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Research on life expectancy highlights need for vital health inequalities efforts

Wednesday, 13 October, 2021
Research on life expectancy highlights need for vital health inequalities efforts

New research on life expectancy has underlined the importance of pioneering work on health inequalities in Northumberland and North Tyneside.

Imperial College London researchers have found that a substantial number of English communities experienced a decline in life expectancy from 2010 to 2019.

And in Northumberland and North Tyneside, there is a gap of 15 years between the best and worst life expectancy for women (91 and 76) and a 16-year gap (87 and 71) in men.

Looking at the national picture, in the five years before the pandemic (2014-2019), life expectancy went down in almost one in five communities for women and one in nine communities for men, according to the new study published in The Lancet Public Health journal and funded by the Wellcome Trust, Imperial College London, the Medical Research Council, Health Data Research UK and the National Institute of Health Research.

One of the report’s co-authors is Jonathan Pearson-Stuttard, who is also chair of Northumbria Healthcare NHS Foundation Trust’s Health Inequalities Programme Board, which was set up earlier this year with the goal of identifying exactly what the inequalities are in our communities in Northumberland and North Tyneside and developing meaningful ways of tackling them.

“These stark gaps in life expectancy and large differences in life expectancy trends across England over recent years demonstrate the need for proportionate and targeted action to address worsening inequalities,” Jonathan said. “This was one of the key driving forces behind the efforts of the Trust’s health inequalities board and a crucial partnership approach, which builds on years of established work across the region.

“The programme board is all about making a real difference to the inequalities across our patients and populations. For example, we are working with the Office for National Statistics (ONS) to develop the first local health index, which will provide us with actionable insights into what drives these persistent inequalities, meaning that we can then introduce effective preventive changes to the health system targeting those with the highest unmet health need.”

Although recent ONS data found that life expectancy for men in the UK had fallen for the first time in 40 years due to the Covid-19 pandemic, the new research shows that life expectancy was declining in many communities for years before the pandemic began.

Sir James Mackey, Northumbria Healthcare’s chief executive, said: “Inequalities in our communities and, most importantly, how they impact on healthcare and health outcomes have long been a focus for us and a key factor that informs our planning. However, Covid-19 has clearly provided another reminder of how entrenched these can be and how much work still needs to be done in this arena.

“That’s why we are leading the way in efforts to tackle these inequalities, not just through our inequalities partnership board and the important and pioneering developments it will be bringing forward, but also Our Community Promise, which is our pledge to make a difference to our population through many of the social determinants of health and the ways we can have an impact, such as education, employment and the economy.”

The new study analysed all deaths in England for all years from 2002 to 2019, amounting to more than 8.6 million records, and assigned people to where they lived at the time of death, based on communities of around 8,000 people, while other statistics are typically based on much larger areas.

It found that between 2002 and 2010 the vast majority of communities saw their life expectancy increase. However, from 2010 to 2014, longevity began declining for women in one in 20 communities and in one community for men. This deterioration accelerated and spread from 2014 to 2019, with life expectancy declining for women in almost one in five communities and in one in nine communities for men.

The researchers note that the regions where life expectancy declines occurred often already had lower life expectancy, alongside high levels of poverty, unemployment and low education. In comparison, between 2002 and 2019, life expectancy increases of nine years or more were seen for men and women in some parts of central and north London.

These trends created stark geographical differences. Communities with the lowest life expectancy were typically located in urban areas in the North, including Leeds, Newcastle, Manchester, Liverpool and Blackpool. Communities with the highest life expectancies were often based in London and the surrounding home counties.

The national gaps between the communities with the lowest and highest life expectancies reached 20 years for women (95.4 years in one part of Camden compared to 74.7 in a community in Leeds) and 27 years for men (95.3 years in Kensington and Chelsea against 68.3 years in a part of Blackpool).

Lead author, Theo Rashid, from the School of Public Health at Imperial College London, said: “These results mirror an earlier trend in the USA – which also saw life expectancy declines prior to the pandemic.

“In both England and the USA, life expectancy declines are associated with unemployment and insecure employment following deindustrialisation, compounded by reductions in social and welfare support, and reduced funding for local governments. These factors had larger effects in the north of England than in London and southern parts of the country.”

His colleague, Professor Majid Ezzati, one of the senior authors, added: “There has always been an impression in the UK that everyone’s health is improving, even if not at the same pace. These data show that longevity has been getting worse for years in large parts of England.

“Declines in life expectancy used to be rare in wealthy countries like the UK, and happened when there were major adversities like wars and pandemics. For such declines to be seen in ‘normal times’ before the pandemic is alarming, and signals ongoing policy failures to tackle poverty and provide adequate social support and healthcare.”

Media contacts

Ben O’Connell, Northumbria Healthcare media and communications officer

Benjamin.O’ or 07833 046680.

Emily Head, Media Manager (Medicine), Imperial College London or 020 7594 6900.