We all hope to live long, happy and healthy lives, but the reality is that the likelihood of that depends on a variety of factors, including where you live in the UK.
New analysis published last week showed concerning reductions in life expectancy in the UK, even in the years before the COVID-19 pandemic hit. The declines in life expectancy were greatest in urban areas, with life expectancy in Leeds estimated to have declined by as much as three years between 2002 and 2019. The data also revealed significant and increasing imbalances in life spans across the country, with a man in Kensington projected to live 27 years longer than his counterpart in Blackpool. Men can now expect to live 16.5 years in poor health, and women almost 20 years – and the gap has been steadily increasing recent decades.
The results are unsettling – reversals in life expectancy are not supposed to happen in wealthy nations like ours, and a difference of 20+ years between countries, much less communities in the same country is startling - but it only tells part of the story.
While the Conservatives have committed loudly to ‘levelling-up’ across the country, the government has yet to spell out what exactly that means in practice in tackling longevity inequalities. One solution is to focus not only on reversing the declines in life spans reported this week but increasing ‘health spans’ - the period of a person’s life spent in good health, free from serious or chronic diseases. While most of us wouldn’t want to live for longer in ill health, the prospect of living healthier for longer is tantalising – and something we may soon be able to deliver, thanks to technology.
This week’s report states that one of the limitations of their research was not analysing the underlying cause of death, which would reveal some the diseases and injuries driving the differences in mortality trends. While on average lifespans have increased globally in the past century, healthspans have not kept pace. Tackling the above-mentioned inequalities will help, but the gap between lifespan and healthspan is not entirely due to socio-economic differences.
As we grow older, the likelihood of developing a chronic disease such as cancer and dementia increases significantly. With an ageing population and lower birth rates, this means that the systems built around a larger, younger, working population supporting a smaller, older, non-working population will not hold up for much longer.
Without including healthspans in the conversation, even if we were able to reverse the decline in longevity revealed by this new research, we are still faced with the issue of how longer, but not necessarily more healthy, lives will impact our already thinly stretched healthcare system and pension model. The challenge of ageing populations, combined with decreasing birth rates, has been described by demographers and economists as an existential issue for advanced economies. The recent National Insurance increases seek to stem the tide in the short-term but, with the UK now facing the highest tax burden in peacetime history, simply continuing to increase taxes is unsustainable.
Science and technology is making unparalleled progress in advancing our understanding of human health and disease. Politicians must support advances and investment in geroscience, genomics, novel gene therapies, new drug discovery techniques, and regenerative medicine, to rapidly accelerate progress in extending healthspans - in every part of the UK. Focusing on longevity alone is simply kicking the can down the road.
While we hope that the trend of decreasing longevity is short-lived, COVID-19 has forced us to reflect on what matters in a way we haven’t for a long time– let's not waste the opportunity.