A record 3.7 million workers in England will have a major illness by 2040, according to research. On current trends, 700,000 more working-age adults will be living with high healthcare needs or substantial risk of mortality by 2040 – up nearly 25% from 2019 levels, according to a report by the Health Foundation charity. But the authors predicted no improvement in health inequalities for working-age adults by 2040, with 80% of the increase in major illness in more deprived areas. Researchers at the Health Foundation’s research arm and the University of Liverpool examined 1.7m GP and hospital records, alongside mortality data, which was then linked to geographical data to estimate the difference in diagnosed illness by level of deprivation in England in 2019, the last year of health data before the pandemic. They then projected how levels of ill health are predicted to change in England between 2019 and 2040 based on trends in risk factors such as smoking, alcohol use, obesity, diet and physical activity, as well as rates of illness, life expectancy and population changes. Without action, the authors warn, people in the most deprived areas of England are likely to develop a major illness 10 years earlier than those in the least deprived areas and are also three times more likely to die by the age of 70. Chronic pain, type 2 diabetes, anxiety and depression are forecast to grow at a faster rate in more deprived areas, while prevalence of chronic obstructive pulmonary disease is four times more common in the most deprived areas than the least. These conditions have a significant impact on quality of life and may limit people’s ability to work for long periods of time. The findings came as separate new figures showed record levels of economic inactivity. According to Office for National Statistics data, the number out of work due to long-term ill health is now a record 2.8 million. The Health Foundation warned that without more measures to improve working-age health, the government’s target to improve healthy life expectancy by five years by 2035 and narrow the gap between the areas with the best and worst health will be missed by a significant margin. Jo Bibby, director of health at the Health Foundation, said good health was a “precious asset”, adding: “A healthy workforce is the backbone of any thriving economy. We are already seeing the impact of poor health on the economy, with record numbers of people out of the workforce. “Without action, the number of working-age people living with major illness is set to increase, particularly in the most deprived areas of the country.” In addition to tackling smoking, poor diet, physical inactivity and harmful alcohol consumption, the report also called for cross-government approach to deal with poor housing, inadequate incomes and poor-quality jobs, investment in public services and for employers to improve working conditions and staff wellbeing. Responding to the findings, Saffron Cordery, deputy chief executive at NHS Providers, called for more support and funding for public health services. “National support is vitally needed for local councils to meaningfully improve the health and wellbeing of their communities,” Cordery said. “Without it, demand for already-stretched NHS services will rise even further. “A whole-government approach is needed to prevent ill health, starting with tackling the root causes of why some people – such as those living in poverty and in deprived areas, as well as ethnic minorities and people with learning disabilities – are more likely to have worse physical and mental health.” TUC general secretary Paul Nowak criticised “years of NHS underinvestment”, saying: “Alongside urgent support for the health service, we also need to address the wider drivers of poor health – insecure work and poverty wages.” A Department of Health and Social Care spokesperson said: “NHS England is working to reduce health inequalities and improve the health outcomes of the poorest 20% of the population, regardless of where they live. “Our Back to Work Plan, backed by £2.5bn, is also helping more people into work – including those living with long-term health conditions – so everyone can reach their full potential.”