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Inequalities in life expectancy increase across England

Inequalities in life expectancy increase across England
By Beth Gault
16 May 2024

Life expectancy inequalities have increased across the country for both women and men, according to a report by the Institute of Health Equity (IHE).

Between 2010-12 and 2017-19, there were ‘statistically significant’ increases in inequalities in life expectancy in six of the nine English regions for women (see box), and three for men.

The largest increases per region were in the North East, where the difference in life expectancy between the poorest and richest neighbourhoods was up by 1.9 years for females to 9.7 years, and 1.5 years for males, to 12.2 years.

Inequalities in life expectancy increases

The six regions where there was a statistically significant increase in inequalities in life expectancy for women were: North East, North West, Yorkshire and the Humber, East of England, East Midlands, South West.

For men, the three regions were: North East, Yorkshire and the Humber and East of England.

The report also looked at the data per local authority and found that inequalities occurred in ‘at least one authority’ in every region. The largest of these increases were the female life expectancy in Kensington and Chelsea, from 6.2 years to 11.9 years, Guildford, from 2.8 years to 8.0 years and Stoke on Trent, which went from 3.8 years to 8.9 years.

The report used data from the Office of National Statistics (ONS) and the Office for Health Improvement and Disparities (OHID) to establish life expectancy and healthy life expectancy. It also looked at the National Audit Office (NAO) to assess local authorities’ spending during the time period.

The authors noted that local authorities fund many of the services that affect the drivers of health inequalities, such as housing, education and social care, and that their spending decreased during the period.

They said: ‘Between 2010/11 and 2015/16, central government support to local authorities (e.g. through the revenue support grant) fell by an average of 41 percent per head of population in England and the tax raised by councils themselves fell by eight percent per head of population.

‘After 2015/16, extra revenue raising powers allowed councils to increase the amount raised each year, so that by 2019/20 this amount was four percent more than in 2010/11 in real terms. However, government support was 58 percent below that in 2010/11 – resulting in overall council spending power down by 34 percent in 2019/20.’

In a letter to MPs, director of the UCL IHE, Professor Sir Michael Marmot, said: ‘It is no surprise that local authorities are struggling to make ends meet and that people are living shorter lives than they should. If you slash the services that support people then health will be harmed. Levelling up was supposed to provide badly needed funding for the most deprived areas. But it was a derisory amount and, as a result, never going to improve health.’

He added: ‘I’m saying to party leaders: make this the central plank of the next government – stop policies harming health and widening health inequalities. To MPs: if you care about the health of your constituents, you must be appalled by their deteriorating health. It’s time for action and political leadership across the board.

‘Important as is the NHS – publicly funded and free at the point of use – action is needed on the social determinants of health: the conditions in which people are born, grow, live, work and age. These social conditions are the main causes of health inequalities.’

The IHE called for the appointment of an independent health equity commissioner and the establishment of a cabinet-level health equity and wellbeing cross-departmental committee.

Deputy director of the IHE, Dr Jessica Allen, who oversees the Institute’s work with local places, said: ‘In the UK the IHE is working with more than 40 local areas, and businesses and other sectors who are prioritising health and reducing health inequalities by taking action on the social determinants of health, where they can.

‘They are doing their best to protect lives and promote health equity with their dwindling and inadequate funds. We know what to do. We are seeing a cultural shift and more action on health inequalities in those areas, where local leaders from different sectors are working together to promote health equity, which is magnificent.’

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