Social security cuts and life expectancy: a longitudinal analysis of local authorities in England, Scotland and Wales

Abstract

BackgroundThe UK Government’s ‘welfare reform’ programme included reductions to social security payments, phased in over the financial years 2011/2012–2015/2016. Previous studies of social security cuts and health outcomes have been restricted to analysing single UK countries or single payment types (eg, housing benefit). We examined the association between all social security cuts fully implemented by 2016 and life expectancy, for local authorities in England, Scotland and Wales.MethodsOur unit of analysis was 201 upper tier local authorities (unitary authorities and county councils: 147 in England, 32 in Scotland, 22 in Wales). Our exposure was estimated social security loss per head of the working age population per year for each local authority, calculated against the baseline in 2010/2011. The primary outcome was annual life expectancy at birth between the calendar years 2012 and 2016 (year lagged following exposure). We used a panel regression approach with fixed effects.ResultsSocial security cuts implemented by 2016 were estimated to be £475 per head of the working age population in England, £390 in Scotland and £490 in Wales since 2010/2011. During the study period, there was either no improvement or only marginal increases in national life expectancy. Social security loss and life expectancy were significantly associated: an estimated £100 decrease in social security per head of working age population was associated with a 1-month reduction in life expectancy.ConclusionsSocial security cuts, at the UK local authority level, were associated with lower life expectancy. Further research should examine causality.

Why is life expectancy in England and Wales falling behind? A cause-of-death decomposition approach.

“…At the local level in the United Kingdom, cuts to social security, social care, public health, and healthcare expenditure have been linked to worse mortality (Alexiou et al, 2021;Martin et al, 2021;Seaman et al, 2024), including higher older-age mortality (Loopstra et al, 2016;Watkins et al, 2017), suicide mortality (Barr et al, 2016), and drug overdoses (Friebel et al, 2022;Koltai et al, 2021). While some work has argued for the causal role of austerity in the life expectancy stagnation within England and Wales , it is important to keep in mind that most of the existing evidence is ecological and that the specific mechanisms linking austerity to higher mortality have not yet been identified.…”