Reducing health inequalities

Our population is ageing.

There are currently more than 21 million people aged 50 and over in England, and more than 10 million aged 65 and over – making up 38 and 18 per cent of the population respectively.

The number of people aged 65 to 79 is predicted to increase by nearly a third, to more than 10 million, in the next 40 years, while those aged 80 and over – the fastest-growing segment of the population – is set to more than double to more than six million. But while greater longevity is to be welcomed, far too many of those later years are being spent in poor health. 

Currently, women can expect to live, on average, another 21 years when they reach 65, while, for men, it is close to another 19. But only half of those years are spent in good health – or disability free, as it is known. 

Inequalities in life and health expectancy remain wide, and have been entrenched and exacerbated, particularly by the COVID-19 pandemic. 

The gap between the local authorities with the highest and lowest life expectancy was 7.4 years in 2017-19 and it grew to 8.7 years in 2020-22. 

“Through concerted and determined local and national action, we can make a huge difference”

There’s also a sharp difference in healthy life expectancy at birth between English regions. 

In the North East, it was just 57.6 years for males and 59.7 for females in 2020-22. In stark contrast, male healthy life expectancy at birth in the South East was 64.6 years and 64.7 years for females. 

In 2020, the COVID-19 pandemic was a significant turning point, causing the sharpest fall in life expectancy since World War II.  

However, regardless of the pandemic, where you live should not dictate how many years of your life are spent in good or very good general health. 

The disorders making the greatest contribution to poor health – cardiovascular disease, stroke, chronic obstructive pulmonary diseases and some cancers – are preventable. To tackle them, we must address their associated risk factors. 

Now more than ever, unhealthy behaviours such as smoking, physical inactivity, drinking too much alcohol and eating an unhealthy diet are in the spotlight.

Local government, with its role in public health, supports and proactively led on hard-hitting national action on obesity, smoking, alcohol and other major health risks, while tobacco control and getting to grips with obesity remain high on the political agenda. 

Local government is also key to tackling the wider factors that shape our health – such as having a secure job and adequate income, decent housing, high-quality education, and green spaces.

Consequently, the LGA strongly welcomed the Government’s commitment to halve the gap in healthy life expectancy. Reducing the avoidable differences in health across the population must be a priority, but it requires action across multiple areas. 

So, we are encouraged by the Government’s commitment to establish a mission delivery board to bring together all government departments with an influence over the social determinants of health. 

The ambition is achievable and has been done before: through concerted and determined local and national action, we can make a huge difference.  

If we tackle this head on, we can help ensure that not only do we add extra years to life, but also extra life to those years.

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