Britain has ended a decade of early deaths. Why?

By our calculations, the UK has a higher number of excess deaths than similar countries such as France and Denmark. This is because, in the early 2010s, life expectancy in the UK stalled in line with long-term trends and in comparison to other countries. This decline in life expectancy has affected all age groups, not just the elderly. And it disproportionately affected the poor. If you travel just 10km (six miles) from the poshest part of Kensington in London to New Cross Gate, life expectancy for men drops from 92 to 74, a staggering 18 years. in sorrow. When more people are dying and life expectancy is stagnating, a greater number of people are also living in ill health.

Life expectancy in Britain, as in almost all wealthy countries, had been increasing for almost two centuries. But in early 2010 something went wrong. Life expectancy at birth today at age 81 is just eight weeks higher than in 2011. In a best-case scenario, in which the pace of improvement between 1980 and 2011 was maintained, life expectancy would have been more than 83 today. According to calculations by The Economist, this is no small difference: it implies that around 700,000 Britons will die between 2012 and 2022, much sooner than they could have.

Two features make this statistic even more worrying. Death mostly comes when people become old. But the reduction in life expectancy has occurred in all age groups. Death rates have stagnated for infants, and increased among young adults and middle-aged people. The death rate for 30- to 49-year-olds in the UK has risen steadily since around 2012, in sharp contrast with neighboring countries.

Although the deaths are spread across generations, they are not spread across the income spectrum. Life expectancy has fallen among the poorest in society but has risen for the richest. A poor English girl can expect to live an average of 6.8 years less than a wealthy girl in 2011, but 7.7 less in 2017. For boys, the gap widened from 9.1 to 9.5 years over the same period.

The combined effect of the pandemic and global demographic trends can only explain some of Britain’s missing crowd. Although other wealthy countries have also experienced recessions, Britain has fared the worst from its European peer group. After stripping away the effects caused by Covid and the wider European recession from the toll of 700,000, you’re still left with those 250,000 unexplained deaths.

It is not easy to fix what has gone wrong. In the US, where life expectancy has fallen even more rapidly in recent years, “deaths of despair” from drugs, alcohol and suicide have caused most of the damage. Dundee is now the drug-death capital of Europe. Yet a similar problem may arise in England and Wales, with the rate of drug deaths almost four times higher than in Scotland.

recent struggles of National Health Service (NHS) has played its part. Hospital wait times record lengths and the crisis in primary care jeopardize timely treatment. But delays in medical care cannot explain all the excess deaths, especially before the pandemic. Furthermore, the greatest improvements in life expectancy come not from treatment but from better diagnosis and prevention, and widespread prosperity. This is where Britain appears to be lagging behind. It could have done much better in all three.

First, diagnosis. Poorer Britons are 20% more likely to be diagnosed with cancer at a later stage, when the disease is more complex and expensive to treat. Having more NHS diagnostic centers would help, as well as reducing backlogs related to the pandemic. It would also be good to prescribe more statins for people at risk of heart attack or stroke. Both treatments are cheap and cost-effective, and are recommended. But with one in 11 NHS posts open, enough radiologists and doctors will be hard to find general practitioners to make a difference.

Next, prevention. Individuals are responsible for their own decisions but public-health interventions, from vaccines to anti-smoking and weight loss programmes, can improve things. They also offer good value for money. One study found that it costs about four times more to gain an additional year of good health through clinical interventions than through public-health programs. Yet funding for the public-health grant, which is allocated by central government to local authorities and accounts for just 2% of the NHS budget, has been cut in real terms in recent years.

Ultimately the biggest improvement will come from raising the standard of living of the poor. There are many reasons for their low life expectancy, from less money to spend on home insulation or nutritious food to the stress of financial insecurity. One useful long-term thing the government could do is to help improve the country’s terrible record on productivity by liberalizing planning and devolution of financial powers to local authorities.

life after life

The government should also recognize the role of deprivation in health. It would be a good idea to re-value the funding formula to benefit general practitioners in the poorest areas. They care for 10% more patients than the richest areas, but receive 7% less cash. And as Chancellor of the Exchequer Jeremy Hunt prepares his budget for March 15, he should recognize how the spending cuts are reflected in other areas. The figures show that life expectancy was worst affected in places with the largest relative falls in housing services and adult social care spending between 2009 and 2019.

In its Covid response, the UK went to extraordinary lengths to protect its citizens from falling prey to premature death. The pandemic may be over, but that work is nowhere near done.

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