Public Health Annual Report 2026 - Compounded disadvantage in the labour market

Intersecting forms of disadvantage related to gender, health, age, ethnicity, caring responsibilities and prior life experience are seen within Cumberland’s labour market. Understanding these overlapping factors is essential to explaining why some men are more likely to disengage from work and experience poor health outcomes, even where job vacancies remain high. These dynamics also have wider implications for household stability and local economic resilience.

According to the 2021 Census, around 8,000 people aged 16 to 64 from ethnic minority backgrounds live in Cumbria, representing approximately 3% of the working-age population, compared with around 20% nationally. People from ethnic minority backgrounds in Cumbria are more likely than White residents to be unemployed (5% compared with 3%) or economically inactive (26% compared with 22%), despite being more highly qualified and less likely to report disability or unpaid caring responsibilities. This pattern indicates the presence of structural barriers to labour market participation, including discrimination or a mismatch between qualifications and available roles.

These ethnic inequalities sit alongside other recognised barriers to employment in Cumberland, including long-term sickness or disability, older age, young people not in education, employment or training (NEET), caring responsibilities, and experiences of multiple disadvantage such as substance dependence, homelessness, justice involvement or experiences of domestic abuse. Economic inactivity in Cumbria is most commonly driven by long-term sickness or health conditions, accounting for 43% of all economically inactive people, followed by retirement or early retirement (22%). Caring responsibilities also remain a significant factor, with over 31,800 working-age people providing unpaid care, around half of whom provide 35 or more hours per week and are economically inactive.

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Gender characteristics

Figure 28: Gender characteristics and other disadvantaged groups, Cumbria wide, taken from the Economic Inactivity in Cumbria Presentation December 25.

 

These drivers of economic inactivity are gendered in different ways. Women are disproportionately affected by caring-related inactivity and lower earning potential, while men are more likely to disengage from work due to health conditions, industrial change and disrupted employment pathways. These patterns are not independent: where men experience unemployment or health-related withdrawal from work, women often absorb increased caring, emotional responsibilities within households, and are more likely to be victims of domestic abuse. This can constrain women’s own labour market participation, reinforce gendered divisions of labour and increase economic pressure within families.

Justice system involvement

Labour-market exclusion, poor mental health and justice system involvement are closely intertwined for many men. For some, contact with the justice system represents the culmination of cumulative disadvantage, including disrupted education, unstable employment, substance use and limited engagement with support. Justice involvement should be understood as part of a broader pathway of social and economic marginalisation.

The health needs of people in prison and under probation supervision are set out in detail in the Chief Medical Officer’s (CMO’s) annual report, published in November 2025. National evidence shows that people in contact with the justice system experience substantially higher burdens of physical ill health, mental health conditions, substance misuse and neurodiversity, alongside markedly lower life expectancy. Men make up the overwhelming majority of the prison population (96% in 2022 to 2023) meaning these inequalities disproportionately affect men and contribute to wider patterns of male premature mortality and morbidity (source: Ministry of Justice).

For some, justice involvement follows periods of employment instability, insecure housing, poor mental health or untreated trauma. Contact with the prison and probation services are an important intervention point. Many individuals entering custody or supervision have had limited or inconsistent engagement with health services in the community. Periods of custody or probation can therefore provide rare opportunities for sustained assessment, treatment and structured rehabilitation.

This framing is relevant to Cumberland. Poor mental health, substance misuse and late presentation to services can culminate in justice involvement, particularly for men. Without effective health and rehabilitation support, justice contact risks reinforcing cycles of disadvantage, further restricting employment opportunities and worsening health outcomes on release. Well-designed prison healthcare, skills development and linked probation services have the potential to interrupt these trajectories, supporting recovery, reducing reoffending and improving long-term employability and reintegration into the workforce.

HMP Haverigg is the only prison located within Cumberland, a Category D open prison, holding just under 500 inmates, primarily convicted of sexual offences. Following concerning inspections and riots historically, recent inspections have highlighted improvements in the rehabilitation programmes, including employment programmes and offending plans resulting in a relatively low proportion of recalls (6%). However, inspection findings also identified long waiting times for trauma therapy, an important part of rehabilitation.

It’s important to note that men from Cumberland who are remanded or sentenced to Category A–C custody are placed outside the local area. This displacement can disrupt family contact, continuity of healthcare and coordination with local probation and employment services and reducing the opportunities to support successful rehabilitation following release.

