I grew up in the North of England in a town called Hull. We lived in East Hull which is the dock area and at one time had a thriving fishing fleet. I left before going to university but many of my class mates lived there all of their lives. The average life expectancy for a child born today on the streets where I played, is 74.1 years for a man and 78.7 years for a woman. I now live in the countryside outside Oxford. The life expectancy for a child born to one of the families in my village is very different. It is 83.5 for men and 86.4 years for women. There is almost a decade difference with East Hull.
The streets of East Hull are now the 21st most deprived area in the UK. The life expectancy for a child born their today is the same as Peru for men and Algeria for women. Suppose the countryside of the South East of England was a country. The men would live longer than any country in the World, including Japan. The women would rank fourth globally after Hong Kong, Japan and Macao. Such is the discrepancy within a single country like the UK.
The data comes from the UK Government Office of National Statistics. They have divided the country in to small areas based on “deprivation”. Deprivation is defined based on seven different domains. Some are economic domains that relate to income, employment and training. Others relate directly to health and to the living environment. Lifestyle is included with “Crime” and “Barriers to Housing and Services”. Using the index they have created ten deciles and then looked at health outcomes for each decile. My childhood streets are now in the lowest decile. Hull, as a City, is in bottom 20% , with half of its population in the bottom decile.
The overall UK averages show women live longer than men. But men in Oxfordshire will outlive women in Eat Hull. The life expectancy gap between deciles is increasing rather than decreasing. According to the latest data, men and women in the top decile are seeing significant life expectancy increases. People in the lowest decile saw no such improvement.
Living Healthier Longer.
“Healthy life expectancy” mirrors the longevity numbers (Newsletter #027). Men in the most deprived areas can expect to live for 52.3 years of their life healthy. In the top decile those men can expect 70.7 years of healthy living. That is an 18 year difference in the right to live a normal healthy life. Women in the bottom quartile fare just as badly. Their “disability-free” life expectancy varies between 50.7 years in those most deprived areas to 66.5 years in the least.
Inequality All over the World
The GINI index is a statistical measure of income inequality. It ranges from 0 to 100%. A country where everyone earned the same amount of money would have a GINI index of 0. A country where a single person earned all the money would have a score of 1. It is not a measure of how rich or poor a country is, since it only measures the “division of the spoils”. Norway has one of the lowest GINI scores at 24.9. The UK has score of 32.8 alongside countries like New Zealand and Romania. The USA has a GINI index of 48.4. The US index is the highest it has been for 50 years. It now ranks with the Peru and Bulgaria.
The inequality is reflected in all the indices we have been looking at in these Newsletters. Infant mortality is the number of live born babies that die in the first year of their life. It is 1.8 per thousand in Norway, 3.6 in the UK and 5.4 in the USA. These are the averages. Infant mortality is comparable between Europe and the USA in affluent groups. The majority of the shortfall comes from the disadvantaged groups. There is a 14.6 year gap between life expectancy in the top 1% by income in the USA and the bottom 1%. The result is that the USA has an average life expectancy of only 79.1 years. This is just behind Cuba but ahead of Panama. The UK is at 81.8 and Norway 82.6.
A Third Age Problem?
The USA data suggests a Third Age problem. Between the ages of 20 and 60 there is not much difference in mortality at any given age between Europe and the USA. Above that more people in the USA are dying. The causes are “behavioural ”. These are deaths related to smoking, drug use and obesity. Behavioural deaths rose so much between 2014 and 2017 that US average life expectancy declined for the first time. Poverty comes to people with age. Life extending does not necessarily match with savings and pensions.
In previous Newsletters I have linked longevity to the growth of prosperity (Newsletter #020). Governments increasingly value their citizens and take steps to protect them. The “great Stink” forced parliament to build public sewage systems across London. Many increases in longevity come from simple things like public works and better hygiene (Newsletter #042). Longevity in different countries around the world travels on an escalator of prosperity. We accept the difference between the UK and Peru because it is part of “development”. Can we accept it within our own countries?
What the ONS data suggests is that the work is not finished in the UK. The issues are the same as the Victorians started work on 150 years ago. They worked on housing, education, child care, crime. These are the same things that make up the deprivation index. Growing old in the most deprived areas of any county is no fun. Fixing the problem is not a function of generating prosperity. What matters is distributing it.
The Inequality data is both a good news and a bad news story. In most developed countries life has extended by 3 months every year for the past 180 years. Over the years many authors forecast that the trend would fail. It never has, but where are the future opportunities to keep it growing? The UK data shows at least one source of future longevity gains. Inequality is an opportunity. Levelling up the prosperity gains and removing the disparities should increase longevity . That will raise the average longevity.
The bad news is the US data. This suggests that the behavioural diseases can reverse the gains made elsewhere. Those diseases are more prevalent in lower income areas. Removing inequality is a priority if we are to stay ahead.