According to a new analysis by the Health Foundation thinktank, healthy life expectancy in Britain has declined for two consecutive years. In a wealthy nation like the UK, where medical advancements are rapidly improving treatments for conditions such as obesity and cancer, it is unacceptable that people are experiencing sickness or disability at younger ages than they were a decade ago.
Key Findings of the Report
The report is based on a survey that relies on self-reported health data, which is less objective than statistics derived from births and deaths. The most significant deterioration has been in mental health among younger adults, while some age groups have reported improvements in physical health. Nevertheless, healthy life expectancy remains a valuable measure of quality of life, and the findings carry serious implications for public services. When the retirement age rises to 67 in 2028, the average person will be in poor health more than six years before they are scheduled to stop working. The researchers emphasise that this decline cannot be attributed solely to the pandemic. Northern Ireland was excluded from the analysis due to insufficient data.
International Comparisons
The UK has fallen several places in a ranking of 21 high-income countries, now sitting in 20th place, just above the United States. Japan remains at the top. The thinktank calls for ministers to prioritise health on par with economic growth, a sentiment likely shared by most people. However, the question remains: how can this be achieved?
Government Actions and Missed Opportunities
The current government made reducing the vast hospital waiting lists built up under the previous Conservative administration its top priority. This delivery-focused approach was undermined by the decision to abolish NHS England. However, neither Wes Streeting's missteps nor administrative flaws are to blame for the underlying problem of worsening population health.
The government's promised shift towards prevention indicates recognition of the issue. Laws such as the new tobacco ban should reduce smoking-related illnesses over time. Yet other determinants of health are harder to target. The socioeconomic causes of physical and mental illness have been known for decades, including insecure or unsafe work and housing. When Aneurin Bevan became the first minister in charge of the NHS, his portfolio also included housing. The deep cuts to council budgets imposed by austerity reduced opportunities for millions of people.
Housing and Regional Disparities
Change is underway in housing, with stronger tenants' rights and ambitious building targets. Regional inequality is being addressed through the £5bn Pride in Place programme. One of the report's starkest findings is the huge geographical disparities: nearly half of London boroughs saw improvements in healthy life expectancy, while the steepest declines occurred in Blackpool and Hartlepool.
Further Policy Levers
There are more levers that ministers could pull if they had the courage and conviction. New policies to address worsening health and economic inactivity among young people are expected soon. However, despite Britain being the most obese country in western Europe, the government has so far been unwilling to challenge the food and drink industry by insisting on product reformulation or imposing minimum unit prices on alcohol. This reluctance is likely due in part to fear of right-wing 'nanny state' headlines.
Most experts consider this the government's single biggest failure in public health. Yet even changes to the food system will not suffice. In addition to central action, ministers must empower local authorities to act on the understanding that health is closely tied to the wider social and economic conditions in which people live.
