Friday , October 22 2021

Why is life expectancy failing? | Society


IA few days ago, a team of researchers, statisticians and geographers will meet at University College London to address an issue of growing concern with doctors and health experts. They will investigate why many British citizens are living shorter and less healthy lives compared to the recent past.

The emergence of a faltering life expectancy in Britain caused a special alarm because it reversed a trend that has remained almost intact for almost 100 years. During this period, lives continued to lengthen, blessing more and more British people with the gift of old age.


But now this increase has come to an end, statisticians have discovered. In fact, among many sections of the UK population, declines have settled. Hence the meeting, organized by the British Society for Population Studies, organized so that delegates can use the data – to be released this week by the Office of National Statistics – to update their life expectancy projections.

"It's a perfect storm," says Danny Dorling, a professor of social geography at Oxford University who organized the meeting in London. "Our faltering life expectancy rates show that we now have the worst health trend anywhere in Western Europe since World War II. To achieve this, we must have made many bad decisions, "he said.

Statisticians noted in 2013 that the rise in life expectancy in the UK began to slow. Gradually, the graph – which has been growing for decades – has stabilized until, a few years ago, it began to decline number of people. The elderly, the poor and the newborn were the most affected. For example, life expectancies for people over 65 have fallen in more than six months.

The trend now causes considerable concern among doctors who view life expectancy figures as Britain's health barometers. From this perspective, the nation is falling ill – and a number of different factors have been presented as explanations.

One statement often made is that humans have simply reached the peak of longevity. "Life expectancy can not be expected to increase forever," Robert Courts, Rep. Tory, recently told the Commons.

Many statisticians, however, point out that life expectancy continues to rise – well above UK levels – in many other places, including Hong Kong, mainland China, Japan and Scandinavia. Other factors must be involved, they say.

For its part, the Health Department initially said that influenza epidemics, triggered by harsh winters, were killing the weak and elderly, increasing mortality rates and reducing life expectancy. But this idea is rejected by Dr. Lucinda Hiam, an honorary researcher at the London School of Hygiene and Tropical Medicine.

"I was working as a GP during this time and I did not notice a dramatic increase in flu among the patients entering my clinic," she said. In fact, it has been shown that five of the seven winters between 2011 and 2017 have had above-average temperatures, making them unlikely to trigger flu outbreaks.

However, the Health Department persisted with the idea for some time. "When my colleagues and I first questioned the strength of the impact that the flu was having on the increased deaths and suggested that the role of the cuts should be explored, we were dismissed by health authorities," Hiam said. "But since then, the evidence that the flu is solely responsible has largely evaporated."

Instead, Dorling, Hiam and many other epidemiologists argue that life expectancy began to decline in Britain as a direct result of the austerity measures imposed by the Conservative-led government in 2010. These cuts – which have taken away more than £ 30 billion of the payments subsidies and social services in the last eight years – were some of the most serious made by any nation after the financial crisis of 2008.

Professor Danny Dorling

Professor Danny Dorling: "We now have the worst health trend anywhere in Western Europe since World War II, in World War II." Photo: Murdo Macleod / The Guardian

And, once imposed, they have led to drastic reductions in social assistance funding, meals on wheels, rural bus services, NHS spending, number of health visitors and many other services. These, in turn, have contributed to the increase in the number of premature deaths of vulnerable people, it is argued.

"Life expectancy began to stagnate shortly after the introduction of the austerity cuts," Hiam said. "That alone does not prove that the last one was the trigger for the first. However, no other plausible suggestion survived the scrutiny, so it is difficult not to complete austerity cuts. "

In the case of care for the elderly, the link seems especially persuasive. "Funding for social care for the elderly has been at a breaking point for decades, and recent austerity cuts have only aggravated the crisis," says Tom Gentry, senior manager of health and care policies at Age UK.

Previously, the only individuals who had contact with many solitary and isolated elderly were community and social workers. Then came the cuts, which led to a dramatic reduction in this last line in defense of the elderly.

"Nowadays, there is often no one talking to older people or observing when they stop eating or noticing that they are not moving or are having balance problems. So they fall, stay there for days before being found, and then are readmitted to the hospital where they have to receive more serious interventions than would have been the case. Inevitably this will mean shortened lives. "

Earlier this year, the Institute and the Faculty of Actuaries said they expected 65-year-old men to die at 86.9 years, below the previous estimate of 87.4 years, while women who reach 65 will likely die at 89.2 years, below 89.7 years. In other words, the life expectancy of people entering retirement age has been reduced by six months.

