Sunday, October 18, 2020

Life expectancy, morbidity, and the pandemic

  In 2019, life expectancy at birth in the UK was 82.9 years for a woman and 79.2 years for a man (the average for both was 81.1 years). These numbers look good, especially when compared with historical figures. In 1950, for example, the average life expectancy at birth for a UK citizen was 68.9 years. The combined effects of economic growth, better education and an improved NHS have delivered an extra 12 years of life. Impressive.

That is until you start comparing the UK with other European countries. When you do this, you find we have seen smaller increases in life expectancy than the western European average – 5.3 years compared with 5.7 years.

Spain and Italy, for example, both had an average life expectancy at birth of 83.1 years in 2019. In France, it was 82.9 years, Sweden 82.8 years and Germany 81.2. The western European average life expectancy was a whole one year longer than in the UK.

The average healthy life expectancy for the UK in 2019 was 68.9 years, meaning that people in the UK spend an average 12.2 years living with some kind of illness.  Britain has the worst healthy life expectancy of any other European country. We come bottom of the league table. We’ve seen a slower improvement in healthy life expectancy (3.6 years) than the western European average (5.8 years).

 And the situation for children is equally bad: the under-five mortality rate in the UK in 2019 was 4.1 deaths per 1,000 live births – one of the worst performances in western Europe, second only to Malta. 

Across the four nations. Scotland has the lowest life expectancy (79.1 years), followed by Northern Ireland (80.3 years), Wales (80.5 years), and England (81.4 years).

The major causes of Britain’s poor health are noncommunicable diseases such as diabetes, chronic respiratory disease and dementia. The Global Burden of Disease shows that deaths from alcohol and drug use have increased by 280% and 166% respectively over the past 30 years. And the health of our nation is not uniform across the country. There’s an eight-year difference in life expectancy between the north and the south of the UK. Life expectancy is highest in Richmond (84.5 years) and lowest in Blackpool (76.4 years) – worse than the average for China, Turkey, Thailand, Cuba, Chile, Jordan and even the US.

The lowest 10 expectancies in England skew towards the poorest places in the north-west and north-east of the country: Blackpool, Middlesbrough, Hull, Liverpool, Hartlepool, Rochdale, St Helens, Sunderland, Blackburn and Manchester. 

Is it a coincidence that the worst life expectancies in England track the upsurge in coronavirus?

The virus has exposed the inequalities that divide our society. It is deprived areas such as Bolton and Rochdale where infections have been endemic. It’s no accident that Liverpool, which scores high on the list of the UK’s most deprived places, was the first region to be classified as very high risk in Johnson’s recalibrated approach to Covid-19.

At the beginning of the pandemic, 1.5 million people in England were deemed at sufficiently high risk of coronavirus to require shielding. The unfortunate truth is that far more people in the UK are at risk than this number suggests. As work from University College London revealed earlier this year, when one includes those over 70 years of age, and those who are under 70 but live with chronic diseases such as diabetes or cancer, the actual number at risk in the UK is more than 8 million people.

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