The life expectancy of women in the most deprived areas of England is falling, new research has revealed.
Previous research has shown those in more affluent areas have a greater life expectancy than those in poorer ones, but researchers have found the gap is widening, with experts saying lives are being lost to preventable and treatable diseases as a result of rising poverty.
The team say the growing gap is probably down to a combination of factors, including the relatively high price of healthy food and difficulty accessing healthcare – factors they say have been exacerbated by issues such as the gig economy and austerity policies.
“We should measure a policy by its impacts on inequality,” said Majid Ezzati, co-author of the study and professor of global environmental health at Imperial College London, adding that reforms such as universal credit have contributed to an increase in poverty.
This year researchers found British women had a shorter life expectancy than those in countries including Spain, France and Greece. Separately, figures from the Office for National Statistics have recently revealed progress in life expectancy has stalled for both men and women in England, and gone backwards in Scotland and Wales.
The authors of the latest study say their findings highlight the importance of looking beyond the big picture. “Once again this is a situation of … not noticing what is happening to the poorest until it actually starts showing up in the average,” said Ezzati.
Prof Alan Walker of the University of Sheffield, who was not involved in the work, said the poorest are paying for government austerity with their lives.
“While these findings are shocking they are sadly not surprising since, as the UN rapporteur on poverty and human rights has just pointed out, the UK government has pursued policies for the past eight years that were intended to fall most heavily on the poorest,” he said. “‘We are all in this together’ was always a cruel joke.”
Writing in the Lancet Public Health journal, Ezzati and colleagues describe how they analysed official data on the 7.65m deaths in England between 2001 and 2016, together with data from 2015 in which the country was broken down into almost 33,000 small areas and then split into 10 equal groups based on their deprivation. In general the most deprived areas fell in urban areas of the north, West Midlands and parts of London.
The results reveal that in 2001 women living in the poorest tenth of England had a life expectancy at birth 6.1 years lower than those in the wealthiest tenth, but the gap had widened to 7.9 years by 2016, with those in the most affluent areas expected to live to 86.7 years, compared with just 78.8 years for those in the most deprived areas. A similar trend was seen for men, with the life expectancy gap between the richest and poorest areas widening from nine years to about 9.8 years over the same period.
“After accounting for how old they are, [those in] the poor [communities] died of every disease at a higher rate than the rich,” said Ezzati, adding that the gap was fuelled in particular by conditions including heart disease, respiratory disease, lung cancer, dementia and deaths among very young infants.
However while overall life expectancy rose for both rich and poor between 2001 and 2016, albeit more so for wealthier areas, between 2011 and 2016 life expectancy actually fell for women in the poorest 20% of the country, with the most deprived group declining by almost three months.
The team say there are probably a number of factors behind the findings, including that public health initiatives might have been more accessible to the wealthy, and those in more deprived areas might find it harder to find time and money to access healthcare, while waiting times are longer and provision is worse.
The team also note there have been cuts to smoking cessation services, and funding problems in the provision of social care – meaning those who can pay for private care do better in the case of chronic conditions like dementia.
Meanwhile they add the cost of healthy foods have risen while families are finding it increasingly difficult to manage financially with a growing reliance on food banks.
“Some of it is things people would call lifestyle but we would tend to think of it as lifestyles people are cornered into,” said Ezzati.
The team have called for pricing policies and regulations on alcohol and foods high in salt, sugar and certain fats and say healthy foods should be made more affordable.
Prof Helen Stokes-Lampard, chair of the Royal College of GPs, described the situation as a travesty.
“There are a myriad of factors at play in determining life expectancy – lifestyle factors, diet and socioeconomic status, for example – all of which can be inextricably linked. But a patient’s access to healthcare is also key, and should not be based on their postcode,” she said.
