Poorest dying nearly 10 years younger than the rich in 'deeply worrying' trend for UK

November 22, 2018, Imperial College London
Credit: CC0 Public Domain

The gap between the life expectancy of the richest and poorest sectors of society in England is increasing, according to new research from Imperial College London.

The research, published in the journal Lancet Public Health, also reveals that the life expectancy of England's poorest women has fallen since 2011, in what researchers say is a "deeply worrying" trend.

The study, funded by the Wellcome Trust, analysed Office for National Statistics data on all deaths recorded in England between 2001 and 2016—7.65 million deaths in total.

The results revealed the life expectancy gap between the most affluent and most deprived sectors of society increased from 6.1 years in 2001 to 7.9 years in 2016 for women, and from 9.0 to 9.7 years in men.

The life expectancy of women in the most deprived communities in 2016 was 78.8 years, compared to 86.7 years in the most affluent group. For men, the life expectancy was 74.0 years among the poorest, compared to 83.8 years among the richest.

The results also revealed that the life expectancy of women in the poorest sectors of society has dropped by 0.24 years since 2011.

Professor Majid Ezzati, senior author of the research from Imperial's School of Public Health, said: "Falling life expectancy in the poorest communities is a deeply worrying indicator of the state of our nation's health, and shows that we are leaving the most vulnerable out of the collective gain.

"We currently have a perfect storm of factors that can impact on health, and that are leading to dying younger. Working income has stagnated and benefits have been cut, forcing many working families to use foodbanks. The price of healthy foods like fresh fruit and vegetables has increased relative to unhealthy, processed food, putting them out of the reach of the poorest."

He added: "The funding squeeze for health and cuts to local government services since 2010 have also had a significant impact on the most deprived communities, leading to treatable diseases such as cancer being diagnosed too late, or people dying sooner from conditions like dementia."

The research team also analysed the illnesses that contributed to the widening gap. Although they found that people in the poorest sectors died at a higher rate from all illnesses, a number of diseases showed a particularly stark difference between rich and poor.

The diseases that led to particularly large loss of longevity in the poor compared to the rich were newborn deaths and children's diseases, respiratory diseases, heart , lung and digestive cancers, and dementias. In 2016, children under five years old from the poorest sectors of society were 2.5 times as likely to die as children from affluent families.

"This study suggests the poor in England are dying from diseases that can be prevented and treated," said Professor Ezzati. "Greater investment in and social care in the most deprived areas will help reverse the worrying trends seen in our work. We also need government and industry action to eradicate food insecurity and make healthy food choices more affordable, so that the quality of a family's diet isn't dictated by their income."

The team conducted their analysis by using information on the where each death occurred, which was matched to small areas of England known as lower super output areas by the Office of National Statistics. These lower super output areas, which each have a population of around 1,500 people, are given a score of deprivation from the Office of National Statistics (called an Index of Multiple Deprivation). The research team point out this means the comparisons are based on a community's deprivation and affluence, and not that of individuals.

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20 comments

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Jim4321
5 / 5 (1) Nov 23, 2018
Correlation is not causation. The authors assume that lack of government spending (resulting in poor communities and lack of material goods) is the cause without one word of how they came to that conclusion. They then propose a cure, spend lots of money raising these peoples standard of living. But there are other candidates for a cause. For example, both intelligence and conscientiousness correlate strongly with longer lifespan. At the very least, the authors should control for these biases before coming to their conclusions as to cause, and, most certainly, before proposing fixes.
V4Vendicar
1 / 5 (1) Nov 23, 2018
The rich form the superior race, by definition.

Killing the poor is essential if humanity is to advance.

Don't feed the animals.

