The huge differences in life expectancy between rich and poor areas is the biggest human rights abuse in developed countries. Recent figures from the London Health Observatory found the gap in life expectancy between those in London’s affluent and deprived wards is now nearly 25 years. And separate analysis by The Equality Trust discovered that the gap in life expectancy for those in different UK local authority areas has increased 41 per cent for men and 73 per cent for women in the last 20 years.
Wherever you look, there are huge life expectancy differences between rich and poor neighbourhoods.
Growing health inequality is often portrayed as a result of people’s lifestyle choices. 'If only poorer people exercised more and smoked and drank a bit less than they too could enjoy the benefits of a longer and healthier life', so they say. But a 25 year life expectancy gap can’t simply be explained by a dedicated diet of booze, cigarettes and chips.
One of the greatest determinants of a person’s health is their income. Differences in average incomes between countries don’t seem to make much difference, but within societies income matters very much indeed. If you rank neighbourhoods from the richest to the poorest, you have, almost perfectly, ranked health from the best to the worst. And this isn’t just a problem of poverty. Even the areas which are just below the richest are slightly less healthy than the richest.
The solution to health inequalities is not to try and change people's health-related behaviours – a crass, ineffective approach that often fails to address why they have them in the first place. The key is to deal with the underlying issues of economic inequality.
Income inequality, relative poverty, unemployment, underemployment, insecure and volatile incomes and the low-pay economy many are now stuck in, all have a negative impact on people’s health. Quite understandably, the relentless grind of life at the bottom of the heap takes its toll on a person’s physical and mental well-being. The lazy stigmatising of poor people as junk-food munching wastrels hardly helps either.
After 30 years of the gap steadily widening between rich and poor, the UK now has a staggering and unusually high level of economic inequality. In fact, the richest 10 per cent now have 850 times the wealth of the poorest 10 per cent. As economic inequality has risen, so too has health inequality.
Perhaps the most shocking element of this is that we really shouldn’t be shocked at all. The link between economic inequality and health has been known for years, and yet policy makers continue to reach for well-meaning but fruitless solutions
Life expectancy inequalities should be seen as a sort of canary in the coalmine. Not only do they reflect all the other inequalities that afflict the UK- in income, education, social class, social mobility, life chances; but they also point towards future problems.
A country that allows its poorest citizens to die 25 years earlier than its richest is one that is likely to suffer from a worrying breakdown in the social fabric that binds society. This is far more than a health issue, it is an issue of how we see ourselves as a country, and how we treat the most vulnerable in society.
Kate Pickett and Richard Wilkinson are authors of the Spirit Level : Why Greater Equality Makes Societies Stronger
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