Life expectancy falls for most disadvantaged in England


The Office for National Statistics (ONS) has published updated life expectancy data for the period 2018 to 2020 which demonstrates that health inequalities are increasing. The life expectancy gap between those living in the most disadvantaged neighbourhoods and wealthiest has widened significantly, and disability-free life expectancy (DFLE) has decreased for almost everyone.

From 2015 to 2017, men living in the least affluent neighbourhoods in England could expect to live for 9.4 years less than those living in most affluent neighbourhoods. The latest evidence shows this has now risen to a gap of 9.7 years, and for women this gap has risen from 7.7 years to 8 years.

This most recent data captures the first nine months of the Covid-19 pandemic – in which mortality rates for the most disadvantaged neighbourhoods and communities were much higher – reflecting pre-existing levels of health inequality and serving only to deepen them further. For example, the risk of dying from Covid-19 was 4.1 times greater for people with learning disabilities.

A Covid-19 impact inquiry from The Health Foundation in July 2021 also found that people of working age in the poorest 10 per cent of areas in England were almost four times more likely to die from Covid-19 than those in wealthiest, which is reflected in the new government data.

The drop in life expectancy seen in England was the second biggest fall globally, after the United States, and was much higher than in countries with similarly-sized economies and levels of wealth.

There has also been a decrease in the number of years of life lived without disability (Disability-free life expectancy) for all men and women. Although this drop has impacted the whole of England, the data shows the strongest decline is found in the most disadvantaged parts of the country.

The healthy life expectancy gap has remained the same. Women living in the most disadvantaged areas of England can expect to live 18.8 fewer years in good health than those in the wealthiest, and men can expect to live 18.2 fewer years in good health.

The link between socioeconomic inequalities and life expectancy was made clear in 2020 in Michael Marmot’s report ‘Health Equity in England: The Marmot Review 10 years on’. These factors, referred to as the social determinants of health are the main contributors to health inequalities. The new ONS data highlights a lack of progress in tackling inequalities and achieving health equity.

The Evaluations of our funding programmes demonstrate that community based action to tackle health inequalities can have a significant impact on wellbeing in a relatively short amount of time. However, for healthy life expectancy to improve we need to see strong interventions from policy makers to support communities to deliver change, and a greater commitment from central government to place health equity as a priority at the centre of all policy decisions.

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