Life expectancy growth stagnates in England for first time in 120 years
12 March 2020
For the first time in 120 years, life expectancy in England has stopped rising and in deprived areas of the country it is falling.
Inequality in life expectancy between the rich and poor, a permanent feature under capitalism, is widening. So too is the gulf separating the rich and poor in terms of the number of years in good health they can expect to live.
An Institute of Health Equity report commissioned by the Health Foundation—Health Equity in England: the Marmot Review 10 Years On—refers to Professor Sir Michael Marmot, a leading expert in public health, who revealed gross inequalities in health outcomes a decade ago. He made recommendations to the national government to reduce the gap, including by “giving children the best start in life” and “fair employment and good work for all”.
The Marmot review 10 Years On reveals, in the words of Professor Marmot, who led the review, that “England is faltering” and has “lost a decade”. His foreword states, “From 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 food banks in large numbers, to ignored communities with poor conditions and little reason for hope … Austerity will cast a long shadow over the lives of the children born and growing up under its effects.”
Since 2011, life expectancy has stalled, a development “unprecedented, at least since the turn of the last century.” The slowdown has been “dramatic”, after previously rising one year every four years since the end of the 19th century. In men overall life expectancy rose by only half a year, from 79.01 in 2010-12 to 79.56 in 2016-18. The rate was lower for women, about a third of a year, from 82.83 to 83.18.
For males living in the most deprived parts of the country, life expectancy averaged 73.9 years in 2016-18, compared with 83.4 years in better-off areas. For women the figures were 78.6 and 86.3 years.
This regression in public health coincides with the introduction of savage austerity by the Labour government led by Gordon Brown after the banking crash of 2008. A trillion pounds was made available to the banks, for which many working-class people have paid with their lives.
The report comments, “If health has stopped improving it is a sign that society has stopped improving. When a society is flourishing health tends to flourish.”
In 2016-18, the difference in life expectancy “between the least and most deprived deciles was 9.5 years for males and 7.7 years for females… In 2010-12, the corresponding differences were smaller—9.1 and 6.8 years, respectively.”
Life expectancy is lower in the North and higher in the South. Differences are increasing both between and within regions. The North East has the lowest life expectancy, London the highest. For both men and women, it decreased the most in the 10 percent of neighbourhoods in the North East with the highest levels of deprivation.
For men only, life expectancy fell in Yorkshire and the Humber, the East of England as well as the North East. The poorest women fared worst. Their life expectancy fell in every region of England, with the exception of London, the West Midlands and the North West.
Among ethnic groups, “Pakistani, Bangladeshi and White Gypsy Travellers have much lower quality of life than other ethnic groups.”
For the least deprived, life expectancy improved. The rich have the greatest chance of longevity. The largest increases in life expectancy were in the least deprived 10 percent of neighbourhoods in London.
Those living in more deprived areas also spend more time suffering ill-health. This has also increased since 2010. Those living in better-off local authorities can expect to live 12 more years of life in good health than those in deprived authorities.
This frightening societal regression also applies to Wales, Scotland and Ireland.
Professor Marmot attributes 20 percent of the slowdown to bad flu seasons. The rest is socially determined—linked to cuts in services, falling disproportionately on the more deprived areas, and increasing poverty due to low wages and benefit reforms. As the report explains, the “health of the population is not just a matter of how well the health service is funded and functions… Health is closely linked to the conditions in which people are born, grow, live, work and age and inequities in power, money and resources—the social determinants of health.”
While cuts to essential services have affected all geographical areas since 2010, the axe has fallen hardest outside London, with the more deprived areas and the South East experiencing larger cuts. The report says, “The cuts over the period shown have been regressive and inequitable—they have been greatest in areas where need is highest… the cuts have harmed health and contributed to widening health inequalities… and are likely to continue to do so over the longer term.”
As a percentage of GDP, government public spending fell by 7 points, from 42 to 35 percent, between 2009/10 and 2018/19. Central government grants to local authorities have suffered punishing cuts. From this year, the central government grant is being phased out altogether. Almost half of all councils, 168, no longer receive any core central government funding. Cuts to local government allocations from the Ministry of Housing, Communities and Local Government fell by 77 percent between 2009–10 and 2018–19. Areas vital for health outcomes such as social protection and education declined most, by 1.5 percent of GDP.
The Marmot review outlines how deprivation in early childhood is associated with a poorer prospect of having a healthier life and longevity:
“Evidence shows that positive experiences early in life are closely associated with better performance at school, better social and emotional development, improved work outcomes, higher income and better lifelong health, including longer life expectancy.”
More than four million children live in poverty in the UK. The review cites the Institute of Fiscal Studies, “[R]elative child poverty, living in a household with less than 60 percent of median income, after housing costs will increase from 30 percent to 36.6 percent in 2021 in the UK.”
Pension poverty combined with poorly insulated housing contribute to unnecessary deaths among the less well off. A report by National Energy Action and environmental group E3G published February 2018 attributed 9,700 deaths annually to people living in cold houses.
The Marmot Review 10 years On draws attention to devastating attacks on the working class, but it has no solution to offer. As in 2010, it ends with a forlorn appeal for government action to reduce health inequalities. It states baldly, “We repeat: we neither desire nor can envisage a society without social and economic inequalities.”
However, what is required is the expropriation of the society’s resources currently in the hands of a super-rich minority.
Boris Johnson’s Conservative government is committed only to ramping up the exploitation of the working class. Under conditions of a developing trade war agenda and meltdown on the financial markets, the British bourgeoise must impose worsening working conditions and the further destruction of services.