For
the first time in 100 years, Britons are dying earlier. The UK now
has the worst health trends in western Europe – and doctors and
experts believe that the impact of austerity is a major factor.
Statisticians
first noticed in 2013 that rises in life expectancy in the UK had
begun to slow down until, a few years ago, it started to decline for
increasing
numbers of people. The elderly, the poor and the newborn were worst
affected. Earlier this year, the Institute and Faculty of Actuaries
said it now expects men aged 65 to die at 86.9 years, down from its
previous estimate of 87.4 years, while women who reach 65 are likely
to die at 89.2 years, down from 89.7 years. In other words, the life
expectancy of people entering pension age has been cut by six months.
At the same time, the government has plans to put up the state
pension age to 68 and has floated the idea of increasing it to 70.
Now it may be forced to backtrack as increases in life expectances
stall.
On
top of the health impacts on the elderly and the deprived, there has
also been a worrying change in infant mortality rates – as was
acknowledged last week by the Office for National Statistics. It
reported that in 2017, there were 3.9 deaths per 1,000 live births in
the UK. In 2016, there were 3.8.
“Infant
mortality had been reducing since the 1980s and reached an all-time
low in 2014. But since then the rate has increased every year,”
said Vasita Patel, a senior research officer at the ONS. “The one
in 2017 is significantly higher than the one in 2014.”
“It
is a perfect storm,” says Danny
Dorling, professor of social geography at Oxford University, who
has organised the London meeting. “Our faltering life expectancy
rates show we have now got the worst trend in health anywhere in
western Europe since the second world war. To achieve that, we must
have made a lot of bad decisions.” To explain this alarming
increase in infant mortality, Dorling blames a host of factors:
“Fewer midwives, an overstrained ambulance service, general
deterioration of hospitals, greater poverty among pregnant women and
cuts that mean there are fewer health visitors for patients in need –
all these factors are involved.” Dorling says, “Life
expectancy in the UK is a long way from what it should be for a
country as rich as ours. The argument should not be about weeks of
life lost or regained but how many years are being lost to life
expectancies because we chose not to do what a normal European
country would do and that is to invest properly in social care.”
Dr
Lucinda Hiam, an honorary research fellow at the London School of
Hygiene and Tropical Medicine and many other epidemiologists argue
that life expectancy started to decline in Britain as
a direct result of the austerity measures imposed by the Tory-led
government in 2010.
These cutbacks – which removed more than £30bn from welfare
payments, housing subsidies and social services over the past eight
years – were some of the most severe made by any nation after the
2008 financial crisis. And once imposed, they triggered dramatic
reductions in funding for social care, meals on wheels, rural bus
services, NHS spending, numbers of health visitors and many other
services. These in turn contributed to increased numbers of early
deaths of vulnerable people, it is argued.
“Life
expectancies started to stall just after the austerity cuts were
introduced,” said Hiam. “That alone does not prove the latter was
the trigger for the former. However, no other plausible suggestion
has since survived scrutiny, so it is hard not to conclude austerity
cuts are involved.”
In
the case of care for the elderly, the link looks especially
persuasive. “Funding
for social care for the elderly had already been at breaking
point for decades and recent austerity cuts only compounded the
crisis,” says Tom Gentry, senior health and care policy manager for
Age UK. Previously
the only individuals who had contact with many lonely, isolated old
people were social and community care workers. Then came the cuts,
which led to a dramatic reduction in this last line in defence of the
elderly. “Today,
there is often no one who is talking to those elderly folk or
spotting when they have stopped eating or noticed that are not moving
around or are having balance problems. Then they fall over, lie there
for days before being found and are then readmitted to hospital where
they have to be given more serious interventions than would otherwise
have been the case. Inevitably that will mean shortened lives.”
The
connection between austerity and dwindling life expectancy is hard to
shake off, says David Walsh, of the Glasgow Centre for Population
Health. The city once had some of the worst life expectancy rates in
the western world – for example in the central area of Calton, a
place blighted by poor housing, illness, high smoking rates, and
violence.
Inhabitants
suffered high death rates linked to drug and alcohol abuse and
suicides. As a result, at the beginning of the 21st century, the male
life expectancy in Calton at birth was 54, one of the worst figures
in the UK. Glasgow subsequently made major efforts to improve death
rates in Calton but is now watching life expectancies slide back
towards their old levels.
“I
think it is pretty clear that austerity is to blame,” says Walsh.
“We have taken away these people’s safety nets.”
The
grim future facing these young adults was summed up by Sir Michael
Marmot, professor of epidemiology at University College London. “If
you were to go to a young man growing up in Calton who is doing drugs
and alcohol and smoking and is unemployed and is unemployable and say
to him: ‘Look, you really shouldn’t smoke.’ Well, you wouldn’t
get far with him and, in any case, he might be quite rational for not
making long-term plans because he does not have a long-term future.”
The
crucial point is that health statistics tells us something
fundamental about how well a society is doing, says Marmot. “When
you see significant differences in life expectancy rates, that is
telling us something particularly important about how well society is
distributing its benefits.” According to Marmot, a former president
of the World Medical Association, a person with a university degree
in Britain has a longer life expectancy than a school leaver with
A-levels who in turn will do better than someone who did not sit
A-levels. “The higher your income the longer you live,” he
states. “Similarly, the higher the status of your occupation, the
longer your life expectancy.”
Equally,
the lower the step on the socio-economic ladder that a person stands
on, the more dependent they are likely to be on help or support from
local authorities. As a result, these individuals are
disproportionately affected when cuts are made to services.
“Two
years ago, I went out of my way not to blame austerity measures for
faltering life expectancy rates,” said Marmot. “Now I am much
closer to blaming them for the ills we are witnessing.”
Professor
Martin McKee, of the London School of Hygiene and Tropical Medicine
said: “Health authorities cannot continue to dismiss the
possibility of a link between cuts and lowered life expectancies. We
need to find precise answers and we need them urgently. The only way
to do that is to set up a proper public inquiry – as a matter of
urgency.”
Britain
is falling into a pattern that has emerged in the US where taxes –
and social care budgets – are low and where much of the healthcare
system is privately run. In the US, life expectancy started falling
significantly years ago. Causes of soaring mortality rates there
include spiralling
rates of drug overdose deaths and suicides. However, care of the
elderly and the very young is also under stress in many states.
“I
am worried that we are heading along the same route as the US,”
says Marmot. “We shouldn’t be. We should be investing
significantly in health and social care like the rest of Europe. Its
social policies are better for health and long life than American
social policies.”
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