Category Archives: Society

Britain, Government, Health, Research, Society

UK health inequality…

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.

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Economic, Government, Politics, Society, United States

US budget and debt ceiling: a continuing danger to the world…

U.S. BUDGET & MARKET CORRECTION

The confrontation over the U.S. debt ceiling might have been resolved meantime, but there is nothing to prevent a repeat of the U.S. economic debacle when the government’s budget comes up for review again in January. Last week, after a wrangling spectacle that lasted several weeks, politicians in Washington slammed on the brakes at the last minute. For a long time, though, the differences between Democrats and Republicans appeared irreconcilable and seemed intent on driving the global economy off a cliff, by triggering a catastrophic default.

President Obama was quick to highlight that nothing has done more damage to America’s credibility in the world, or standing with other countries, than what we’ve seen over the past few weeks. Yet, any sense of relief is likely to be distinctly short-lived. For what will prevent this whole exercise being repeated in a few months? What was agreed on Capitol Hill was a stay of execution, rather than a reprieve. Congressmen still have utterly different views of the role and extent of government, and far less reason now than ever to trust each other.

Outside of America, the most important thing is to ensure that the risk of another global recession is eliminated because of the disaster that would follow a U.S. default. The world will expect that America’s politicians are mature enough to forge a long-term budget deal. In the likely absence of such bipartisan spirit, a partial fix would be to eliminate the need for Congress to approve each increase in the debt ceiling, and rely on the market to provide the necessary fiscal rectitude and discipline.

Market correction does not imply a recipe for unrestricted spending. The House of Representatives would still retain control of the purse strings, and could refuse to fund certain aspects of the government’s operations it was unhappy with. Otherwise, the U.S. will continue to bump up against the ceiling time and again, with the possibility and threat of a catastrophe unfolding. Given that the debt’s numerical value is bound to increase – even if it shrinks as a proportion of GDP – the market should be used as a rectifying tool, rather than politicians in Washington who have proved they are unfit to compromise on their conflicting (and perhaps even reticent) agendas.

AN IMPASSE THAT COULD BE BROKEN WITH MID-TERM 2014 ELECTIONS LOOMING

Following the deal to reopen the U.S. government, John Boehner, Speaker of the House of Representatives, said: ‘We fought the good fight. We just didn’t win.’ These words expressed by Mr Boehner, in theory the most powerful politician in Congress, disguises the fact that Republicans fought an ignoble and pointless fight that has inflicted deep damage on the United States. True, the U.S. government has averted the calamity of a debt default, but to suggest his Republican party did not win is putting it mildly. The Republicans achieved nothing of what it was seeking, most notably a postponement of President Obama’s signature health care reform. Instead, many will suggest it suffered a crushing defeat that might just bring the party to its senses.

That outcome, however, is far from guaranteed. Judging by reactions following last Wednesday’s Senate and House votes that ended the crisis, the ultra-conservative minority that has been holding America to ransom shows little sign of changing its ways.

America must now count the cost of this completely unnecessary exercise in futility. The $20 billion direct loss to the U.S. economy is just the start of it. The ‘good fight’ Mr Boehner refers to has further poisoned the atmosphere on Capitol Hill, and distracted America’s legislature from far more important issues – such as immigration policy reform and climate change. Then there is the damage to the country’s reputation and financial standing. The budget deal that has allowed the U.S. government to resume business has settled exactly nothing.

The government is being funded again, but only until mid-January; the U.S. Treasury is authorised to borrow, but only until early February. There is no guarantee whatsoever that the zealots, unchecked by Mr Boehner, will use these deadlines once again to provoke a repeat shutdown and a new round of brinkmanship on the debt ceiling.

Under the agreement, a bipartisan joint House and Senate panel is being set up, with instructions to work out by mid-December a blueprint to balance the budget, and thus resolve the arguments underlying all of the issues between Mr Obama and Congress. This may offer a glimmer of hope but few will give it much chance of succeeding where numerous attempts in the past have failed. To reconcile the vast differences between the parties on taxes and spending will require compromise on both sides not yet seen.

The best hope of averting a new crisis could lie in the approach of the 2014 midterm elections, because Republicans may fear a brutal backlash from voters. Ultimately, the impasse is not economic but political, and could be settled at the ballot box.

Pollsters clearly show that the majority of Americans blame Congressional Republicans for the folly that has ensued on Capitol Hill. If Republicans do bring about a repeat of the budget debacle early next year, then they will surely be heading for a fully deserved electoral disaster.

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