable that around 40% of children growing up in the shadows of some of the richest football clubs in the world (Aston Villa, Burnley FC, Everton FC, Liverpool FC, Luton FC, Manchester City, Newcastle United, Nottingham Forest, and Wolves) live in poverty and have lower life chances. As a country, we can afford to change this and its vital for the future health of our country that we do so urgently. Our children are our future – and they will judge us harshly on this.”

Professor David Taylor-Robinson, HEN Academic Director, Professor of Public Health and Policy at the University of Liverpool, and co-author of the research, said: “Many aspects of child health and wellbeing are worse in the UK compared to other rich countries. As a country we rank 27th for child health according to UNICEF, nowhere near the Premier League. One of the main reasons for this is that we have scored own goals with our policies for children, particularly regarding child poverty. But fortunately, there’s nothing inevitable about this situation, and with new management strategy fortunes can change overnight.”

Dr Luke Munford, HEN Academic Director, Health Economist from the University of Manchester, and co-author of the research, said: “The Premier League is seen as one of the best, if not the best, leagues in the world. However, our league table demonstrates the graphic inequalities that exist in England. Manchester City did ‘the treble’ last year, yet we show that children being born and brought up near The Etihad face among the worst prospects in the league. Interestingly, the Manchester derby shows that children born near their neighbours – Manchester United – have among the best child health. These inequalities that exists within a relatively close geographic space highlight the size of the challenges faced. To keep the Premier League’s reputation as the best, we need to improve the outcomes of children and reduce inequalities.”

Professor Kate Pickett, HEN Academic Director, Professor of Epidemiology, University of York, and co-author of the research, said: “We all want our children to have the chance to be the best they can be. Our Children in the North could shine so brightly if we created a level playing field for them. This report shows how badly we need government to get stuck in to do just that.”

The league table lead has been published by the new virtual institute Health Equity North. HEN brings together world-renowned academics who have a unique understanding of their regional communities to lead the creation of research and place-based policy solutions that address public health problems and health inequalities across the North of England.

A recent report from HEN academics and the All-Party Parliamentary Group Child of the North found that children in the North are some of the least protected from the current cost of living crisis. HEN is calling on government to ensure families with children have enough money and security of income to meet basic needs, such as healthy food to eat and warm homes.

Recommendations from HEN academics include:

  • increasing child benefit by up to £20/week; increasing the child element of universal credit; suspending the two-child limit
  • expanding provision of free-school meals
  • increased investment in welfare, health and social care systems that support children’s health, particularly in deprived areas, reversing the cuts that have hit disadvantaged areas in the North the hardest.
  • a joined-up strategy to tackle health inequalities, putting children’s health and wellbeing at the heart of policy.

View the Child Health and Wellbeing League results and a blog on the analysis from the HEN Academic Directors here:


[1] The data used comes from End Child Poverty ( [based on Department for Work and Pensions data]) and the Office for Health Improvement and Disparities (

[2] The football clubs were geo-referenced to the local area with which they are most associated, so Manchester United’s data, for example, is for Trafford Borough Council, Chelsea FC is represented by data from the Royal Borough of Kensington and Chelsea, and Nottingham Forest is represented by data from Nottingham City Council. Liverpool and Everton have the same data as their grounds, Anfield and Goodison, are in the same local authority (Liverpool).

[3] The final league points represent the sum of ranks for each outcome. For example, Manchester United’s league-winning score of 121 points comes from ranking 1st for Poverty, 3rd for Weight, 1st for Deaths, 4th for Life expectancy (male), 3rd for female life expectancy, 1st for Attainment and 13th for Gap in Deaths.

National Institute for Health and Care Research north west National Institute for Health and Care Research north east National Institute for Health and Care Research manchester National Institute for Health and Care Research yorkshire