The CMO’s report emphasises the importance of continuity of care, trauma-informed practice and integration between prison healthcare, probation services and community provision. Rehabilitation involves rebuilding identity, confidence and credible pathways into employment. Addressing substance misuse as a coping response to distress, supporting mental health and neurodiversity needs, managing long-term physical conditions, and building skills and confidence for reintegration into work. Approaches that focus solely on compliance or punishment, without addressing underlying health drivers, are unlikely to prevent reoffending or support sustainable workforce participation.

Justice-based health interventions should be understood as part of a wider workforce and prevention strategy. Improving health and rehabilitation within prisons and probation services, and access to stable accommodation post-release, can reduce repeat justice contact, support transitions into stable employment, and mitigate the downstream impacts on families and communities. In this context, justice involvement is both a marker of accumulated disadvantage and a critical opportunity to reshape adult identity and life trajectory.

Loneliness and community life

Data from the Health Foundation’s Local Authority Dashboard, drawing on the Community Life Survey 2023 to 2024, provide an important insight into the social fabric of Cumberland. Nationally, Cumberland ranks amongst the highest for measures of neighbourhood belonging, speaking to neighbours and reporting that people would be there if needed, ranking 7th, 10th and 8th respectively out of 151 upper tier local authorities. However, Cumberland ranks substantially lower for loneliness, placing 66th out of 151 authorities (Health Foundation, 2024).

This apparent paradox suggests that while Cumberland benefits from strong place-based identity and visible community connection, this does not necessarily translate into protection from emotional isolation. It may reflect a distinction between social contact and emotional disclosure. In communities where norms of stoicism and self-reliance are strong, individuals may experience connection without vulnerability, belonging without necessarily sharing distress. This dynamic is particularly relevant when considering men’s mental health and patterns of delayed help-seeking.

Place, identity and aspiration

The preceding sections describe structural labour-market patterns. This section returns to the question of identity.

Chapter 3 described how identity formation in boys and young men is shaped by belonging, recognition and perceived competence within family, peer and community settings. Using Erik Erikson’s model of identity development (Figure 22) as a guide, we can understand continued identity development into adult as the navigation of intimacy and relationships in early adulthood, then contribution to society and operating as part of a family in later adulthood. This section explores the functioning of male identity through contribution to and functioning in society, through employment, unemployment, addition and physical health outcomes. For many men in Cumberland, identity and aspiration are closely tied to local labour markets, community norms and historically valued forms of work, shaping both what futures feel possible and which pathways feel socially successful.

Cumberland’s industrial history, rural geography and the presence of a small number of high-status employers have created narrow and highly visible definitions of success. Secure, skilled employment in some large employers carry strong social value, while other forms of work are often perceived as lower status. Where men do not access these roles, aspiration may narrow rather than expand, with disengagement from work experienced as personal failure rather than as a response to structural constraint.

Stakeholder feedback highlighted limited perceived alternatives among men who do not follow dominant local employment pathways. Rather than reflecting a lack of ambition, this pattern suggests constrained aspiration. In this context, staying local can be both a source of belonging and a barrier to opportunity.

These dynamics intersect with health and help-seeking behaviour. Where identity and worth are tightly bound to work, illness, redundancy or declining physical capacity can threaten a man’s sense of self, increasing shame and reluctance to seek support. This contributes to patterns of late presentation, economic inactivity and disengagement described earlier in the chapter. Over time, limited aspiration and repeated experiences of exclusion can reinforce cycles of withdrawal, risk-taking or reliance on coping strategies such as substance use or gambling.

Importantly, place also represents a potential protective factor. Strong community identity, attachment to locality and pride in place can be harnessed to support positive transitions, provided alternative pathways are made visible and credible. Creating opportunities for men to develop valued roles within their communities, including in caring, mentoring, education, health and public service settings, can broaden definitions of success. Interventions that build aspiration through locally rooted role models, skills development and supported transitions into new forms of work were championed by stakeholders.

Understanding the relationship between place, identity and aspiration is therefore central to addressing men’s health inequalities in Cumberland. Without expanding what futures feel achievable and socially valued, efforts to improve employment outcomes, health behaviours and service engagement are likely to remain limited. This reinforces the need for place-based strategies that recognise identity as a determinant of health, not merely an individual characteristic.