Life expectancy is one of the most important indicators a country can produce about the health of its population. Any deterioration in it is a marker of significant underlying societal problems.
In early August, the Office for National Statistics (ONS) produced two alarming reports on life expectancy confirming that something is very wrong with health in the UK. The reports analysed changes in mortality rates across the UK and internationally, comparing 20 countries from 2001 to 2016. They show that life expectancy in the UK increased for a number of decades before 2011, and then stalled between 2011 and 2016.
The UK and US had the slowest improvement in life expectancy of all 20 countries in the period 2010 to 2016. Prior to this, in the period 2004 to 2010, these two countries were among the top five and were seeing the fastest improvements. This is a very sudden change.
By 2016, only three of the 20 countries analysed had lower male life expectancy than the UK: Poland, the Czech Republic and the US. The other 15 are all doing better and many of them showed little or no slowdown in their rising life expectancy.
Women in the UK saw the greatest slowing of life expectancy: annual improvements reduced by 90% from 12.9 weeks to 1.2 weeks per year between 2011 and 2016 and the six years prior to that.
According to the ONS, female life expectancy at birth in the UK in 2014 was 82.99 years; in 2016 it was 82.84. (For men, it was 79.25 years in 2014 and 79.18 two years later.) In addition to the Czech Republic, Poland and the US, Germany also fared less well for women.
Portugal and the Czech Republic would do better if they didn’t lose so many of their young people through migration to the UK. The influx of young, healthy migrants makes the picture in the UK look better that it really is. For example, in 2015, which saw the greatest increase in mortality in the UK since 1968, the only age group that didn’t see mortality rates rise was that aged 25 to 29 – which benefited from the largest net inflow of 60,000 migrants.
Even more recently, there has been a steeper drop in the number of non-UK nationals from the EU working in the UK, with the total falling to 2.28m by April to June 2018. As migrants to the UK from the rest of the EU tend to be young and healthy (compared to the population they join) we should expect to see this affecting the reported health of the UK in future. However, the new ONS statistics clearly show that the peak of life expectancy in the UK was reached in 2014 and has been lower since then, long before the UK voted to leave the EU, and before EU migrants stopped arriving in the numbers that they had been.
The MP Robert Court has suggested the slowdowns are simply human life expectancy reaching a natural plateau. But the data do not support this. Things are not only still getting better in some countries, but getting better even faster than before. The top three countries for improvements in recent years for men are Japan, Norway and Finland, while for women they were the Czech Republic, Denmark, Japan and Italy.
It could get worse
Worryingly, these data are so far only available internationally to 2016. The last two years, 2017 and 2018, have shown an even greater increase in deaths in the UK, with 10,375 extra deaths in the first seven weeks of 2018 alone when compared to the average for the last five years. A quarterly mortality report published by ONS in June, showed a statistically significant increase in mortality rates of 5% for January to March 2018 when adjusted for age changes of the population. These figures suggest the next report on life expectancy will be an even greater cause for concern, and the one after that will be worse again.
The search for a cause is narrowing. When exploring the increase in deaths in 2015, we proposed four possible causes: an epidemic, a natural disaster, errors with the data, or problems with the function of the health and social care system. There has been no natural disaster or environmental event. The suggestion of influenza or cold weather causing the increase in deaths is no longer a plausible hypothesis. This is not a blip, but a sustained, consistent reversal of previous health improvements. Cuts to health and social care under the guise of austerity since 2010 coincide with increasing mortality, and now not only slowing of life expectancy improvements, but for some, worsening life expectancy.
When asked to respond to the latest ONS figures, a spokesperson for the Department of Health and Social Care said: “The latest stats show that life expectancy is increasing and we are committed to helping people live healthier lives.” The response refers to the fact that overall, there was a small rise in UK life expectancy for both men and women between 2015 and 2016. Yet, when asked if the government was concerned that life expectancy in 2016 still remained below the level reached in 2014, the spokesperson said: “The number of deaths can fluctuate each year but generally people are living longer.”
The government’s response is not sufficient. Persistent concerns from academics, doctors, professional bodies, and public health experts have been consistently disregarded by the DHSC. When asked directly, people in the UK said their health was getting worse, year on year, from 2011 to 2014. Yet they too were ignored.
The poor life expectancy record of the UK between 2010 and 2016 is shocking, especially when contrasted with how fast life expectancy was improving in the six years before then. Out of the 20 countries that the ONS compared, only the US has a worse trajectory. The new statistics, and the timing of the trends, with deteriorating health occurring after 2010, suggest that the US and UK handled the financial crisis of 2008 very badly compared to countries that have had better health outcomes. The question this raises is – why?
These figures are not just numbers. They are human lives. The government can no longer ignore all those who are calling for them to act. The time for excuses and empty statements has long passed – urgent action is needed.