Austerity blamed for stalling life expectancy

For the first time in more than 100 years, life expectancy has failed to increase across the country, and for the poorest 10% of women, it has declined, a report by the Institute of Health Equity found.

Marmot Review: 10 Years On revealed that over the last decade, since the publication of The original Marmot Review, health inequalities have widened overall, and the amount of time people spend in poor health has increased.

The report found public funding cuts have had the most impact on the most deprived communities outside of London and the south-east, and accentuated the north-south divide.

While public sector spending on services went from 42% of GDP in 2009-10 to 35% in 2018-19. With some of the most deprived 20% of authorities, such as Liverpool, suffered the biggest funding cuts.

The review also found that the more deprived the area, the shorter the life expectancy, a social gradient has become steeper over the last decade, with the women in the most deprived 10% of areas suffering a fall in life expectancy from 2010-12 and 2016-18.

While mortality rates are increasing for men and women aged 45-49, which report author Professor Sir Michael Marmot says could be related to so-called ‘deaths of despair’ (suicide, drugs and alcohol abuse) as seen in the USA.

‘This is shocking. In the United Kingdom, as in other countries, we are used to life expectancy and health improving year on year. It is what we have come to expect. The UK has been seen as a world leader in identifying and addressing health inequalities but something dramatic is happening.

‘Put simply, if health has stopped improving it is a sign that society has stopped improving.

‘Austerity has taken its toll in all the domains set out in the Marmot Review. From rising child poverty to an increase in precarious work and zero-hours contracts.

‘From the housing affordability crisis to a rise in homelessness as well as an increase in the number of people with insufficient money to lead a healthy life who are resorting to foodbanks in large numbers and ignored communities with poor conditions and little reason for hope.

‘And these outcomes, on the whole, are even worse for minority ethnic population groups and people with disabilities.

‘We cannot say with certainty which of these adverse trends might be responsible for the worsening health picture in England. Some, such as the increase in child poverty, will mostly show their effects in the long term.

‘We can say, though, that austerity has adversely affected the social determinants that impact on health in the short, medium and long term. Austerity will cast a long shadow over the lives of the children born and growing up under its effects.

‘Given the strength of evidence on social determinants and health inequalities, it is not an act of hubris to speculate that had the government acted on all the recommendations in the Marmot Review, health would have continued to improve and health inequalities not have grown larger.

‘Certainly, a report we subsequently prepared in 2012 warned of the risks to health from austerity policies.’

Cllr Ian Hudspeth, chairman of the Local Government Association’s community wellbeing board, said public health funding grants to councils have been reduced by £700 million in real terms from 2015/16 to 2019/20.

‘This report is a significant wake-up call about the need to tackle the widening health inequalities across the country.

‘Councils want to work with government on closing this gap by focusing on the social causes of ill-health, such as early years development, education and employment opportunities and improving services for older people.

‘Sustainable, long-term investment in councils’ public health services is also needed if we are to reverse reductions in life expectancy and tackle health inequalities across the country.

‘Councils know their communities best and are committed to improving their health. Through their services, councils help people live longer and in greater health, in better conditions while improving their emotional, mental and physical wellbeing.

‘We have long argued that previous reductions to the public health grant have been a false economy, which only compound acute pressures for NHS and social care services further down the line.’

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