Ills, skills and labour markets: Tackling health-related economic inactivity in post-industrial England

Economic inactivity is a historic and persistent feature of labour markets in rich nations, with recent UK increases typically attributed to post pandemic shocks. Health related economic inactivity (HREI), both a symptom and driver of health inequalities, has become the most politically charged and apparently least tractable element. Contemporary UK social policy increasingly frames inactivity as a problem of individual deficit, with activation and personalised support posited as routes to productivity and growth. Using qualitative data collected with stakeholders in post-industrial North East England, this article illustrates how such logics can falter when they encounter structurally saturated systems shaped by long term sickness, insecure housing, debt, disrupted access to care and weak labour markets. In these conditions, frontline actors are required to perform the labour of joining up fragmented infrastructures while navigating conditionality driven fear and precarity. This paper argues that these dynamics expose the limits of supply side welfare reform by showing how structurally saturated conditions constrain what employment support systems can achieve in practice, underscoring the need for sustained, place-based approaches capable of addressing embedded inequalities.