What is the difference between a girl born near Huntingdon and a boy born in Great Yarmouth today? She can expect to live more than 20 years longer than him.
The government’s Levelling Up White Paper, released in February, seeks to close the gap between the richest and poorest, aiming to improve healthy life expectancy by five years by 2035.
However data from the Office of National Statistics (ONS) shows that inequality was already rising before Covid19. Furthermore, the pandemic has disrupted long term trends in life expectancy, with a much larger effect on poorer areas. This casts doubt on whether the government can possibly achieve its target. What are the chances for Jaywick near Clacton, the most deprived area in England?
The long rise in life expectancy has stalled
Life expectancy is the number of years which the average person can expect to live. It has been rising steadily in most developed countries for two centuries. The average child born in the UK in 1841 would live to 40: by 2019 the figure had reached 80.
However, around 2011 this long term rise in life expectancy levelled off. For the first time since the second world war, life expectancy fell for some groups. When Covid19 struck, this had already begun in most western European countries, but was most marked in the UK. There is debate, and no agreement, among researchers about the causes.
Life expectancy is not the same for all groups of people. In general, women live longer than men, and people live longer in the South of England than the North, but life expectancy can vary by several years within a single city or county.
Further, for most people “healthy life expectancy” is considerably less that overall life expectancy. By the age of 64, most people no longer report that they feel “healthy”, and most report some disability which limits their everyday life. So the average 65 year old man will have 17 years in poor health, and his partner 22.
Unequal lives
Since the pandemic is not over, it is too soon to measure the true impact of Covid19, but preliminary evidence suggests that it has lowered average life expectancy by more than a year. Data from the ONS shows that the effect is much larger in the most deprived areas, with people from these areas reportedly spending less of their lives in good health.
David Finch, Assistant Director of Healthy Lives at the Health Foundation has called for “a fundamental shift” in the government’s approach to life expectancy. He argues that there is “a clear opportunity to move beyond the rhetoric and into action,” in the white paper on Health Disparities, due to be published later this year.
Life expectancy in East Anglia
Overall life expectancy is higher in the East than in England as a whole. Over the last 20 years it has risen here by about 2.5 years for women and 3 years for men. On average, boys and girls born in 2019, before Covid hit, can expect to live to around 80. However, since 2011, the rise has flattened for women, and for men it has fallen by a few weeks.
Of course, life expectancy is not the same in all places. The gap between the longest and shortest overall life expectancy, for both girls and boys, across the region is currently around 17 years.
- It is highest (reaching late 80s for boys and early 90s for girls) around Huntingdon, and in South Cambridgeshire and St Albans. Healthy life expectancy is also high in Hertfordshire, Suffolk and Central Bedfordshire
- It is lowest for boys (71) in Great Yarmouth, followed by Tendring (Clacton), and Lowestoft, and for girls (76) around Clacton, followed by Bedford and Great Yarmouth. Healthy life expectancy is also low in Luton, Peterborough and Thurrock
As a result, a girl born in Peterborough today can expect to remain healthy until 59, while a boy born in Central Bedfordshire will still be healthy at 67.
Life expectancy reflects deprivation
These differences in life expectancy reflect overall levels of deprivation. The ONS Index of Multiple Deprivation measures deprivation on seven broad factors: income, employment, education, health, crime, housing, and access to services.
In the Eastern Region, Luton, Peterborough and Thurrock are among the most deprived 40 Local Authorities, while Central Bedfordshire, Cambridgeshire and Hertfordshire are among the 40 least deprived.
But within Local Authorities there are stark contrasts. The ONS calculates deprivation indices for very small areas, each with a population of around 2,000 people, and ranks them in order of deprivation (from 1 as the most deprived to 32,845 as the least). Tendring, Waveney and Great Yarmouth dominate the most deprived list, with Jaywick near Clacton ranking as the most deprived area in England.
At the other end of the scale, Trumpington, near Cambridge, is the sixth least deprived in England, and every area in Uttlesford is in the top half of the deprivation scale.
There are also startling contrasts within individual Authorities. One of the most remarkable is Southend, with the most deprived area (to the east of the town centre) ranked 136, while Leigh on Sea, two miles away, is ranked 32,713.
Public health, not just personal choice
The national indicators suggest that Covid19 will have increased these inequalities. It is clear that “levelling up” is a challenge, not only across the region, but also within individual Authorities.
As Jo Bibby, of the Health Foundation says “there needs to be a fundamental shift in the government’s approach, from a focus on people’s individual responsibility and choices towards actively creating the social and economic conditions that enable them to live healthier lives. This means providing secure jobs, adequate incomes, decent housing and high-quality education. Improving health should be made an explicit objective of every major policy decision. Otherwise, the gap between rich and poor will further widen and ‘levelling up’ will remain little more than a slogan.”
Whether the government’s strategy is up to the challenge remains to be seen.
