Inequalities in life expectancy and healthy life expectancy have widened in England over the past decade, largely because of social and economic conditions, a report reveals.
The research, which marks 10 years since the publication of the Marmot Review, shows widening inequalities have been particularly severe among women.
Female life expectancy declined in the most deprived 10% of neighbourhoods between 2010-12 and 2016-18 and there were only negligible increases in male life expectancy in these areas.
There are also growing regional inequalities in life expectancy, with life expectancy lowest in the North East and highest in London.
Overall, life expectancy in England has stalled since 2010 – something that has not happened since at least 1900.
“If health has stopped improving it is a sign that society has stopped improving. When a society is flourishing health tends to flourish,” the authors wrote.
The research reveals the gradient in healthy life expectancy is steeper than that of life expectancy, which means people in more deprived areas spend more of their shorter lives in ill-health than those in less deprived areas.
Overall, the amount of time people spend in poor health has increased across England since 2010.
“The national government has not prioritised health inequalities, despite the concerning trends and there has been no national health inequalities strategy since 2010,” the authors said. “We see this as an essential first step in leading the necessary national endeavour to reduce health inequalities. The goal should be to bring the level of health of deprived areas in the North up to the level of good health enjoyed by people living in affluent areas in London and the South.”
The authors argue there is no biological reason for stalling life expectancy and widening health inequalities, pointing out that other countries are doing better – even those with longer life expectancy than England.
“The slowdown in life expectancy is not down to exceptionally cold winters or virulent flu, and cannot be attributed solely to problems with the NHS or social care – although declining funding relative to need in each sector will undoubtedly have played a role. The increase in health inequalities in England points to social and economic conditions, many of which have shown increased inequalities, or deterioration since 2010,” they said.
The researchers found there has been an increase in poor quality work, including part-time, insecure employment.
The number of people on zero hours contracts has increased significantly since 2010 and the incidence of stress caused by work has also increased.
Meanwhile, real pay is still below 2010 levels and there has been an increase in the proportion of people in poverty living in a working household.
Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said the government must boost spending on public health and, in next month’s Budget, prioritise funding for the most deprived areas first.
“It is not enough for the government to state that austerity is over. Failing to invest in preventative care will just pile pressure on A&E departments, GPs and other front-line services and the evidence that services such as sexual health clinics and smoking cessation work is overwhelming,” he argued.
Dickson claimed new integrated care systems offer an opportunity for health and local government alongside primary care networks to work together as they will hold responsibilities for population health and ensure that health services benefit people equally.
“With proper funding for both health and care, this is a real opportunity to provide new types of service based on what is best for their local communities,” he added.