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| Life expectancy gap between rich and poor areas fell under Labour – study | Life expectancy gap between rich and poor areas fell under Labour – study |
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| The gap in life expectancy between the richest and poorest communities in England narrowed during the course of the last Labour government, although not entirely as a direct result of policies intended to tackle the issue, new research reveals. | The gap in life expectancy between the richest and poorest communities in England narrowed during the course of the last Labour government, although not entirely as a direct result of policies intended to tackle the issue, new research reveals. |
| Between 1999 and 2003, there was close to a seven-year gulf in life expectancy between those living in the richest 10% of areas and the poorest 10%. But during 2006-10, the last years of the Labour government, that gap had shrunk by 2.5 years – from 6.9 years to 4.4 years – according to work carried out by the King’s Fund thinktank. The average life expectancy was 78 years for the poorest 10% and 82.4 years for the richest over the period. | |
| Labour pledged to tackle the health inequalities that lead to varying life expectancy, giving extra money to local authorities. The NHS, with a substantial funding increase, was also charged with increasing efforts to get life-threatening diseases better under control, including by reaching deprived communities with improved treatments for conditions such as diabetes, blood pressure and heart disease. | Labour pledged to tackle the health inequalities that lead to varying life expectancy, giving extra money to local authorities. The NHS, with a substantial funding increase, was also charged with increasing efforts to get life-threatening diseases better under control, including by reaching deprived communities with improved treatments for conditions such as diabetes, blood pressure and heart disease. |
| Those efforts probably played a part in the improved life expectancy, but wider social and economic factors made a bigger impact, says the report. Poverty decreased among pensioners and children over the Labour years, while the quality of the housing stock improved and more people were in employment. | Those efforts probably played a part in the improved life expectancy, but wider social and economic factors made a bigger impact, says the report. Poverty decreased among pensioners and children over the Labour years, while the quality of the housing stock improved and more people were in employment. |
| “We think employment deprivation comes out of our analysis as particularly important,” said the report author, David Buck. “Those areas of high unemployment are associated with lower life expectancy. The fact that you are in employment gains you income, social networks, resilience and self-worth.” | |
| The report warns that the future may not look so bright. “Austerity, and, as importantly, the policy reaction to it, will have consequences for health inequalities,” it says. | The report warns that the future may not look so bright. “Austerity, and, as importantly, the policy reaction to it, will have consequences for health inequalities,” it says. |
| “Our previous research showed that poorer groups were not sharing the improvements in lifestyles that wealthier groups were enjoying. In this research we show how employment, housing and older people’s deprivation all help to explain health inequalities, and why some areas persistently do worse than others. This means that the NHS and wider government policy need to refocus on inequalities in health, if some of the positive findings that happened over the 2000s are not to be lost.” | “Our previous research showed that poorer groups were not sharing the improvements in lifestyles that wealthier groups were enjoying. In this research we show how employment, housing and older people’s deprivation all help to explain health inequalities, and why some areas persistently do worse than others. This means that the NHS and wider government policy need to refocus on inequalities in health, if some of the positive findings that happened over the 2000s are not to be lost.” |
| The report draws on and updates the findings of the Marmot review – titled Fair Society, Healthy Lives and published in 2010 – which was commissioned by the Labour government and broadly accepted by the coalition. It featured what the King’s Fund refers to as “the Marmot curve” – a graph showing that rich areas have better health on average at every level of income. | The report draws on and updates the findings of the Marmot review – titled Fair Society, Healthy Lives and published in 2010 – which was commissioned by the Labour government and broadly accepted by the coalition. It featured what the King’s Fund refers to as “the Marmot curve” – a graph showing that rich areas have better health on average at every level of income. |
| Related: Are foreigners really gaming the NHS to pay for their medical treatment abroad? | Related: Are foreigners really gaming the NHS to pay for their medical treatment abroad? |
