For a hundred years, life expectancy grew. Now, rising health inequality could change thatby Michael Marmot / March 21, 2018 / Leave a comment
Britain in 2011 was a better place to live than Britain in 1921. We know this because people, on average, live much longer now. In 1921, men in England and Wales had a life expectancy of 56 years and women of 60 years. Ninety years on the figures were 79 and 83 years for men and women respectively—a 23 year improvement in only 90 years; one year extra in lifespan for every four years that passed. It’s not that staying alive is everything—although it is a rather important precondition to doing anything else. Rather, I put such weight on it because it correlates with other measures of health, many of which we can’t measure so well.
A long-lived society tends to be a healthier society, and health, in turn, is a good reflection of how well a society is doing—better, I would argue, than GDP. In a flourishing society that is meeting the needs of its members, those members will generally have long and healthy lives. For example, it was clear that the Soviet Union and its client states in Central and Eastern Europe were not good places to live in the 1970s and 1980s because health was so bad. Year on year, life expectancy improved in “western” Europe and stagnated or sometimes declined in the east. Then, in Russia particularly, things got worse again. When the Soviet Union dissolved, average incomes went down, while the spread of incomes got wider, and life expectancy collapsed.
Happily, though, England and Wales have generally been part of that healthy trend in the west. But there are now two clouds over this rosy picture of health, and therefore society, improving ineluctably. The first is inequality. In the aftermath of the Grenfell fire in 2017, I noted that in the Royal Borough of Kensington and Chelsea, life expectancy for men in the area around Grenfell was 14 years shorter than in the plush parts of the borough, even though these were only walking distance away.
Standing, as it did, in the midst of London’s richest borough, Grenfell was an extreme manifestation of inequality—look at the profile of the people who died or were made homeless there. Overwhelmingly, they were minorities or migrants, and very often they were poor. But we see enormous gaps in longevity everywhere, linked to measures of affluence and deprivation; the more deprived…