How the power to delay death has allowed inequality to flourish

Homeless in locked down London. Victoria Jones/PA Wire/PA Images

Two years ago my second child was born with a condition which meant he could not breathe unaided. I thought he was going to die. My perspective on the world changed in those early days of his life, as he used a breathing device and then a ventilator, and then received a tracheostomy at two weeks old.

Facing your own mortality, or that of someone close to you, is life changing. But recognising our mortal vulnerabilities is also a fundamentally important part of human nature.

Not facing up to them – until we are forced to by a crisis like coronavirus – is not good for society. Yet for many years in many Western societies there has been a collective reluctance to face our mortality and the reality of our fallible physiological condition.

Psychologists and sociologists have examined this sense of denial of death since the 1960s, a period without world wars or pandemics which has witnessed incredible advances in medical technology. Over that time, people have lived longer and longer lives.

The average age of death in the UK is now 79 for men and 83 for women. Those who die prematurely or before their parents are considered as out of sync with the natural order of things.

But now a global pandemic is happening. So what can we hope to learn from it?

As an academic who has worked on death and society for almost two decades, I barely know where to start. But I do feel that the pandemic provides us with a perfect opportunity to reassess how we value life, death and what happens in between – particularly with regard to social and economic equality.

A couple of weeks ago the BBC news presenter Emily Maitlis was widely praised for drawing attention to the deep societal inequalities that coronavirus has exposed. My favourite antihero Jonathan Pie also predicted how COVID-19 would lay bare the enormous economic inequalities inherent in the UK, where “the rich are protected and the poor and vulnerable aren’t”.

Controlling life and death has meant that the workplace – where we sell our labour – has changed radically in the past 60 years. Since the birth control revolution of the 1960s, millions of women have entered the labour market (while typically remaining responsible for the lion’s share of child rearing). And a gradual economic shift towards a service economy and away from production and manufacturing has led to much less hazardous workplaces – and fewer work-related deaths – for most in the UK.

This means that the average person can now expect to spend 50 years of their life working. That’s five decades spent trying to generate sufficient income to cover living costs, and if possible, some savings for a retirement spanning another 20 or so years.

Older and wiser?

These changes to working lives, and the financial imperative to earn enough to live, have perpetuated economic inequalities. Those born into affluent families race up the occupational hierarchy and housing ladder compared to those born into poverty.

Highly educated and relatively wealthy people feel more equipped to self-advocate for their healthcare and can better afford high-quality, nutritious food. They inevitably live longer than their poorer counterparts, as during their working lives they live in larger accommodation with outside space, eat better, and have more stable and secure employment.

Medical and public health advancements have therefore contributed to the growth of the gap between the richest and the poorest in society. And coronavirus has shown in stark terms how, despite extraordinary measures to cover some people’s wages during lockdown, those at the bottom of society simply cannot afford to be unwell.

So in terms of what we can learn from COVID-19, as we reflect on the social and economic cost of this pandemic, we will need to assess how we view and accept our own mortality and that of others.

This requires a sensible debate about life expectancy and poverty. About whether we need, or want, to continue to constantly strive for longer and longer lives – and at what cost. The more people who live into their 90s and beyond, the greater the financial pressure on the workforce, and the more socio-economic inequality thrives.

Moments where we fully realise that we are not invincible, individually and collectively, are profound. As I did when my son was born, facing the very real possibility of death can forever alter how you see the world.

While delaying death can be regarded as a medical and public health success, and something of a modern luxury, it has allowed social and economic inequality to grow unfettered. Such inequity has to stop. Let this be a life-changing moment for all of us.

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