Appendix: Background information on case studies and methodology

UK case studies were selected in collaboration with the RSA to address the aims of this report. International case studies were selected in collaboration with the RSA and Demos Helsinki, and an advisory group, to include:

  • places with consistently good performance on measures of inclusivity and health outcomes
  • places which were seen to have succeeded in improving their economic performance and inclusiveness from a precarious starting point
  • places adopting innovative approaches to the alignment of economic prosperity and population health.

In 2019, the research team (of Health Foundation, RSA and Demos Helsinki staff) interviewed between eight and 15 participants for each case study area, apart from Saarland where they interviewed only three due to logistical issues and Leeds where they interviewed 30. Participants included senior policy and practice representatives from across national and local government, economic development, health, public services, research and academia, business and the third sector. The insights from UK cities were tested at a roundtable and those from international case studies were tested with an expert advisory group.

Leeds

In 2018 Leeds had an estimated population of just over 789,000. Leeds recovered well from the economic downturn in 2008 and experienced an economic transition from a manufacturing to knowledge economy. However, poverty remains a pressing concern.

Plymouth

In 2019 Plymouth had a population of around 260,000. The closure of many of Plymouth’s dockyards in the mid to late 20th century left the city with high unemployment. The city struggles with a life expectancy lower than the national average, particularly in ex-dockyard areas.

Glasgow

In 2019 the population of Glasgow was nearly 1.7 million across its greater region. In the 1960s the city saw the closure of steelworks, coal mines, engine factories and other heavy industries, leading to mass unemployment and high levels of urban decay. There are currently wide health inequalities, exemplified by a 15-year gap in male life expectancy at birth across Glasgow’s neighbourhoods and an equivalent 11-year gap in female life expectancy (in the period 2008–12).

Scotland

Life expectancy in Scotland has increased over the past three decades, but like other parts of the UK has stalled in recent years. There are significant geographical variations. For example, the so-called ‘Glasgow effect’ describes the significantly lower life expectancy and health of residents in Glasgow compared to the rest of Scotland and the UK.

Finland

Once one of the poorest countries in Europe, Finland is now a top performer in wellbeing, ranking highly in many wellbeing indexes, including life expectancy, income equality and prosperity.

Sweden

Sweden has a robust welfare state and a population of around 10 million people (as of February 2020). The country has done consistently well on measures of inclusivity, social progress and health, although significant inequalities in self-reported good health remain between social groups. Sweden experienced a deep economic recession with negative growth in the beginning of the 1990s, but the plunge was not as dramatic as in Finland, and the recovery was faster.

Burlington, US

Burlington is the largest city in the state of Vermont, US. The economy transitioned in the 20th century from a focus on lumber, boatbuilding, freight and rail transport, to education, health and social care, retail and utilities. Income inequality is lower in Burlington than the national average, as are the poverty and unemployment rates. Chittenden County, of which Burlington is a part, has among the highest life expectancies in the US today at 81.4 years, which is higher than the national (79.1) and state (80.2) figures.

Saarland, Germany

South Saarland is an old mining and steel region in south-west Germany that faced an economic crisis in the 1970s and 1980s as its traditional industries collapsed. However, the region was able to avoid much of the social trauma associated with deindustrialisation. Today, Saarland has a high life expectancy; it has increased steadily over the years, from 77.4 in 2000 to 80.2 in 2015.

However, the area has been less successful in weathering more recent economic storms. The economy of the area has suffered since the 2008 recession, performing weakly on GVA and employment in comparison to most other regions in the European Union.

New Zealand

In 2019 New Zealand had a population of around 5 million. Life expectancy differs considerably between social groups; life expectancy at birth from 2012 to 2014 for non- Māori men and non-Māori women was 83.9 and 80.3 respectively, compared to 73.0 for Māori men and 77.1 for Māori women. New Zealand shares a similar (market liberal) political economy to the UK, but it ranks higher than the UK in measures of inclusivity.

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