LIFE EXPECTANCY & THE GAP BETWEEN RICH AND POOR

Publication of life expectancy figures this week reveals a population living longer, healthier, and according to some analysts, happier lives. The persistent and alarming gap, however, in life expectancy between those at the top and bottom is largely obscured.

Broadly, health has improved, but much at the same rate as it has for over 100 years. Analysis by the Equality Trust, though, has found that in the last 20 years alone, the gap in life expectancy for those in different local authority areas has increased 41 per cent for men, and an astonishing 73 per cent for women.

East Dorset has been declared as the Local Authority with the highest male life expectancy, with men there now expecting to live almost a decade (8.9 years) longer than those in Blackpool, the authority with the lowest life expectancy. The gap is just as striking for women. Those in Purbeck live over 7 years longer than those in Manchester, and there is now a dramatic 18 year difference in ‘healthy life expectancy’ between women living in Richmond (72 years) and Tower Hamlets (54 years).

The reasons for widening health inequalities are complex, but one contributing factor is the huge growth in economic inequality in the UK over the past 30 years.

A well-established social gradient exists for life expectancy and health, with poorer people experiencing worse health than the affluent. A growing body of research suggests that this is because socio-economic inequality is itself a root cause of health inequalities. In short, due to the unequal distribution of income, wealth and power, the wealthy are able to protect and improve their health; the poor are not.

Economic inequality in the UK has grown monumentally since the early 1980s. The richest 10 per cent of households now own 40 per cent of the UK’s wealth. This equates to being 850 times the wealth of the bottom 10 per cent. If income distribution was the same as it was in 1977, the bottom fifth would be £2,000 a year better off and the top fifth £8,000 less. Given this growth in economic inequality, it should not be unsurprising to see a similar growth in inequality in health outcomes. A recent report from Health Scotland argues that the only way to reduce the social gradient in health is to reduce inequality in income and wealth.

Yet, it is not only those at the bottom who should be concerned with widening inequality – it is something that could affect everyone. The socio-economic observations are important to note. Most developed countries enjoy a similar rate of improvement in life expectancy regardless of their rates of economic growth. But, when inequality increases, improvements in health are a little slower (and when it decreases they are a little faster). In the event of a really catastrophic change in inequality occurring this can push health improvements into reverse. This happened in some Eastern European countries following the social and political upheavals of the early 1990s. In these countries life expectancy dropped dramatically, with some still not having made up for the lost ground more than 20 years later.

The complex nature of health inequality poses a number of specific challenges for policy makers. For example, how can government possibly calculate a fair and reasonable retirement age when there are such wide fluctuations in life expectancy in different areas?

There is a real danger that the Coalition Government in the UK will sweep under the carpet the damaging effects of growing disparities in health. A recent Office for National Statistics consultation in response to budget cuts has proposed that statistics on health inequalities no longer be collected. If this proposal is accepted this would create an almost insurmountable barrier to those wishing to identify and address health problems.

Further analysis shows that economic inequality is not only just a health issue. More unequal societies, for instance, are more likely to experience poorer literacy rates, a higher incidence of drug addiction, greater levels of violence and a myriad of other social ills. In the last few days government advisers have called for measures to reduce inequality in order to reduce child poverty and in the removal of barriers to social mobility. Such measures would allow more people to live longer, healthier and more productive lives.

If we want a healthier society the Government must start taking steps now to reduce the UK’s dangerous and corrosively high levels of economic inequality.