Austerity Blamed for 'Shocking' Decline in Life Expectancy

Peter Russell

February 25, 2020

Health and life expectancy in the UK has endured serious setbacks over the past decade, an influential team of analysts said.

A review by Sir Michael Marmot, 10 years after he warned that health inequalities and social deprivation would lead to worse health and growing costs for the NHS, found life expectancy falling in many English regions, and increasing amounts of time spent in poor health by people in their later years.

In  opening remarks to the report, Health Equity in England: The Marmot Review 10 Years On , Sir Michael, a leading expert on health inequalities, said England had experienced continuous improvements in life expectancy since the beginning of the 20th century but that from 2011, "these improvements slowed dramatically, almost grinding to a halt".

Describing the current situation as "shocking", Sir Michael, director of the UCL Institute of Health Equity, said "life expectancy actually fell in the most deprived communities outside London for women and in some regions for men. For men and women everywhere the time spent in poor health is increasing."

Austerity and a North and South Divide

The review confirmed a widening health inequality gap between north and south England, with the largest decreases in life expectancy seen in the most deprived 10% of neighbourhoods in the North East, and the largest increases in the least deprived 10% of neighbourhoods in London.

It found that austerity had taken a toll in the intervening years, bringing about "rising child poverty and the closure of children's centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to foodbanks in large numbers, to ignored communities with poor conditions and little reason for hope".

Among the key points in the follow-up report were:

  • 'Place matters', with deprivation linked to lower life expectancy, particularly for women where life expectancy in the most deprived areas fell between 2010-12 and 2016-18

  • Marked regional differences in life expectancy, particularly among people living in more deprived areas

  • Increasing mortality rates for men and women aged 45-49, perhaps linked to so-called 'deaths of despair', including suicide, drugs, and alcohol abuse

  • An increase in child poverty, standing at 22%, related to a decline in spending on education and closure of children’s and youth centres

  • A housing crisis and a rise in homelessness

The '10 Years On' report was concerned with the situation in England, but a similar picture had emerged in Scotland, Wales, and Northern Ireland, and "need not have happened", it said.

"Put simply, if health has stopped improving it is a sign that society has stopped improving," Sir Michael said in his foreword.

Recommendations

Among its recommendations, the report called for:

  • Every child to be given the best start in life, with the aim of reducing child poverty to 10%, level with the lowest rates in Europe

  • Putting equity at the heart of national decisions about education policy and funding

  • Increasing the national living wage, reducing 'zero hours' work contracts, redesigning Universal Credit, and reducing sanctions for welfare benefits, particularly in cases involving children

  • Health equity and wellbeing to be at the heart of local, regional, and national economic planning and strategy

Jennifer Dixon, chief executive at the Health Foundation, which commissioned the report, commented: "The evidence is clear and the solutions are there – what is needed is the will to act.

"Where there has been progress, it has been fragmented and underpowered.

"Steps should now be taken to implement a package of policies over the next 5 years that will lay the foundations for sustainable improvement over the long-term.

"Areas that need immediate investment include addressing child and in-work poverty, the public health grant to local authorities, and children’s services such as Sure Start."

'A Shocking and Timely Reminder'

Shirley Cramer, chief executive of the Royal Society for Public Health, said: "It is a damning indictment of the past decade that, despite being among the wealthiest countries in the world, life expectancy among some groups – such as women on low incomes – has not just stalled but actually gone backwards.

"It is high time that we re-evaluate the bottom line for economic policy, and replace growth of GDP with a goal to improve the health and wellbeing of the public.

“At the heart of this picture of widening health inequalities is years of austerity, and a failure to fully appreciate that people’s health begins with the conditions in which they live, breathe, eat, work and play.

"As vital as the NHS is, the new Marmot Review is a shocking and timely reminder that our health is more than our health service."

In a joint letter, 21 leading health organisations, including 15 Royal colleges, called on the Prime Minister to accept all the recommendations of the Marmot review and address health inequalities. The signatories wrote: "Our professions are keeping the NHS going as demand rises, but what we really want is for that demand to fall. The UK has the resources to make that happen, and quickly. There is simply no need, nor justification, for delay."

Imran Hussain, director of policy and campaigns at Action for Children, said: "While politicians hail the end of austerity, every day at Action for Children our frontline services tell us child poverty levels are at the worst they can remember with parents coming to us desperate for help to keep their families warm and well fed.

"It’s long past time for the Government to deliver ambitious policies to tackle child poverty and restore the real value of children's benefits to what they were before they were cut – as well as bring in a National Childhood Strategy to give all vulnerable children a safe and happy childhood."

Matt Hancock, Secretary of State for Health and Social Care, said: "There is still much more to do, and our bold prevention agenda, record £33.9 billion a year investment in the NHS, and world-leading plans to improve children’s health will help ensure every person can lead a long and healthy life."

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