An Investigation into Inequalities in Adult Lifespan

Abstract

This very timely report highlights how, despite huge increases in life expectancy, the gap in lifespan between richest and poorest in society is increasing for the first time since the 1870s. Life expectancy increased in the early part of the 20 th Century due to, among other things, improvements in health, clean drinking water and the introduction of vaccination. This paper finds that in England and Wales, 5% of men that have attained the age of 30 are living on average to 96.0 years, 33.3 years longer than the lowest 10%. This gap grew by 1.7 years between 1993, when it was at its narrowest, and 2009. ILC-UK's own 2014 research (Linking State Pension Age to Longevity), supported by Age UK, found that measures such as healthy life expectancy and disability-free life expectancy vary significantly by region and social class. This trend is particularly worrying for society and policymakers must do more to begin to narrow this gap again. Preventing inequalities due to ill health and disability must be a priority for policy action. But there is also a fairness challenge in the context of increasing the State Pension Age. John Cridland has been appointed by the Government as the Independent Reviewer of State Pension Age. Whilst sustainability of the state pension will be at the forefront of his concerns, Mr Cridland is also likely to consider the impact of inequalities in life expectancy. ILC-UK believes there are likely to be significant unintended consequences of further increases to State Pension Age in 2028 if inequalities in lifespan are not addressed. Increasing State Pension Age up to levels where disability rates are higher raises concerns about transferring spending from the State Pension to disability or other working age benefits. Increasing the State Pension Age further might also impact on the supply of carers as some people are obliged to work for longer when they would prefer to be carers. Public policy is beginning to recognise the challenges ahead. The DWP Select Committee are conducting an Inquiry into "early drawing of the state pension". Labour have proposed a flexible state pension age so manual workers can retire earlier than other workers. We hope that this paper adds to the evidence base to allow for an informed debate. The challenge now is how we can reduce inequalities in the future whilst, in the short term, ensure that the poorest among us do not find retirement out of their reach.

An investigation into the impact of deprivation on demographic inequalities in adults

“…In previous research, we analysed inequalities in lifespan from the 1870s to the present (Mayhew & Smith, 2019). 8 We found that these were inversely correlated with life expectancy so that as life expectancy improved the gap in lifespan narrowed.…”

“…That life expectancy and lifespan are adversely affected by deprivation has been studied for well over a century (Charlton & Murphy, 1997). The mechanisms by which this occur are based on a complex mix of factors such as low educational attainment, hazardous working environments, a lack of social mobility, adverse life styles including the self-inflicted health dangers of poor diet, smoking habits and drug abuse, which largely reflect individual behaviours, but also by ambient exposure to the physically harmful effects of crime, air pollution and accidents (Mayhew & Smith, 2019).…”

“…6 Note, however, that the use of the 90% and 5% cut-offs is arbitrary and derived from the value of l x based on the corresponding percentiles for any given life table. Our experience is that this definition is good at picking up outliers in distributions and is therefore more sensitive to variations in deprivation than alternatives such as the inter-quartile range (Mayhew & Smith, 2016, 2019. Table 5 shows the decile variation in lifespan for men and women based on this approach.…”

“…van Raalte et al, 2018 and the recent review of the UK state pension age by the Department for Work & Pensions (2017). Mayhew & Smith (2016, 2019 argued that unhealthy lifestyles are the main reason for variations in lifespan -causes being poor diet, lack of exercise, smoking and obesity. This is because major killers of the last century such as polluted water and air and slums are now largely in the past with one or two exceptions such as toxic vehicle emissions.…”

All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours

“…In addition to its limitations as a predictive model, the above conceptualization of individual choices tends to blame ill health on the suboptimal decision‐making of individuals. In one of many examples, a 2016 scientific report on increasing gaps in UK life expectancy between rich and poor concludes: ‘Since chronic disease is often attributable to life choices such as smoking and diet, the blame for the widening [of inequalities] must be laid increasingly at the door of individual lifestyles rather than ambient risks and hazards’ . Such approaches retain their appeal because they align with relatively straightforward and inexpensive policy solutions supported by the public including, for alcohol consumption, information campaigns emphasizing personal responsibility, drinking guidelines and school‐based educational programmes.…”