UK’s falling life expectancy is like post-Soviet crisis, warn experts

[Regulator]

A really interesting article in the Times today.

Britain is the only western country other than the opioid-ridden US in which life expectancy has continued to fall after a bad flu outbreak in 2014-15, in a pattern which researchers said was reminiscent of post-Soviet Russia.

Sustained falls in life expectancy should not happen in rich countries and Britain must regard the trends as a “major warning sign”, American academics said.

Flu can only explain a third of the three-month drop since 2014 in how long people can expect to live in Britain and ministers should investigate “extremely important” changes properly, the scientists said.

Alarm over stalling progress in life expectancy has been escalating over the past year. The Times revealed that life expectancy in some parts of the country has fallen by a year since 2011, while official figures showed 10,000 more people died in the first two months of this year than would have been expected, the biggest jump since the Second World War.

The causes of the fall are disputed, with loneliness, overstretched hospitals and the crumbling elderly care system all suggested as contributors. The government announced a review of rising mortality last month.

Researchers at the University of Southern California have compared changes in life expectancy in 18 western countries, finding that 12 experienced dips in 2014-15 during a bad flu season. Most rebounded the next year — with the US and UK the only ones without “robust gains” to 2016, according to data published in the The BMJ.

“Life expectancy is a core indicator of conditions of health and wellbeing in a country,” Jessica Ho, lead author of the study said. “When progress in life expectancy stagnates or even reverses, it tends to be an important warning signal about conditions within a country. It’s extremely important to understand why life expectancy has declined, particularly when the declines are sustained over multiple years, as is the case for both the UK and the US.”

She said that it was “exceedingly rare” for countries to experience falls two years in a row. “This is the sort of thing that happens during epidemics, like the global HIV/Aids epidemic, or in countries undergoing dramatic social and economic change, like Russia during the post-Soviet transition. Simply put, rich developed countries should not be experiencing declines like this. That the UK and the US are experiencing these declines is a major warning sign,” she said.

Dr Ho said that analysis of causes of death showed that flu “explained at most 35 per cent of the decline for the UK”, with conditions such as dementia contributing to the fall. The decline in the US is driven by an opioid epidemic that claims tens of thousands of lives a year, a problem which Dr Ho warned “is showing the potential to become global in scope”.

She added that falls in life expectancy “can signal poor performance of the healthcare system in reaching vulnerable populations like the elderly”.

Danny Dorling, of the University of Oxford, said: “The decline in health outcomes that has become very clear after 2014 has not occurred before in the UK since at least during the Second World War. No other country in all of Europe has seen such a slowdown in health improvements. We urgently need the health select committee of the House of Commons to begin an inquiry where all the leading authorities are asked why has this happened and what should be done.

“My suspicion is that the UK cutting public spending far more than other states is one of the key reasons why the UK stands out like a sore thumb.”

[Rocky]

I wonder about the access to health care issue here. My mother is 85 and lives in an affluent area of north London. GP and primary care services have always been below par and they seem to be getting worse. Her surgery has seen a high turnover of doctors and nurses, and it is a huge nightmare trying to get an appointment. Waiting times to get an OP appointment have also soared. All indicative of local health services in crisis.

It seems to me that Lansley's reforms with moving public health to local authorities and the refusal of this Tory government to engage in initiatives such as sugar taxes and anti-obesity strategies are likely to make the life expectancy problem worse. Add in the rise of rough sleepers, increasing mental health problems, drug addiction together with increasing pressures on social services and social care, you have a recipe for a perfect storm. Given the new Health Secretary, Matt (Tony?) Hancock has an obsession with technology as the NHS's saviour - more apps and big data will solve all our ills and given the challenges to public sector funding from Brexit (not to mention staffing), I can't see this life expectancy trend getting better.

[Iris]

Can I be slightly controversial and say that the Times article is just a teensy bit sensationalist? It's got all the hallmarks of a bit of over-analysis - flashy headline and scary but irrelevant "opioid-ridden" tag, random quotes from random people that when you look at them don't actually reinforce each other (Dorling is talking about health outcomes - which is much more than deaths, the SoCal article isn't talking about life expectancy but about age at death), "the Times revealed" something they couldn't possibly have got in any scientific sense from the data they're analysis given the vagaries of statistics.

It's certainly true that there's been a slowdown in the rate of mortality improvement (https://www.actuaries.org.uk/news-and-i ... provements), but that's something rather different.