How To Tackle England’s ‘Increasing’ Health Inequality

By Aaron Walawalkar, News and Digital Editor 25 Feb 2020
Helpers at a food bank in Cambridge. Credit: Kartik Raj

Experts have urged the government to take action as the life expectancy gap between the richest and poorest parts of England widens.

A report from the Institute of Health Equity has revealed that England’s life expectancy has flatlined for the first time in a century.

It also found that the difference in life expectancy at birth between the least deprived 10 percent and most deprived 10 percent of areas was 9.5 years for men and 7.7 years for women in 2016-18 – up from 9.1 and 6.8 respectively in 2010-12.

In the poorest 10 percent of areas, women’s life expectancy dropped between 2010-12 and 2016-18.

Prof Sir Michael Marmot, one of the country’s leading experts on health inequality, produced the report 10 years on from his first review into England’s health gap.

“England is faltering,” he wrote. “From the beginning of the 20th century, England experienced continuous improvements in life expectancy but from 2011 these improvements slowed dramatically, almost grinding to a halt.

“For part of the decade 2010-2020 life expectancy actually fell in the most deprived communities outside London for women and in some regions for men.

“For men and women everywhere the time spent in poor health is increasing.”

Across England, men’s life expectancy rose by about half a year from 79.01 in 2010-12 to 79.56 in 2016-18, while in women it increased by about a third of a year from 82.83 to 83.18 during the same period.

Marmot added that, while it cannot be definitely proved, there is an “entirely plausible” link between widening health inequalities and a decade of austerity measures.

“Austerity will cast a long shadow over the lives of the children born and growing up under its effects,” he wrote.


What Can Be Done?

The report contains a list of 25 recommendations the government must adopt “as a matter of urgency” to address the widening health gap. These include:

  • reducing levels of child poverty to 10 percent – in line with the lowest rates Europe
  • improving the quality and availability of early years services, such as Children’s Centres
  • investing in preventative services to reduce school exclusions
  • developing a national strategy for reducing inequalities in health, led by the prime minister
  • aiming for net zero carbon emissions by 2030
  • reducing high levels of poor quality work and precarious employment
  • ensuring a healthy standard of living for all
  • investing in the development of deprived areas

In his foreword, Marmot endorsed a message he had written 10 years ago in his initial review:

“Health inequalities are not inevitable and can be significantly reduced… avoidable health inequalities are unfair and putting them right is a matter of social justice.

“There will be those who say that our recommendations cannot be afforded, particularly in the current economic climate.

“We say that it is inaction that cannot be afforded, for the human and economic costs are too high.”

Responding to the report, Health Secretary Matt Hancock told the BBC: “There is still much more to do, and our bold prevention agenda, record £33.9bn a year investment in the NHS, and world-leading plans to improve children’s health will help ensure every person can lead a long and healthy life.”

  • Read the full report here