‘Idon’t need to come here often but I need it now,” Phill, a former fish filleter, tells the volunteers at the Rock Foundation food bank in Grimsby, as he gathers three carrier bags to last him the week. “I don’t like it – I call it scrounging, even though I need it. But I don’t come willy-nilly.” Outside the queue is showing no sign of slowing. Two hours after opening, on a cold, grey day in the town once famous for its fishing fleet, men, women and whole families are still turning up to collect food from a trestle table inside the entrance of a derelict school near the docks. The facility will help about 200 people today. Demand has soared, particularly for emergency “NFA” (no fixed abode) bags. Not because more people are on the streets, but because they contain food which does not require increasingly costly energy to cook. Having cycled from his flat nearby, Phill’s back is convulsed in spasm because of a prolapsed disc, the result of his time on the docks lifting heavy crates of dogfish, sea bass and cod. He has not worked for a decade, and has given up trying to get medical help. “I’ve just learnt to get on with it. I’m sick of banging my head against the wall around here,” he says. Britain is suffering from worsening health, as the NHS and social care system buckles amid chronic staff shortages and soaring demand after the Covid pandemic and years of underinvestment. Rates of long-term illness are significantly higher in the north of England than in London and the south-east. In Grimsby it’s no different, with a recent warning from the hospital trust that its main departments are either full or facing significant pressures. Across the country NHS waiting lists and ambulance response times have hit record lengths, while seeing a GP or dentist has become an almost gladiatorial battle, fought each morning over jammed phone lines. Beyond the immediate impact on individuals, economists fear the crumbling health system is failing to keep people fit enough to stay in work, at a time when employers are struggling to fill a near record number of job vacancies. Official figures show long-term sickness among working-age adults has topped 2.5 million for the first time. In the latest in our series on Britain’s missing workers, the Guardian explores the links between health and wealth in Grimsby. The town is in North East Lincolnshire, a borough that has had the biggest fall in the number of years of life in good health in England and Wales over the past decade. The measure has been relatively steady nationwide at just over 62, but here it has fallen since 2011 – by nine years for men and almost five for women. In wealthier areas of the UK, such as Wokingham, Berkshire, healthy life expectancy is about 15 years higher – almost the same gap as between the UK average and Sudan. Such declines are “simply staggering”, says Andy Haldane, a former Bank of England chief economist. Now chief executive of the Royal Society of Arts thinktank, Haldane fears Britain’s worsening health is hitting economic growth and worsening the cost of living crisis. “It suggests a sharp regress in lifespans after more than 200 years of uninterrupted progress,” he says, suggesting the interlinked gains for health and economy made since the industrial revolution risk going into reverse. On a misty morning outside Grimsby town hall, a group of social workers flown in from South Africa gather for an induction day, newly recruited by the local authority to help fix its failing children’s service. Rated “inadequate” in a damning Ofsted report last year, the government has appointed a commissioner to oversee its work. Philip Jackson, the council’s Conservative leader, is pushing to end a reliance on agency staff – half of the local social care workforce – but has struggled to hire locally. He says a combination of factors are contributing to ill health in parts of the town – not least the decline of its once famous fishing industry – but dismisses suggestions that government cuts or a lack of funding play a role. The council budget has been slashed by almost £60m a year since 2010, while the authority is expected to overspend this year because of the troubles at its children’s services division. Last year it closed half of its 12 family hubs to save money. “We’re using the money we’ve saved from closing the buildings to deliver the services differently, to families in their own homes, which is proving to be just effective,” says Jackson. Matthew Patrick, a Labour councillor and local party leader, disagrees. “You’ve had the decline locally and nationally. Almost every service has been cut,” says Patrick, whose party faced its own share of criticism while leading the council for almost a decade, until the Tories won control in 2019. Still, he argues north east Lincolnshire was hamstrung by Westminster. “We’ve seen the rise of food banks, plus every indicator that you’ve seen nationally in other areas about the rise of poverty and the challenges coming from austerity. It has hit Grimsby very hard,” he adds. Despite challenges linked to the decline of its trawler fleet, Grimsby’s economy is making progress in the renewables sector as a hub for offshore wind, as well as ports and logistics, chemicals and food processing. That said – in a town where Brexit won overwhelming support – almost 200 jobs were put at risk last month after the Icelandic owners of a major local fish processing plant warned they would pull out of the area, following steep losses caused by leaving the EU and the Covid pandemic. While there are local job opportunities, Jackson says there is a “difficulty around reskilling” people so they can take up vacancies. There are some Grimbarians who have “attitudinal issues” to overcome, he says. “If they aren’t willing to get themselves into a situation where they can participate in the jobs market, that does make it a lot more difficult for them – and if they’re not looking after their health properly too.” It is not the case for everyone. Many people are genuinely looking for work, Jackson says. However, some families have not seen work in two or three generations, even now with significant vacancies across low and high-skilled employment. “Some of them probably don’t even want to [find work], you know? They’ve learned a different lifestyle,” he adds. It is a delicate issue in a town where Sacha Baron Cohen angered residents by portraying it as a rundown badlands in his film Grimsby and Channel 4 faced a backlash over its “poverty porn” series Skint. However, Jackson denies – when pressed – that his comments might suggest he thinks local people are lazy. The council is doing more to work in partnership with local health authorities and voluntary organisations to help people struggling with both their physical and mental health, as well as employment. On the 1950s-built Nunsthorpe estate, Stephen Ryder, the managing director of Creating Positive Opportunity, a community business group, is running a cut-price gym class, funded in part by the council for people out of work and struggling with their fitness. Funded in part by the council, the session is run by the personal trainer Emma Camm and is designed to help people rebuild their physical health, mental wellbeing, confidence and soft skills in order to give them the building blocks for finding work. Dale Escombe, 52, is lifting weights in a session run by Camm. He lost a job because of being overweight. “It put a downer on things, a big dint in my confidence” he says. The former tree cutter comes to the centre about two or three times a week for English, maths and gym classes, and hopes to find a job working in an office. “I was sat on the settee for about three months watching telly. But coming here, with Emma has given me my confidence back.” A government spokesperson says it recognises the links between health conditions and work, and that £1.3bn of investment is being made available across the country over the next three years. Councils have also been given an additional £3.7bn for local priorities, including an extra £12m for north east Lincolnshire. “We have a range of initiatives to help those with a long-term illness start, stay and succeed in work, including tailored work coach support, and our updated employer guidance sets out how to support people to remain in work while managing a health condition,” the spokesperson adds.