Geography matters when it comes to the public spending that is decided: locally, nationally and internationally. Locally, in England, it is not unusual to hear of fewer than a quarter of people voting in some wards to elect the councillors who decide how resources are allocated within the very small remit they have to vary spending. I am writing this in early April 2026, as the local election campaigns in many areas begin to ramp up. Reports are arriving from the doorsteps of what the political parties are hearing, and the parties themselves are learning more clearly that local social geographies help explain whether they can be popular, or not, among the minorities of people still energised enough to vote.<\/p>\n
One correspondent in the West Midlands told me that in her local area people seem to have become quite selfish and much more ready to pull the ladder up once they think they have had their share. References to \u2018looking after our own\u2019 abound, although few seem to quite be sure about what our own looks like these days. Immigration looms large as an issue; usually those discussing it are highly uninformed, and of course the cost of living is punitive for many \u2013 this is obvious anywhere that is not affluent (which is most places).<\/p>\n
Some working-class pensioners complain and say they will never vote Labour again, disappointed by the current government. When it is pointed out that their state pension has risen this April, a few retort that they will then pay more income tax as a result! There is little gratitude to be had. The lifting of the two-child benefit cap is rarely referred to. It is not seen as having been a great achievement by many of those folk whose doors are knocked on to try to secure their vote. Perhaps because the government was so lukewarm over its lifting.<\/p>\n
The few activists that remain in the traditional parties consider the \u2018marked up rolls\u2019 of who last voted in recent elections. They also know who last promised on the doorstep that they might vote for them. They have an inkling from recent by-elections that some groups, especially folk who are not white, will never vote for the nationalistic and inward-looking \u2018Reform UK\u2019. But they also know that the Green vote will rise in very different sets of areas: in poorer places where people worry most about racism, and often quite different areas where concerns about the environment are high (and cost-of-living fears are low). Both types of area currently appear to be seeing surges in the Green vote.<\/p>\n
Labour is squeezed, the Tories are lacklustre, the Liberals quietly benefit. \u2018Reform UK\u2019 expect to make many gains. Ultimately all this will alter for who, and on where, local public spending is most focused upon. Voting influences who loses out and who wins a little more; or who gains some comfort from the idea that the person they elected is against doing very much locally at all \u2013 other than attempting to bring spending down. Some people vote against their neighbours. However, as most that is spent locally is what has to be spent just to keep basic statutorily mandated public services running, council taxes don\u2019t fall regardless of who you elect.<\/p>\n
In Wales, Plaid Cymru does well. A clear platform articulated by sincere politicians can win back a lot of the voters. Labour in Wales promises not to spend more, nor to enact its tax raising powers. Labour, the traditional party of Wales, still tries to look like a low-tax Reform. In contrast, in Scotland, the SNP with its pro-social agenda is on the rise again, now beginning to cement its pace as the traditional party of that country. In Scotland, public spending is about a fifth higher per person than in England. The reasons are primarily geographical; Scotland is more sparsely populated. In rural areas, services have to be duplicated across many small communities. A large network of roads and ferries has to be maintained. Many smaller schools and remote GP surgeries are needed. High public spending in such circumstances is not inefficiency. People there increasingly understand this, alongside supporting the aspiration of government to actually make lives better, not simply trying to maintain poor standards and wait for the fabled economic growth to come.<\/p>\n
The most basic measure of a better life is whether you get to live at all. The simplest of all international statistics is the infant mortality rate. This is the proportion of babies that die in their first year of life, most in the first few days, expressed per thousand born. In affluent countries, infant mortality now thankfully tends to be very low, but as a measure it hardly improves at all anymore, and yet it differs greatly between places. Infant mortality serves as an indicator, not just of a rate of sorrow, but of what might still be possible. Although, primarily, it is not simply public spending on health that achieves the better outcomes, but a society that sees more of its people as people, as mattering.<\/p>\n
![\"\"](\"https:\/\/www.dannydorling.org\/wp-content\/files\/Figure_1-19.png\")
