More than a million people outside the wealthiest areas of England lived shorter lives than they should have between 2011 and the start of the pandemic, a new report from the UCL Institute of Health Equity (IHE) has found.1
The report analysed the life expectancy of people across England who do not live in the wealthiest 10% of areas using published Office for National Statistics data on excess deaths in the decade from 2011.
They found that between 2011 and 2019, 1 062 334 people died more prematurely than they would have done if they had lived in the wealthiest areas. Of these, the report estimates that 148 000 were attributable to the post-2010 austerity measures implemented by the coalition government.
Additionally in 2020, during the pandemic, inequality between the least and most disadvantaged 10% of areas contributed to a further 28 000 excess deaths, when compared with that over the previous five years.
IHE director and global expert in health inequalities Michael Marmot said the trend was “a dismal state of affairs.” He said the latest report added weight to previous reviews2345 that showed that austerity had contributed to overall UK life expectancy failing to increase, life expectancy falling for women in the 10% of poorest areas, and health inequalities widening.
“If you needed a case study example of what not to do to reduce health inequalities, the UK provides it,” Marmot said. “The only other developed country doing worse is the US, where life expectancy is falling. Our country has become poor and unhealthy, where a few rich, healthy people live. People care about their health, but it is deteriorating, with their lives shortening, through no fault of their own. Political leaders can choose to prioritise everyone’s health, or not. Currently they are not.”
To add context to the UK data, IHE compared it with European Union data6 on healthy life years (HLY). It found that, in 2014, men and women in the UK had a higher average number of HLY than those in the EU. But by 2017, HLY in the UK had stagnated for men, and had fallen for women. In the same period, HLY increased by more than two years in the EU. Consequently, 10 EU countries had higher HLY than the UK for males, and 14 had higher HLY than the UK for females.
The institute is currently working with over 40 local authorities, businesses, and other sectors across the UK to ensure local policies are assessed for their likely impact on health and wellbeing.
But Marmot added, “What must happen at the same time, though, is leadership from central government, making reducing health inequalities a central plank of the next government. That means implementing fairer social and economic policies, with health at the heart.”
A Department of Health and Social Care spokesperson said the government was “committed to tackling inequalities in outcomes, experiences, and access to healthcare across the NHS.” It cited five new cancer clinical audits from NHS England to reduce unwarranted variation in treatments and outcomes, adding, “Additionally, our major conditions strategy will apply a geographical lens to each condition to tackle regional disparities in health outcomes.”
Health inequalities would also be tackled with the proposed legislation to prohibit children born on or after 1 January 2009 from legally buying cigarettes, the spokesperson said.
