A new report from the Institute of Health Equity (IHE) has found that a million people in 90% of areas in England died prematurely between 2011 and the start of the pandemic.
In contrast to the traditional focus on the health of the poorest, the new report, Health Inequalities, Lives Cut Short, considers the life expectancy of 90% of the general population who do not live in the ten percent of wealthiest areas.
Using several official data sources, the IHE made these calculations from the number of excess deaths – the increase in the number of deaths beyond what would be expected – in the decade from 2011 in England.
The report found that of the one million people who died prematurely, 148,000 of them were additional to what might have been expected if the post-2010 austerity measures hadn’t been imposed.
Additionally in 2020, during the pandemic, inequality between the least and most disadvantaged 10 percent of areas contributed further 28,000 excess deaths, when compared to that over the previous five years.
Previous research has shown that pre-2010 government policies were beginning to close the health inequalities gap. Such policies included coordinated investment in the early years, education and neighbourhood renewal, as well as healthcare.
However, the new findings from the IHE add weight to its two reviews of health inequalities in 2020 – that the cumulative impact of regressive funding cuts associated with austerity contributed to life expectancy failing to increase, life expectancy falling for women in the 10% of poorest areas, and health inequalities widening.
The IHE additionally analysed European Union data, comparing healthy life years (also known as disability-free life expectancy) in the UK to other EU countries.
The IHE found that, in 2014, both males and females in the UK had a higher average number of healthy years lived (HYL) than those in the EU. However, by 2017, HLY in the UK had stagnated for men and fallen for women. In the same period, HLY increased by more than two years in the EU. Consequently, ten EU countries had higher HLY than the UK for males, and 14 had higher HLY than the UK for females.
Established evidence shows people’s health is mostly determined by their social circumstances, with NHS care only accounting for 20 percent of population health.
IHE director Professor Sir Michael Marmot said: ‘If you needed a case study example of what not to do to reduce health inequalities, the UK provides it. The only other developed country doing worse is the USA, where life expectancy is falling.
‘Our country has become poor and unhealthy, where a few rich, healthy people live. People care about their health, but it is deteriorating, with their lives shortening, through no fault of their own. Political leaders can choose to prioritise everyone’s health, or not. Currently they are not.’
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