by Steve Bishop

The general expectation that the life chances of successive generations should be greater than those preceding them has been a widely accepted goal of social policy for almost a century. The assumption has been that we will live longer, be healthier and enjoy a greater standard of living than our parents and grandparents.

Even the brutal assault initiated by the Thatcher regime, on the post war social democratic achievements of the NHS, Council housing, comprehensive education, nationalised industries and local government, was given the ideological fig leaf that the benefits of greater wealth for a few would ‘trickle down’ to benefit us all. Such a smokescreen could not fool all of the people all of time but as long as enough people continued to benefit the myth of a benevolent, people friendly capitalism could be pedaled. The Blair/Brown years of Labour government did little to disabuse the population of this notion and, if anything, exacerbated the view that a general increase in wealth at the top would benefit those at the bottom. As life expectancy in general continued to rise this illusion could continue to be sustained. A decade into the austerity programme initiated following the 2008 financial crisis however, the landscape is changing.

LIFE EXPECTANCY DECREASES

The British Society for Population Studies (BSPS) is a London School of Economics supported society with the stated objective, “to further the scientific study of biological, economic, historical, medical, social and other disciplines connected with human populations and to contribute to the public awareness of them.” In July the BSPS held a conference in London to consider the issue of “Stalling Life Expectancy”, addressed by a range of keynote speakers, concerned that since 2014 life expectancy in the UK has fallen by just over a year for both men and women.

Early warnings of this trend were denounced by the Department for Health as “a triumph of personal bias over research”, but in a climate where we are also witnessing a widening gap in life expectancy between the rich and the poor, this cannot be ignored. The trend, first noticed in 2013 following decades of increasing life expectancy, indicated a flattening out before starting to decline for increasing numbers, with the poor and the newborn the worst affected.

Danny Dorling professor of social geography at Oxford University, and organiser of the BSPS conference stated, “Our faltering life expectancy rates show we have now got the worst trend in health anywhere in western Europe since the second world war. To achieve that, we must have made a lot of bad decisions.”

The trend in the UK flies in the face of improved life expectancy levels found in other parts of the world, including Hong Kong, mainland China, Japan and Scandinavia. The Department of Health claims that flu epidemics, triggered by harsh winters, were killing the weak and elderly, raising mortality rates and reducing life expectancies. However, this claim contradicts data which shows that five of the seven winters between 2011 and 2017 had above-average temperatures, making them unlikely triggers of flu epidemics.

Recent data produced by the Office of National Statistics (ONS) supports the concerns. The ONS figures show that from 2006 to 2011, life expectancy at birth of females in the UK rose by 12.9 weeks per year, but between 2011 and 2016 the rate of increase dropped by 90% – more than in any other country analysed – to 1.2 weeks per year. Among males, only in the US was there a greater slowdown in life expectancy growth at birth than in the UK, where improvements dropped by nearly 76%, from 17.3 weeks per year between 2006 and 2011 to 4.2 weeks per year between 2011 and 2016. The trends in the United States are a salutary warning of the direction of travel in the UK, where a decade of austerity has had a dramatic impact upon health, welfare and social care services. The austerity programme pursued by the Tory government, initially propped up by the Liberal Democrats and more recently given a lifeline by the Democratic Unionist Party, has resulted in an estimated £30bn being taken out of essential public service provision in the past decade. 

Many epidemiologists are now arguing that a causal link between austerity and early deaths cannot be discounted. Dr Lucinda Hiam, an honorary research fellow at the London School of Hygiene and Tropical Medicine, has stated, “Life expectancies started to stall just after the austerity cuts were introduced. That alone does not prove the latter was the trigger for the former. However, no other plausible suggestion has since survived scrutiny, so it is hard not to conclude austerity cuts are involved.”

In US cities such as Baltimore the difference in life expectancy between richer and poorer districts can be as much as 20 years. Not far behind, in the UK the same comparison for Kensington and Chelsea reveals a life expectancy difference of 16 years.

According to the 2019 edition of the Bloomberg Healthiest Country Index, Canada’s 16th-place ranking far surpassed the United States, which dropped slightly to 35th place. Life expectancy in the US has been trending lower due to deaths from drug overdoses and suicides. It is also worth noting that Cuba was placed five spots above the US, making it the only nation not classified as "high income" by the World Bank to be ranked so far up. The UK came in at 19^th behind many other European nations including Spain, Italy, France and the Netherlands.

INEQUALITY

In the UK it can be no coincidence that unearned income, from property, interest, dividends and investments rose by 40% between 2010-11 and 2015-16. For the top 10% that has meant an annual average increase in unearned income of £38,000 a year at a time when household income averaged £25,000 in 2015-16, according to latest HMRC data. This data goes on to show that more than a quarter of the population had no unearned income, relying entirely on paid employment, the value of which fell in real terms over the period, not paying enough to keep up with inflation. Those with unearned income outside of the top 10% made just £28 on average, modest income on some modest savings, a far cry from the figures earned by those at the top.

This disparity in income is inevitably reflected in a disparity in life chances as the tax system rewards those with wealth, rather than those who work to create wealth. Poor life chances mean less chance of succeeding in education, more chance of engaging in risk taking behaviour, indulging in poor diet choices, succumbing to the escapism of drugs and alcohol and, therefore, a greater likelihood of reduced life expectancy.

It would not be difficult to predict which areas of Baltimore or Kensington and Chelsea would house those enjoying the fruits of massive unearned income dividends and those getting by on average household income. For those on low pay or benefits the scenario is even more bleak.

Labour Shadow Chancellor, John McDonnell, commenting on the HMRC figures stated,

“An economic model that rewards wealth creators less than wealth extractors is not sustainable economically or morally.”

Clearly a Conservative government of any hue is not going to change this situation. Having established a corporation tax haven based low wage, low regulation economy, precisely to make life easier for transnational corporations and the City of London, they will not change their spots, however many election friendly promises Boris Johnson may make about investing in the Northern Powerhouse.

A Labour government under Jeremy Corbyn fired by a manifesto addressing the needs of the many not the few, as in 2017, could begin to turn the tide with mass popular support. The wealth divide in the UK is increasingly in danger of becoming an even greater health divide than at present. Redressing that imbalance can only begin with better life chances, an economy which guarantees job security and a health and social care system which truly provides support freely from cradle to grave.

Even that would only be a start, tiny steps on the road to an economy which guarantees peace, health, homes and jobs for all its citizens, but steps that must be taken.

Margaret Thatcher, architect of austerity

Billboard outside mansions in Rich Lane, Kensington and Chelsea. By Paul Farmer