Ally Fogg 

British life expectancy is slightly lower than a few other countries. Big deal

Ally Fogg: Jeremy Hunt should be worried about inequalities within the UK, not who tops the international Premier League for Not Dying
  
  

Drinking and smoking in a pub
'Whenever figures like these emerge, politicians ramp up the rhetoric on our unhealthy habits – drinking, smoking, drug-taking and poor diet.' Photograph: Murdo Macleod Photograph: Murdo Macleod

It is often noted that in a British supermarket you can buy canned lager at a lower price than you might pay for bottled water. That has to make you think. What it makes me think mostly is this: what a bloody marvellous country to live in. If you've ever looked at the clock at about 11.05pm on a Saturday night and cursed because you've missed the chance to nip to the off licence for another bottle of wine, then spare a thought for the people of Sweden where, in most of the country, the latest time on a Saturday that one can buy take-out alcohol is Friday.

This may be one of the reasons Sweden remains close to the top of the league table in healthy life expectancy. This week's Lancet reports analyses of data from the snappily titled Global Burden of Diseases, Injuries and Risk Factors Study 2010. The paper collates and ranks various different life expectancy measures from 19 comparably developed countries, and compares them to the same figures from 1990. The health secretary, Jeremy Hunt, thinks the findings are "shocking". I am not sure why. In just 20 years, British life expectancy has jumped 4.2 years. We're doing particularly well on years lost to road injury, diabetes, liver cancer and chronic kidney disease. Yay, go us.

The problem, though, is that while we're getting healthier and living longer all the time, so are other countries, some at a much faster rate. Not content with dominating world football in recent years, the Spanish have also shot from fourth to the top of the Premier League for Not Dying, while we Brits languish in mid-table mediocrity, at 12th out of 19, exactly where we were back in 1990. Not great, but spare a thought for the Danes, who have plummeted from 13th to 18th, below even the notoriously lardy-arsed Americans, with only the poor, sickly Finns sparing their blushes at the foot of the table. Presumably those countries are now scrapping it out in a relegation dogfight, and if they don't pull their socks up then next season they'll be in a keeling-over contest with the Faroe Islands and Azerbaijan.

You might guess from my tone that I am not taking this especially seriously, and you'd be right. Health and life expectancy are not competitive sports. Even if they were, Britain has no divine right to top the tables. As it happens we're not really doing that badly anyway, only a couple of years behind the best. One feature worth noticing in the new figures is the narrowness of the range between bottom and top. On the table for Healthy Life Expectancy for example (that is, years lived without serious illness or disability), Spain has an average of 70.9, Finland is at 67.3, with Britain tucked between on 68.6. Those differentials are about as small as could reasonably be imagined in an international comparison of this nature.

More importantly, the differences in average life expectancy between countries are trivial in comparison to the different life expectancies within countries, even from one neighbourhood to the next. To take an example of just one metropolitan borough, Trafford stretches from inner city Manchester to suburban Cheshire. The difference in life expectancy from the poorest area to the richest is more than 10 years for men and six years for women, over just a few miles. If Hunt wants to be shocked by life expectancy differentials, I'd suggest he could start looking much closer to home.

Whenever figures like these emerge, politicians ramp up the rhetoric on our unhealthy habits – drinking, smoking, drug-taking and poor diet – and it would be foolish to deny that these are immensely serious public health concerns. But other similarly serious factors barely get a look-in – inequality, poor housing, poverty, unemployment, long working hours, workplace stress and other social factors significantly impact upon our health. The health secretary didn't miss a beat in using the latest statistics to justify his government's NHS reforms, and shunted the onus for improvements on to local health commissioners. All the while he shares responsibility for government policies that are pushing huge numbers of the least healthy among us into ever greater poverty, insecure employment, poorer quality housing and homelessness. Now that, Mr Hunt, is shocking.

 

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