Northern England, which was worst hit by the first wave of coronavirus, also suffered more than the South during the Spanish flu outbreak more than 100 years ago, according to research.

A recent study by the Northern Health Sciences Alliance (NHSA) found the Northern Powerhouse area suffered over 12 more Covid-19 related deaths per 100,000 than the rest of England.

Now one of the authors of that research has analysed the 1918 Spanish flu outbreak, which killed 50-100 million people globally, for any health inequalities.

Clare Bambra, professor of public health at Newcastle University, teamed up with other academics – including Dr Paul Norman from Leeds University – to study similarities in how the two quite different pandemics affected England’s regions.

She said: “We found that, similar to today with Covid, there was much higher mortality from Spanish flu in northern England, and the Midlands.

“The lowest rates were in places like Surrey – around 200 deaths per 100,000 in 1918 – and the highest rates were up in places like Hebburn and Jarrow in the North East, where it was almost 1,200 deaths per 100,000."

The Northern Echo:

The data was sourced from the 1920 report into the Spanish flu pandemic’s mortality rate compiled by the Registrar General – the equivalent of today’s head of the Office for National Statistics.

Writing at the time, Sir Bernard Mallet said: “The northern parts of the country suffered decidedly more, on the whole, than the southern.”

Prof Bambra said the same was true a century later, despite the creation of the welfare state and the NHS in the intervening time.

She said: “In the NHSA report, we found that mortality in the first wave of Covid was around 12 deaths per 100,000 higher in the Northern Powerhouse than in the rest of England.”

Prof Bambra, who has written a paper published in the journal Environment And Planning A: Economy And Space, said it was too early to directly compare the towns worst affected by Spanish flu and the areas most hit by Covid. But she said it was clear that Northern regions did worse in the 1918 outbreak and were doing worse in 2020 with Covid.

She said: “It has to do with social and economic inequality. Inequality in people’s working conditions, in their standards of living, in people’s nutrition and in the underlying risk factors.”

The public health expert said this was not inevitable.

“I don’t think it needs to be accepted,” she said. “There is evidence from other countries that you can really close regional inequalities in health.

Jamie Driscoll, Labour’s North of Tyne elected mayor, said: “There’s a direct link between economic security and health. It’s been proven time and again.”

A Government spokesperson said: “We remain determined to level up on health outcomes as well as opportunity. We have committed £170m to help families stay warm and well fed this winter while our Universal Credit increase has resulted in millions of people receiving more money than previously.

“We have worked with local authorities and over £300m has already been allocated in England.”