| The thinkthank used more recent data on some 6,700 English communities to look at what might lie behind the finding and update it. They found that many variables contribute. “For example, for every 10% increase in older people suffering deprivation, life expectancy falls by six months; for a 10% increase in employment deprivation (those involuntarily unemployed), life expectancy is a year lower,” they write. “In contrast, for every 10% more fruit and vegetable consumption, life expectancy is seven months greater whereas for every 10% increase in binge drinking, life expectancy is four months lower.” | The thinkthank used more recent data on some 6,700 English communities to look at what might lie behind the finding and update it. They found that many variables contribute. “For example, for every 10% increase in older people suffering deprivation, life expectancy falls by six months; for a 10% increase in employment deprivation (those involuntarily unemployed), life expectancy is a year lower,” they write. “In contrast, for every 10% more fruit and vegetable consumption, life expectancy is seven months greater whereas for every 10% increase in binge drinking, life expectancy is four months lower.” |
| But geography appears to be a more important factor over and above these general effects, says the report. Those who commute to London from the suburbs may have five months higher life expectancy and those who travel into the centre may enjoy double that. Being in parts of the north-west, Yorkshire and Humberside and parts of the Midlands is associated with lower life expectancy. | But geography appears to be a more important factor over and above these general effects, says the report. Those who commute to London from the suburbs may have five months higher life expectancy and those who travel into the centre may enjoy double that. Being in parts of the north-west, Yorkshire and Humberside and parts of the Midlands is associated with lower life expectancy. |
| The report notes a geographical pattern to what it calls persistently lower life expectancy, unchanging over the years. Some areas in the north of England around urban centres perform worse than anywhere else in England. Conversely, many of the areas with persistently high life expectancy are relatively large rural patches with more sparse populations, although there are also communities in city centres, particularly west London, with persistently high life expectancy. | The report notes a geographical pattern to what it calls persistently lower life expectancy, unchanging over the years. Some areas in the north of England around urban centres perform worse than anywhere else in England. Conversely, many of the areas with persistently high life expectancy are relatively large rural patches with more sparse populations, although there are also communities in city centres, particularly west London, with persistently high life expectancy. |
| By the end of the Labour years, the targets to reduce the gap for spearhead areas –local authorities with the worst health and deprivation indicators – had been missed. But, said Buck, “one reason the target was missed was because the rest of England did so well”. The report finds that there were improvements within leading areas. Hackney, for example, a London borough often associated with inequalities, saw the biggest closing of the gap for men, by 2.9 years. | |
| Income deprivation was “not a significant factor when we include other measures of deprivation”, says the report. For the future, it suggests that tackling health inequalities needs to go beyond medical and social care, as with the “Devo Manc” initiative for Manchester. | Income deprivation was “not a significant factor when we include other measures of deprivation”, says the report. For the future, it suggests that tackling health inequalities needs to go beyond medical and social care, as with the “Devo Manc” initiative for Manchester. |
| “Greater Manchester is seeking to integrate a wide array of public services around families to save money but more importantly to deliver a more appropriate mix of medical and social interventions to tackle the causes and implications of inequalities and poverty, with a particular focus on tackling ingrained long-term unemployment,” says the report. | “Greater Manchester is seeking to integrate a wide array of public services around families to save money but more importantly to deliver a more appropriate mix of medical and social interventions to tackle the causes and implications of inequalities and poverty, with a particular focus on tackling ingrained long-term unemployment,” says the report. |
| Public health responsibility has been devolved to local authorities and localism could provide some of the answers, the report suggests. | Public health responsibility has been devolved to local authorities and localism could provide some of the answers, the report suggests. |
| “But this won’t be straightforward or easy. In particular, more local political participation around the NHS could be a double-edged sword,” it says. “There is a real danger that the electorate will vote on the basis of saving the iconic hospital down the road, rather than the complexity and interplay of the factors that drive inequalities in health, which are not easy to reduce to political sound bites. | “But this won’t be straightforward or easy. In particular, more local political participation around the NHS could be a double-edged sword,” it says. “There is a real danger that the electorate will vote on the basis of saving the iconic hospital down the road, rather than the complexity and interplay of the factors that drive inequalities in health, which are not easy to reduce to political sound bites. |
| “Avoiding this pitfall will remain one of the greatest challenges to local leadership. As we have made clear ... devolution will have a chance to reduce inequalities in health only if it happens within the context of supportive wider central government policy, swimming with the tide, not against it.” | “Avoiding this pitfall will remain one of the greatest challenges to local leadership. As we have made clear ... devolution will have a chance to reduce inequalities in health only if it happens within the context of supportive wider central government policy, swimming with the tide, not against it.” |