Health inequality is blighting the UK

Life expectancy is going up, but so too is the gap between rich and poor

Richard Wilkinson
Friday 25 October 2013 16:06

Yesterday’s publication of life expectancy figures seemed to reveal a population living longer, healthier, and according to some, happier lives. But this obscures a more important story - the persistent and alarming gap in life expectancy between those at the top and bottom.

Overall, health has indeed improved, but at much the same rate as it has for over 100 years. But analysis by The Equality Trust has found that in the last 20 years alone, the gap in life expectancy for those in different local authority areas has increased 41 per cent for men and a staggering 73 per cent for women.

The Local Authority with the highest male life expectancy is East Dorset. Here men can now expect to live almost a decade (8.9 years) longer than those in Blackpool, the authority with the lowest life expectancy. The gap is just as dramatic for women. Those in Purbeck live over 7 years longer than those in Manchester, and there is now an 18 year difference in 'healthy life expectancy' between women living in Richmond (72 yrs) and Tower Hamlets (54 yrs).

The reasons for widening health inequalities may be complex, but one contributing factor is the huge growth in economic inequality in the UK over the past 30 years.

There is a well-established social gradient in life expectancy and health, with poorer people experiencing worse health than the wealthy. A large and growing body of research suggests that this is because socio-economic inequality is itself a root or ‘fundamental cause’ of health inequalities. In short, due to the unequal distribution of income, wealth and power, the wealthy are able to protect and improve their health; the poor are not.

Since the early 1980s, economic inequality in the UK has grown astronomically. The richest 10 per cent of households now own 40 per cent of the UK’s wealth. This is 850 times the wealth of the bottom 10 per cent. If income distribution was the same as it was in 1977, the bottom fifth would get £2,000 a year more, the top fifth £8,000 less. Given this growth in economic inequality, it is perhaps unsurprising to see a similar growth in inequality in health outcomes. In fact, a recent report from Health Scotland argued that the only way to reduce the social gradient in health is to reduce inequality in income and wealth.

It is not only those at the bottom who should be concerned with widening inequality - it may affect us all. Most developed countries enjoy about the same rate of improvement in life expectancy regardless of their rates of economic growth. However, when inequality increases, improvements in health are a little slower and when it decreases they are a little faster. When a really catastrophic change in inequality occurs this can actually push health improvements into reverse. For some Easter European countries, this was the case after the social and political upheavals of the early 1990s. In these countries life expectancy dropped very dramatically, and in some has still not made up the lost ground over 20 years later.

Health inequality also poses a number of specific challenges for policy makers. How can government possibly calculate a fair and reasonable retirement age when there are such wild fluctuations in life expectancy in different areas?

Despite the damaging effects of growing disparities in health, there is a real danger that the Coalition will sweep this issue under the carpet. A recent ONS consultation in response to expected budget cuts has proposed that statistics on health inequalities no longer be collected. This would create a huge barrier to those wishing to identify and address health problems.

But as our research shows, economic inequality is not only a health issue. More unequal societies are more likely to experience poorer literacy rates, higher incidents of drug addiction, greater levels of violence and a multitude of other social ills. Just last week government advisers called for measures to reduce inequality in order to reduce child poverty and remove barriers to social mobility. Such measures would allow more of us to live longer, healthier, more productive lives. But talk is cheap. If we want a healthier society the Government must take steps now to reduce the UK's dangerous and corrosively high levels of economic inequality.

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