Life expectancy increases but gap widens between rich and poor
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Version 0 of 1. Life expectancy is rising faster than thought, with 90 expected to become the norm in some affluent areas of the country by 2030, putting further pressure on pensions, health and social services, according to new research. But the gap between rich and poor continues to widen. Men in Blackpool can currently expect to live to just 75.2 years, the lowest life expectancy in the country, while those in the City of London – where life expectancy is highest – live an average of 83.4 years. The longest life expectancy for women is also in the City, at 87.3 years. Kensington and Chelsea, the richest borough in London, is close behind. Based on the latest data available for England and Wales, from 2012, the study shows that the eight-year gap in men’s lifespan between more and less affluent districts yawns as large as the gap between England and Wales as a whole and Sri Lanka or Vietnam, say the researchers from Imperial College London. The seven-year gap for women is as large as that between the UK and Malaysia or Nicaragua. Professor Majid Ezzati, senior author of the study in the Lancet medical journal, says poverty and austerity are largely to blame. “The present UK coalition government has cut public spending on a range of social determinants of health under the rhetoric of austerity,” he said. “Such policies will, at best, cause the rising inequality trends to continue, and could well worsen them because their adverse effects are particularly large on children and working-age people, and on more disadvantaged social groups and communities, with signs of a rise in poverty already emerging. “Moreover, National Health Service reforms, which devolve health and social care responsibilities to local governments, coupled with tight budgets and a large role for the private sector in commissioning and provision of health services, will weaken health systems and worsen inequalities in health care access and quality.” The authors say that current official forecasts underestimate how long people in the UK are likely to live. After testing a number of predictive models, they believe they have one that gives a more reliable estimate, based on small areas rather than national figures. Their forecasts for 2030 are 85.7 years for men and 87.6 years for women. The gap between the sexes has closed, probably in part because more women are smoking, reducing their chances of a longer life. Ezzati quoted the Oxford epidemiologist Sir Richard Peto, who said: “If women smoke like men, they die like men.” Deaths among young men from road accidents and homicide have also dropped, however, he said. The Office for National Statistics, which produces the official predictions, currently forecasts life expectancy in 2030 will be 2.4 years lower for men and one year lower for women than the Imperial researchers suggest. Although the difference may seem small, it will have an impact on government spending, said Ezzati. “Pensions will have larger pay-outs than planned, and health and social services will have to serve an even older population than currently planned.” The study gathered data on mortality in 375 of the 376 districts in England and Wales. In a few districts, including Camden, Harrow, Richmond upon Thames and Westminster, as well as Kensington and Chelsea, life expectancy is expected to pass 90 for women by 2030. In the City of London, 92 for women and 90 for men will be the norm. Even with the rise in life expectancy, the UK as a whole trails a number of other countries. The highest life expectancies in the world in 2012 were 81.2 years for men in Iceland and 87 years for Japanese women. “Therefore female life expectancy in England and Wales in 2030 will be only slightly better than that of Japanese women in 2012,” says the study. More importantly, write the authors, their results show that “national progress in the UK has come at the cost of rising within-country inequality, as also seen in the USA”. Ezzati told the Guardian that other work had shown that five years of austerity had taken their toll. “Very good research has shown that when social conditions have become worse, especially for children and younger people, there has been greater health inequality,” he said. The NHS, he said, had helped keep Britain a more equal society. In one of the poorer London boroughs, such as Southwark, more affluent London residents would get the same hospital care as their less fortunate neighbours. That could change if the NHS becomes fragmented and the use of private providers increases. “People’s access to really high quality healthcare is jeopardised,” he said. Professor Sir Michael Marmot, director of the Institute of Health Equity at UCL, said the Imperial forecasts may well be more accurate than those of the ONS because they were based on local areas. The study suggests that the affluent will benefit from state help more than the poor because of their longer lives. “The implication is that people of higher socioeconomic position will benefit from health and other services for longer than more deprived people. Is this fair?” he asked. But, he said, “we should not see more spending on pensions and health care for people living longer as a problem. It is a success! A rich country can afford it. Why not?”. He added that the research did not address the question of people’s health in old age. They might have longer lives, but more sickness. Peter Passmore, professor of ageing and geriatric medicine at Queen’s University Belfast said that GP care might play a bigger part in keeping people alive and well for a longer time than hospitals. “Increased longevity has previously been ascribed mainly to improvements in social conditions, education, nutrition and better vaccinations and vaccination rates,” he said. “It is extremely important in the broader sense to have national finances in a state which will provide for any further need for enhanced expenditure in health, social care and pension provision.” The study was funded by the Medical Research Council and Public Health England. |