One of Britain's most thriving regional cities is taking stock of a less welcome title this morning as the national blackspot for premature death in both adults and childen.
Used to headlines about glamorous nightlife or the biggest concentration of lawyers outside London, Leeds is to receive the largest share of a £120m government package of emergency health funding for inner cities.
The move is designed to target inequalities in health care masked by overall average figures which make an NHS area look healthy when parts of it are in severe crisis. Leeds is a classic example, with the overall premature death rate the same as nationally, but figures more than twice the average in some central wards.
Central parts of Leeds come ahead of similar areas in Liverpool, Manchester and Teesside in rates of infant mortality and the big adult killers of cancer and coronary heart disease.
The £5m "inequality bonus" for Leeds was welcomed yesterday by the local health authority, which next week debates a local strategy to cut the annual coronary toll of 5,000 deaths.
"We are a very big city and our averages are in line with the country as a whole, but that hides the problems in central wards such as Chapeltown or Harehills," said Liz Scott, the director of public health. "A surprising side of this is that those wards show a very low take-up of health service provision, both in referrals to hospital and the use of modern treatments, like the 'defurring' of arteries."
Much of the £5m is expected to go on better health education in areas like Harehills - a bonus welcomed yesterday in the local Meeting Point cafe, run by the area's Anglican and Methodist churches.
Apart from all-day breakfasts, staff behind the steamed-up windows give informal health advice so efficiently that patients have been informally referred to the cafe by Harehills GPs.
The novel form of health education, which may be copied in similar schemes by the NHS, ranges from networking with social services to practicalities like getting to remote hospitals. Manageress Pauline Burrow cites a pensioner customer with a white stick, finishing his mug of tea, who was given a crucial hand when his wife was admitted to hospital.
"It was right the other side of town but we found out about the NHS Access bus for him, and he's got a weekly lift nicely sorted out," said Pauline, whose waitress colleague Brenda drew on her own experience to give other practical tips.
She said: "I've got high blood pressure which has been monitored very well now for years. But I only found out about it because I was with a group of friends including a trainee nurse who wanted to practice taking blood pressure."
Brenda's mother was less fortunate, dying of a coronary at 69 with her chronic high blood pressure undiagnosed. That sort of lack of regular contact with the health service is thought to be one of the causes of the high premature mortality.
But simply going more often to the GP or Jimmy's - the vast St James's University hospital which dominates Harehills - is not seen in the café as a realistic solution.
"The last time I was in casualty," said one of Brenda's colleagues, "I took my sister and we were there from 10 past five in the evening until five past midnight."
Mike Ramsden, chief executive of Leeds health authority, does not deny the charge - another reason why Leeds needs the inequality bonus. He says: "We're having to tackle the number of people with 12 month waits for major coronary surgery by offering them appointments at a private hospital in Sheffield, paid for by the NHS."
