Health and growth, mapped

Where health is worst, the economy tends to be weakest too, and vice versa. Across the region, the average ward (an electoral division) scores just 20.8 on a 0-100 economic index benchmarked against an England-wide score of 50. Indeed, 172 of the region's 192 wards sit below the England median and 127 are in the bottom national quartile. The region’s economic challenges mirror its poorer health outcomes, showing how tightly economics and health are linked.

That link is what Emma Frew, an NIHR Research Professor in Health Economics at the University of Birmingham, and Aditya Goenka, Chair in Economics, with the team of Dr Lin Liu, University of Liverpool, and Linting Gu, University of Birmingham, were commissioned to map for the West Midlands Combined Authority (WMCA). "Under the original devolution deal, economic growth, transportation and housing were the few key things combined authorities had agency over," says Goenka. "Health was not one of them ... eventually, what's happening in the economy depends on the productivity of workers, and that link was missing."

The project grew out of years of work by Frew for the Midlands local authorities on public health investment. A first phase by the team, done in 2025, built the academic case for treating health as economic infrastructure. A second phase tested it in practice. They combined more than 300 indicators, across all 7,009 electoral wards in England, into four indices covering economic conditions, health outcomes, healthcare access and wider determinants such as housing and green space, and then drilled down into two local authorities, Dudley and Sandwell, ward by ward.

One relationship in particular stood out. Across the region, child health tracks economic disadvantage closely (a correlation of 0.62). In Sandwell, 23 of the borough's 24 wards sit below the England median on the economic index, and all of them do on child health, with Great Bridge standing out as the most acute case, while wards like Abbey and Newton post noticeably better health scores than their economic position would predict.

"It raises an interesting conversation about whether there's something about community resilience in those areas that we could learn from, that could inform policies in other areas," Frew says. "There's an opportunity for shared learning, to understand on a deeper level what's making communities more resilient to comparatively worse economic conditions.

For Frew, the child health finding is important because local authorities already have the tools to affect it. "Local authorities are really well placed to invest in services for child health," she says, referring to nutrition in schools, access to green space, leisure facilities, housing, transport. "It changes the emphasis of thinking about child health, much more than just health outcomes, to actually seeing it as a key foundation of the economic strategy."

The findings, and an interactive dashboard built from the data, have been shared with WMCA and the two local authorities involved for the purposes of strategy and service planning. 

"Health is often seen as a product of economic prosperity," Frew says. "What we've shown here is that the reverse is also true. Not only is it a product, but it's also a key ingredient."

Goenka sees the same shift in how WMCA's own economists now talk about growth. "The way the economic team thought about economic growth now takes the humans, the society, the community much more into account, rather than thinking just in terms of investment in technology," he says. "For me, that's a big achievement."

This shift is reflected in WMCA’s 2026–27 Areas of Research Interest, which identify income inequality as a potential obstacle to growth, and in its Theory of Growth, which highlights early years, care and tackling inequality as foundations of inclusive growth.

The work translated academic research into a usable framework for policymakers. Both phases were run as academic consultancy, and Enterprise took on the administration, contracting and processing, liberating the team to focus on the research.