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Working at the heart of their communities, Yorkshire and Humber GPs witness the effects of poverty on their patients’ health every day. Working with practice teams, and increasingly the voluntary sector, GPs try to ameliorate the social determinants of health for the vulnerable and socially excluded. Unemployment remains high in this area because the textile, mining, and steel industries, which employed many of the region’s 5 million or so residents in the past, have gradually died off. Substantial numbers of the oldest and youngest in the region are living in poverty: 23% of children and 20% of older people compared with the national averages of 4.9% and 7.4%, respectively.1 Deprivation is concentrated in the major urban centres of Bradford, Leeds, Hull, and Sheffield, alongside pockets of destitution in the former mill towns of West Yorkshire and some rural areas: some of the poorest communities in Europe can be found in our region.Marmot has confirmed the impact of deprivation on health and life expectancy through the social gradient theory.2 Sadly there are numerous examples to illustrate this from our region. For example, if you hop on the number 83 bus in the leafy south west of Sheffield and travel northwards, the life expectancy of women quickly drops by 10 years.3 In Hull there are life expectancy gaps of 12 years for men and 11 years for women between the richest and poorest.4 Rates of premature mortality from coronary heart disease are more than double in deprived areas of Sheffield compared with affluent counterparts.5 The contrast in life expectancy and health in relation to poverty can only be described as unjust and immoral.In 2009 Glasgow University’s Professor Graham Watt used the metaphor of a swimming pool to represent both the social gradient and increased workload …

Mining for Deep End GPs: a group forged with steel in Yorkshire and Humber