Life expectancy ‘flatlines’ for the first time in over 100 years
Author: Jo Carlowe
For the first time in over a century, life expectancy in England has stopped improving, and health inequalities have widened between rich and poor.
This is the shocking finding from a publication today from Professor Sir Michael Marmot, of the Institute of Health Equity.
Ten years ago, Sir Michael Marmot published his landmark review on health inequalities. In today’s 10-year updated report: Health Equity in England: The Marmot Review 10 Years On, Sir Michael confirms that, for the first time in more than 100 years, life expectancy has failed to increase for a decade across the country, and for the poorest 10% of women it has actually declined. Over the last decade health inequalities have widened overall, and the amount of time people spend in poor health has increased since 2010.
Today’s report, also confirms an increase in the north/south health gap, where the largest decreases in life expectancy were seen in the most deprived 10% of neighbourhoods in the North East, and the largest increases in the least deprived 10% of neighbourhoods in London.
The 10-year on review, commissioned by the Health Foundation, discounts the theory that the slowdown in life expectancy improvements can be solely attributed to severe winters or flu. The report lays out that more than 80% of the slowdown, between 2011 and 2019, results from influences other than winter - associated mortality. And the slow down in life expectancy improvement in the UK is more marked than in most European and other high-income countries, except the USA.
Austerity and funding cuts are cited as a major contributor to health inequalities.
Deprived areas and areas outside London and the South East have experienced larger cuts. The more deprived the area, the shorter the life expectancy. For women in the most deprived 10% of areas, life expectancy fell from 2010-12 and 2016-18. There are also marked regional differences in life expectancy, particularly among people living in more deprived areas. And death rates are increasing for men and women aged 45-49 – perhaps related to so-called ‘deaths of despair’ (suicide, drugs and alcohol abuse) as seen in the USA.
Despite the cuts and deteriorating outcomes some local authorities and communities have established effective approaches to tackling health inequalities. The Review highlights the need for government action to build on these success stories.
“This damage to the nation’s health need not have happened. It is shocking. The UK has been seen as a world leader in identifying and addressing health inequalities but something dramatic is happening. This report is concerned with England, but in Scotland, Wales and Northern Ireland the damage to health and wellbeing is similarly unprecedented,” says Sir Michael.
“Austerity has taken a significant toll on equity and health and it is likely to continue to do so... if you ask me if that is the reason for the worsening health picture I’d say it is highly likely that is responsible for the life expectancy flat-lining, people’s health deteriorating and the widening of health inequalities.”
Sir Michael added: “Poverty has a grip on our nation’s health - it limits the options families have available to live a healthy life. Government health policies that focus on individual behaviours are not effective. Something has gone badly wrong. We will be monitoring and reporting on inequalities in health and expect the government to listen.”
The report, which sets out a series of recommendations, calls on the prime minister to lead in the development of a national strategy for action to reduce health inequalities by tackling social circumstances.
British Medical Association board of science chair Prof Dame Parveen Kumar said “alarm bells should be ringing for the government”.
“It is unacceptable that those living in the most deprived areas outside of London are seeing their life expectancy stalling or even declining in some cases – this must be addressed.
“As this report highlights, fulfilling the ambition outlined in the government’s Green Paper - to ensure that people can enjoy at least five extra healthy, independent years of life by 2035 and to narrow the gap between the experience of the richest and poorest – has never been more important.
“We welcome this report which should serve as a reminder of the importance of the government bringing forward a prevention white paper. It is also crucial that we see further details of their next action points as a matter of urgency if we are to stem this worrying tide and improve the health of the nation.”
Responding to the findings, health secretary Matt Hancock said: “Every single one of us, no matter who we are, where we live, or our social circumstances, deserves to lead a long and healthy life.
“The ultimate goal of the NHS is to increase healthy life expectancy, and this government is determined to narrow the gap by levelling up access to healthcare across England.
“I thank Professor Sir Michael Marmot for his dedicated work to shine a light on this vital issue. His findings show just how important this agenda is, and renew my determination to level up health life expectancy across our country. After all, levelling up health is the most important levelling up of all.
“There is still much more to do, and our bold prevention agenda, record £33.9 billion a year investment in the NHS, and world-leading plans to improve children’s health will help ensure every person can lead a long and healthy life.”