England's urban areas do not share a single pattern of mortality. The ONS findings discussed in this report showed differences between the largest built-up areas, smaller settlements and London, with further variation between population groups.
Looking beneath the overall picture
Major built-up areas had the highest age-standardised mortality rates for most ethnic groups in the analysis. Exceptions included Pakistani, Bangladeshi, Black African, Black Other, Arab and Any Other Ethnic Group populations, for whom higher rates occurred in smaller or medium-sized built-up areas.
London and smaller settlements
During March 2021 to May 2023, London recorded lower mortality rates than other large built-up areas. It also had the lowest rate among disabled people in the comparison, while small and minor built-up areas had the lowest rate for people reporting poor health.
Differences within places
Among small and minor built-up areas, the Bangladeshi group had the highest rate and the Chinese group the lowest. In major built-up areas, the highest rate was among White British people and the lowest among Black African people. These distinctions show why an overall city-level figure cannot describe every community's experience.
The policy response
Veena Raleigh of The King's Fund linked the findings to entrenched deprivation and wider socioeconomic inequality. The Department of Health and Social Care pointed to proposed shifts towards community services, digital systems and prevention. The report placed the challenge in both healthcare delivery and the conditions influencing health outside it.