Let nature take it's course.
greenonions1
3 / 5 (2) Nov 23, 2018
Jim
The authors assume that lack of government spending (resulting in poor communities and lack of material goods) is the cause
I don't see that they made this assumption. Look at this sentence -
We currently have a perfect storm of factors that can impact on health, and that are leading to poor people dying younger
So acknowledging that the cause of this disparity is complex.
Obviously much deeper research into the causes, and interactions of factors - will lead to much more detailed understanding. However - as the study identifies - there are some pretty obvious ones - like access to medical care, and diet. So do you do nothing - and wait a few decades for more research, or do you explore changes that would improve health care, and healthy food options - that would most likely have an impact. Children dying at 2.5 X the rate of richer children - would seem like good incentive to explore action - rather than wait for more research.
Greg1958
1 / 5 (2) Nov 23, 2018
must be all that great universal socialized health care
greenonions1
3 / 5 (2) Nov 23, 2018
must be all that great universal socialized health care
Because the private system in the U.S. does so much better - right?

https://www.brook...nd-poor/

Maybe you could compare the health statistics of Britain and the U.S. -
https://www.natio...s/Health
Jim4321
5 / 5 (1) Nov 23, 2018
Greenonions

It depends on whether this is supposed to be a scientific report or a policy paper. We need to identify the actual causes. Otherwise we will spin our wheels indefinitely while people suffer. I have no objections to political policy. It just belong on a scientific website.
Jim4321
not rated yet Nov 23, 2018
Just does not belong on a scientific website. Darn autocorrect.
greenonions1
5 / 5 (1) Nov 23, 2018
Just does not belong on a scientific website
I love Physorg - specifically because they post all kinds of different articles - some more scientific than others. This research was published in Lancet Public Health. Seems spot on for a journal looking at public health issues. Many scientific articles conclude by saying 'more research is needed.' There is a lot of work around the world - looking at the causes of the life expectancy issue. How are we 'spinning our wheels' - if we go for the low hanging fruit - and try to improve poor peoples access to health care, and diet? Even if these are not primary causes - surely it is a good goal for a society to want everyone to have good medical care, and a healthy life style - including diet.
Jim4321
5 / 5 (2) Nov 23, 2018
Greenonions
Thank you for your thoughtful responses. Why are these people in the UK getting poor health care? After all its free. This is the kind of question we need to answer. From a medical point of view, the most difficult thing is to get people to make lifestyle changes. Even faced with death a year or two in the future, most cannot or will not make changes. Consider your type two diabetic who insists cupcakes and candy bars. You can implore all you want, tell them that they will not see their grandkids grow up. Nine out of ten will not change. Getting patients to willingly comply with medical necessity is the biggest challenge facing healthcare. If we could find a solution to this problem, we could begin to close the socio-economic gap.
Anonym954878
1 / 5 (2) Nov 23, 2018
come on liberal ---tell the real truth.... they do not want to tell you, these peoples diet has no fruits-- no vegetables..a bag of carrots is cheap for gods sake.... from conception through the early years without proper nutrition the children lose a big chunk of potential IQ and studies have shown in Indian and other poor countries -up wards of 50-60% grow up with IQs in the idiot range....unemployable... and you wonder why generation after generation end up like parasites. If someone collects free money or services they must be forced to use it on vegetables or get nothing-- like they do in third world countries--- as all the first world countries are headed towards becoming a third world hell hole as the only ones having more than 1.5 kids are the breeding crazy low IQ parasites and to be kind....they are not intelligent enough to do anything about it....but damn the politicians must.
greenonions1
not rated yet Nov 23, 2018
Jim
Getting patients to willingly comply with medical necessity is the biggest challenge
But think Jim - earlier you insist that we need to identify the causes. In other words - not jump to conclusions - but do the research to fully understand the situation. Now you make assertions - without providing support. I don't disagree with your observation of behavior. I think - as pointed out before - it is complex. Why they are not getting good health care is a great question. I am from the U.K. - and my view is that the system is pretty broken. Because I have good insurance here in the U.S. - I have much better care than my family in U.K. Both sides of the pond - poverty is a huge problem. Yes - I know someone who has diabetes, a liver transplant - and wont lose weight or stop drinking coke. Complex issues.
greenonions1
5 / 5 (1) Nov 23, 2018
a bag of carrots is cheap for gods sake..
I was talking with someone recently who works with extreme poor here in the U.S. He said that the poor often eat a lot of fast food. I argued that fast food is not a cheap way to eat - and that I can eat much more nutritional food, much cheaper, by cooking at home. He said that the problem goes much deeper than just a cost comparison. If your parents don't cook at home - it just becomes your life style to eat at micky D's. I don't think there are simple solutions.
aksdad
not rated yet Nov 24, 2018
As Jim4321 points out, the simple fact that poor people don't live as long as wealthier people tells us nothing about the causes. In a country where everyone has the same access to healthcare, this disparity implies that the healthcare system isn't the reason. People who are chronically poor tend to make lifestyle choices that are self-defeating and may, unsurprisingly, also shorten their lives.
Jim4321
5 / 5 (1) Nov 24, 2018
greenonions