Comparisons of Infant mortality rates in Europe in recent years<\/p><\/div>\n
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England has one of the highest infant mortality rates in Western Europe. It rose by a fraction during the years of greatest austerity to reach four children, per thousand born, dying in their first year of life in 2019. The rates fell with the onset of the pandemic as fewer people had children in the most unplanned of circumstances; but have risen since. France has a similar rate, however this is mostly because poorer people are more likely to have children there. Many more babies are born in France each year than in England, but a similar proportion die. The rates are lower in Germany, Spain and Italy where there are far fewer births than in France, including especially among the poorest, whose living circumstances are more often detrimental to health. But it also matters that these societies are more equitable than England\u2019s. Infant mortality is lowest in the most equitable Nordic countries: half what it is in England.<\/p>\n
Medical and scientific progress, economic growth, or trends in health behaviour over time, all no longer have a great influence on the trends in infant mortality between states in Europe or within the USA. Instead, it is the structure of each society that matters the most now. Public spending is a part of that. However, countries that spend more on public services, including on health, and which provide more equitable services, also are almost always more cohesive. People are less likely to slip through the cracks. Babies are less often born in circumstances where their most basic chances of survival are poorer. In terms of a newborn infant\u2019s chances of survival, England is now more similar to California and New York than it is to the rest of Western Europe. Thankfully, English society is not yet as divided a society as society is within the states of Ohio, Georgia and North Carolina.<\/p>\n
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![\"\"](\"https:\/\/www.dannydorling.org\/wp-content\/files\/Figure_2-20.png\")
Comparisons of Infant mortality rates in large USA states and England in recent years<\/p><\/div>\n
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If people in the USA wish to have more stable, less divided and more cohesive societies, they would need to become more like their apparently poorer, but socially far better-off European counterparts. There appears little appetite for this as I write, although voters in California and New York are usually among the most opposed to the Trump government. Unfortunately, many people in English are now toying politically with becoming more like some parts of the United States. This is why voting matters, from the most basic of local election tactics and agendas, through to regional and national contests. Voting is not just about public spending. It is also about what kind of a society you want: less or more individualistic; less or more nationalist.<\/p>\n
It is possible to change, but sudden changes are rare. However, we should be bolstered when they happen and not succumb to nihilism. The \u2018EU27\u2019 dotted line in the first graph accompanying this piece is so high because several countries in Eastern Europe still have higher mortality rates than England. Nevertheless, across most of Eastern Europe infant mortality has been falling. In Hungary (not shown in the graph) the infant mortality rate fell from 5.0 per 1000 in 2013, to become lower than England\u2019s by 2017, and in every year thereafter. This was not because the Hungarian government was making wonderful investments in their health services, but because far fewer poorer people in Hungary were having children than before, in a country in which there was increasingly little hope of a better society due to the authoritarian government.<\/p>\n
In April 2026 Hungarian society changed. Some four out of every five adults who could vote, voted in the general election. They decisively ousted Orb\u00e1n\u2019s government. To do so, most voted for a party they would not normally support. Collectively, Hungarians chose to try to become more like mainstream Europe: less nationalistic, less individualistic, less afraid. Donald Trump and JD Vance had both publicly supported Viktor Orb\u00e1n. Orb\u00e1n\u2019s government had publicly and financially supported the rise in the far-right in several European countries, including in England. The choice now is between what kind of society you want to live in. Geography reveals the alternatives, voting reveals the current preferences, the hopes and the fears.<\/p>\n
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Sources<\/strong>:<\/p>\n Europe: https:\/\/ec.europa.eu\/eurostat\/databrowser\/product\/page\/tps00027<\/p>\n England: https:\/\/www.ncmd.info\/publications\/child-death-review-data-release-2025\/<\/p>\n https:\/\/www.nuffieldtrust.org.uk\/resource\/infant-and-neonatal-mortality<\/p>\n Metropolitan France: https:\/\/www.insee.fr\/en\/statistiques\/serie\/000067681<\/p>\n USA: https:\/\/www.cdc.gov\/nchs\/state-stats\/deaths\/infant-mortality.html<\/p>\n <\/p>\n