This has implications not only for our health services but also for our pension industry. "The recent reduction in improvements in life expectancy has already had consequences," said Cobus Daneel of the actuarial body, Research on Continuing Mortality. "Insurance companies have released money because it is perceived that they may not have to pay as much to pay future pensions as previously expected. It is clear that life expectancy still has room for improvement in the future "

At the same time, the government plans to raise the retirement age to 68 and has increased the idea of ​​raising it to 70. Now it may be forced to back down, as rising life expectancy is at a standstill. "The increase for age 68 is scheduled to come in between 2037 and 2039 and I would expect that now there would be a new revision before they are implemented," added Daneel.

Last week, former health secretary Jeremy Hunt admitted that some cuts in welfare funding imposed by the Conservative government "went too far." However, the Department of Health continues to reject any link between these cuts and declines in life expectancies. "We are working to help people live longer, healthier lives," a spokesman said. "Survival of cancer is at a record level, while rates of smoking and teenage pregnancy are at an all-time low."

However, the connection between austerity and life expectancy is difficult to overcome, says David Walsh of the Glasgow Center for Population Health. The city has had some of the worst life expectancy rates in the Western world – for example, in central Calton, a place marked by poor housing, disease, high rates of smoking and violence.

Inhabitants suffered high mortality rates linked to drug and alcohol abuse and suicides. As a result, at the beginning of the 21st century, male life expectancy at Calton at birth was 54, one of the worst figures in the UK. Glasgow then made great efforts to improve mortality rates in Calton, but now he is seeing life expectancies slip back to their old levels.

"I think it's pretty clear that austerity is the fault," says Walsh. "We took the safety nets out of these people."


The shadowy future faced by these young adults was summed up by Sir Michael Marmot, professor of epidemiology at University College London. "If you were a young man growing up in Calton, who is using drugs, alcohol, and tobacco, you are unemployed and can not hire and tell him," Look, you really should not smoke. " get away with it and in any case it can be quite rational not to make long term plans because it does not have a long term future.

In addition to the health impacts of the elderly and the needy, there has also been a disturbing change in child mortality rates – as recognized last week by the Office of National Statistics. It reported that in 2017 there were 3.9 deaths per 1,000 live births in the UK. By 2016, there were 3.8.

"Infant mortality has been declining since the 1980s and peaked at all times in 2014. But since then, the rate has increased every year," said ONS researcher Vasita Patel. "The 2017 figure is significantly higher than in 2014."

To explain this alarming increase in infant mortality, Dorling blames a number of factors: "Fewer midwives, an overburdened ambulance service, general hospital deterioration, greater poverty among pregnant women and cuts that mean fewer health visitors to the needy – all these factors are involved. "

The crucial point is that health statistics tell us something fundamental about how well a society is doing, says Marmot. "When you see significant differences in life expectancy rates, this is telling us something particularly important about how well society is distributing its benefits." According to Marmot, former president of the World Medical Association, a person with a university degree in Britain, Britain has a longer life expectancy than a person who leaves school with A levels who, in turn, will do better than someone who does not have A levels. "The higher your income, the more you live," he says. "Likewise, the higher the status of your occupation, the higher your life expectancy."

Likewise, the lower the level of socioeconomic ladder a person is in, the more dependent he or she will be on the help or support of local authorities. As a result, these individuals are disproportionately affected when services are cut off.

"Two years ago, I went out of my way not to blame austerity measures for hesitant life expectancy rates," Marmot said. "Now I'm much closer to blaming them for the evils we're witnessing."

Professor Sir Michael Marmot

Professor Sir Michael Marmot: "Two years ago, I struggled not to blame the austerity measures for wavering life expectancy rates." I am now much closer to blaming them for the ills we are witnessing.

While Marmot remains cautious, Dorling and Hiam are more certain of a causal link between the austerity cuts and lower life expectancy rates. However, everyone agrees on one issue: that there is now an urgent need for a large-scale investigation into the issue, a measure that is also supported by Professor Martin McKee of the London School of Hygiene and Tropical Medicine.

McKee said: "Health authorities can not continue to disregard the possibility of a link between cuts and low life expectancies. We need to find accurate answers and we need them urgently. The only way to do this is to establish an appropriate public inquiry – urgently. "

Of course, mortality rates in the next few years can stop their decline and begin to show renewed growth. But rejoicing would be a mistake, says Dorling.

"Life expectancy in the UK is very far from what it should be for a country as rich as ours. The argument should not be about lost or recovered weeks of life, but how many years are being lost for life expectancy because we choose not to do what a normal European country would do, ie invest adequately in social care. "

The real fear is that Britain is falling into a pattern that has emerged in the US, where taxes – and social assistance budgets – are low and where much of the healthcare system is run by private companies. In the US, life expectancy began to fall significantly years ago. Causes of high mortality rates include rising rates of drug overdose deaths and suicides. However, the care of the elderly and the very young is also under stress in many states.

"I'm worried that we're following the same path as the US," says Marmot. "We should not be investing significantly in health and social care, like the rest of Europe." Their social policies are better for health and long life than American social policies. "

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