Sorry I wasn't clearer. I was proposing "willing compliance with medical necessity" as an example of an alternative hypothesis to explain the socio-economic discrepancy. I was not proposing it as policy, nor do I see how such a policy could be implemented. In my own experience, it does look like one of the eight hundred pound gorillas.
greenonions1
not rated yet Nov 24, 2018
In a country where everyone has the same access to healthcare
Once again - a statement is made - with no support. The British NHS is in a mess. A few minutes on google - or talking to someone who uses the system will show you how stressed and broken it is - http://www.indepe.../150608/

If you don't like the service you get under the nhs - you can go private, and pay for it. My mom was going to have to wait months for a cat scan - so ponied up the £400 (yep - something that would be thousands of $ here in the U.S) - and her cancer was discovered months earlier. You don't think that may change your outcomes? The article as much as recognizes this.

Greater investment in health and social care in the most deprived areas will help reverse the worrying trends


The NHS would not be a good model for a health care system. I think there are many European countries with much better services.
greenonions1
not rated yet Nov 24, 2018
Jim
I was proposing "willing compliance with medical necessity" as an example of an alternative hypothesis to explain the socio-economic discrepancy.
Gotcha. And I am sure that is one of the major issues. It would be an interesting study - to see if there is a discrepancy - in terms of how often people go to the doctor, and how long they wait to go to the doctor - when there are symptoms.
MR166
1 / 5 (1) Nov 24, 2018
"As Jim4321 points out, the simple fact that poor people don't live as long as wealthier people tells us nothing about the causes. In a country where everyone has the same access to healthcare, "

From what I understand that is not true at all. The U.K. has 2 health systems one public and one private. The public one meters out health care in order to keep the costs down.

Secondly, diet plays a huge part in one's health. The wealthy tend to eat more healthful foods and in general have a more healthful lifestyle.

Finally one needs to adjust the data in order to factor in the effects of immigration from poor nations.
MR166
not rated yet Nov 24, 2018
The true costs of treatment in the US healthcare system are pretty much impossible to figure out. Bills from the hospital are 10x more than the "covered" amount that Medicare or the insurance companies pay in some instances. A surgeon might bill $10,000 and get paid only $1,500 for his services.

Thus, the uninsured get hospital bills that are 10x higher than the insured for the same services.

TheGhostofOtto1923
1 / 5 (1) Nov 25, 2018
In related news, dumbest animals in the wild are dying nearly 10 years younger than the smartest animals. So what are the other animals doing to save these unfortunates?

Imagine, if you will, a world in which all humans possess brains that function like the very best ones do now. Everyone is equally smart. Everyone is equally healthy. And no one suffers from debilities now common within the species such as OCD, down's, epilepsy, ADHD, psychosis, autism, or even psychopathy.

Imagine if we could fix genetic defects in the womb and prevent unborn children from suffering the results of their addicted and malnourished and irresponsible mothers.

If we think that healthcare is a universal right, shouldn't this right be extended into the womb? I'm not talking about the right to life, I'm talking about the right to have the best life we can possibly have.

And this right should begin at conception for all unborn human beings intended to be brought to term.
TheGhostofOtto1923
3 / 5 (2) Nov 25, 2018
Re the article, you cant maintain quality and innovation without competition. This is the fatal flaw with socialized medicine or socialism in general.

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