Life expectancy, like poverty, is a growing concern for the UK

Life expectancy is a function of several things. One of those things is wealth - or, to put it another way, poverty.

New research has found that life expectancy in certain parts of England fell in the decade preceding the pandemic. This is an unusual trend for a rich country in a period without a civilian-enlisting war or massive health crisis (such as a pandemic).

In Northern Ireland, overall life expectancies rose over the decade from 2010 to 2019. But, locally, it is not all good news.

To start with, the rate of growth in NI slowed in the latter half of the decade. Perhaps more worryingly, there are areas of England where life expectancy simply dwarfs that in every council district in Northern Ireland.

It is fair to ask why men and women in parts of South England live, on average, more than a decade more than people in all parts of NI.

Moreover, there are several indications that Northern Ireland might soon see rising poverty. Where there are risks of more poverty, there are risks of negative effects on life expectancy.

The cut to Universal Credit will impact here more than most parts of the UK. The economic uncertainties caused by Brexit are different in NI compared with the rest of the UK, but so far Brexit has generally led to a lot of immediate economic problems and medium-term uncertainties without any tangible benefits. The pandemic will have its own long, negative economic tail.

Then, of course, there is housing. One surprising economic finding from recent years is that NI has the lowest rate of poverty in the UK. That finding – from early last year – is almost entirely down the affordability of local housing. Since then, house prices have boomed.

England

According to a study by Imperial College London published this week, life expectancy has fallen in many parts of England over the past decade. The report covers a period up to 2019, i.e. before the pandemic. It found that from 2002 to 2010, life expectancy was broadly on the rise, before declining in some areas after that.

By 2019, the differences in life expectancy between different parts of England had ballooned. The largest gap for women was 20 years, while the largest gap for men was 27 years.

A woman living in the London Borough of Camden had (in 2019) a life expectancy of 95.4 years, while a woman living in parts of Leeds had an expectancy of 74.7 years. A man living in the London Borough of Kensington and Chelsea had a life expectancy of 95.3 years, while a man in Blackpool’s was 68.3 years.

According to estimates from the Office of National Statistics, average UK life expectancy is 79 years for men and almost 83 years for women.

The latest figures for Northern Ireland show much smaller differences in life expectancy between different areas – but that fact doesn’t tell the whole story.

Northern Ireland

In February, the Department of Health published life expectancy figures for the period 2017-19. The average NI life expectancy was 78.8 years for men and 82.6 years for women – which is slightly lower than the UK average but only by a tiny amount.

Life expectancy for men (by council area) was highest in Lisburn and Castlereagh, at 80.1 years, and lowest in Belfast (76.1 years). For women, it was also highest in Lisburn and Castlereagh (83.5 years) and lowest in Belfast (81 years).

Moreover, unlike in some parts of England, life expectancy in NI continued to rise throughout the decade 2010-19.

So, in some ways, Northern Ireland is doing pretty well. However, the fact that life expectancy in other parts of the UK is as high as 95.3 years for men (over 15 years higher than in any part of NI) and 95.4 years for women (over 10 years higher than anywhere in NI) begs the question of whether local life expectancy should be much higher than it is.

Poverty

Another recent study, this one from the Kings Fund, found that the difference in life expectancy between some of the wealthiest and poorest areas of England has more than doubled since 2000.

Meanwhile, the Imperial College study found that life expectancy broadly continued to climb in England’s wealthier south, whereas the places that saw falls in life expectancy were in the north, which tends to be less wealthy.

This is unsurprising. Scope wrote last year about an Institute for Health Equity study, and how it showed that health and health outcomes (including life expectancy) is not simply the result of people making better or worse choices, it is directly linked to poverty – which itself is shaped by government policy.

Life expectancy is not the be all and end all of successful health policy. Healthy life expectancy – the number of years someone can expect to live in good health, i.e. without significantly disabling illnesses or injuries – is arguably just as important.

However, poverty affects healthy life expectancy in the same way it affects life expectancy, and for similar reasons. Indeed, the 2020 Institute for Health Equity study covers both key statistics.

The economic outlook for the UK right now is shaky, to say the least. When it comes to life expectancy and healthy life expectancy, this should be of great concern.

Government

Government has major roles in tackling poverty and in public health. Stormont is responsible for many of the relevant policy areas here in Northern Ireland. However, the reach of both the Executive and the Assembly is always constrained by Westminster. NI does not have a fully fledged national government, because it has little or no wriggle room in terms of year-on-year financial clout. We get handed a lump of cash from London and are allowed to spend it.

The Conservative Party has been in power since 2010. During this period there have been several governments, under three different Prime Ministers, each of whom have showed different visions of what they want for the country.

One thing that hasn’t changed much, however, is the attitude to welfare reform and Universal Credit. Despite long-running campaigns and voluble opposition, social security payments were recently cut by over £1,000 per year.

Of course, the government says its aims are to make work pay (note that over a third of Universal Credit claimants are in work) and that its plan is to “level up” wages, the economy, and those parts of the country that are traditionally less well off.

One thing that has seemingly changed is the current Prime Minister’s attitude to life expectancy.

In July last year – during a speech on levelling up, no less – Boris Johnson said that “it is an outrage that a man in Glasgow or Blackpool has an average of ten years less on this planet than someone growing up in Hart in Hampshire or in Rutland”.

Last week - perhaps with the latest life expectancy figures in mind - Mr Johnson was saying “never mind life expectancy, never mind cancer outcomes – look at wage growth.”

For anyone alarmed about the direction of travel for life expectancy, that does not augur well.