Greater Manchester's Covid death rate has been 25% higher than the rest of England during the pandemic, new research has found.
The study into the impact of the virus in the region also said life expectancy in north-west England declined more during 2020 than in England overall.
The report says health inequalities in Greater Manchester have been exposed and amplified by the pandemic.
It calls for more resources directed at education, employment and housing.
The report was originally commissioned in 2019 by the Greater Manchester Health and Social Care Partnership - the devolved health body responsible for health across the city region.
It asked one of the world's leading experts on health inequalities, Prof Sir Michael Marmot, to look at how it could improve the health of Manchester's population.
But the pandemic led to a change in emphasis, meaning today's report looks at the toll the virus has taken across the area.
It found the city had a 25% higher Covid-19 death rate than England as a whole in the 13 months to March 2021.
That high death rate contributed to a decline in life expectancy in the wider North West that was larger than the average in England, it said.
Life expectancy in the North West fell in 2020 by 1.6 years for men and 1.2 years for women compared with an average in England of 1.3 years and 0.9 years respectively.
'We're all struggling since Gary died'
In the garden of their family home in Oldham, Gary Gilmartin's sisters Jayne Risby and Debbie Phillips are still coming to terms with the death of their brother.
"He was just really special, a really special person. I'd say out of all the family he was the real character," says Jayne of her brother.
Gary fell ill after a family holiday to Spain in March of 2020, just as the pandemic was taking off.
Three weeks after dancing and singing karaoke with his sisters in Benidorm, Gary was dead.
A dedicated Manchester City fan, Jayne says her brother was hugely popular.
"He was just a massive Mancunian, a lot of people in Manchester just absolutely loved him."
And Jayne says the whole family - Gary was one of five siblings - is struggling with grief.
"The loss of him affects us now for the rest of our lives, we'll never have Gary around for a party, we'll never have him round for dinner.
"I just feel like he's been stolen away from us and it's left a massive void."
Both sisters know that Gary is one name among hundreds of thousands - each one a painful story of loss.
"There's millions aren't there, all worldwide. Really, we're all suffering."
In the report, Sir Michael says the pandemic exposed and amplified existing issues in the city.
"Greater Manchester has high levels of avoidable health inequalities as a result of longstanding economic and social inequities, and as across the country, ethnic disadvantage," he said.
"The city region has also experienced high rates of mortality from Covid-19 and particularly damaging long-term economic and social effects during the pandemic as a result of prolonged lockdowns.
"The kind of recommendations that I make are not just about health care or not just about public health.
"They're about housing and transport and community development and jobs and schools. It cuts across the board. And we need to spend to improve the health and wellbeing for future generations as well as for now."
The proposals also include a call for extra resources for early years care, better mental health services for young people, and measures relating to the environment and workplaces.
Mayor of Greater Manchester Andy Burnham has welcomed the report's findings.
"The pandemic has brutally exposed just how unequal England actually is," he said. "People have lived parallel lives over the last 18 months.
"People in low-paid, insecure work have often had little choice in their level of exposure to Covid - and the risk of getting it and bringing it back home to those they live with.
"Levelling up needs to start in the communities that have been hit hardest by the pandemic.
"To improve the nation's physical and mental health, we need to start by giving all fellow citizens a good job and good home."
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2021-06-29 23:10:38Z
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