Deprivation, gender and health inequalities in England
Yesterday the Office for National Statistics released its most recent data on inequality in life expectancy in England. The data shows that that between 2001-2004 and 2007-2010 average life expectancy in England increased by 1.75 years to just over 80 years. Yet, with overall increases in life expectancy, health inequalities have grown. Life expectancy at birth is now 8.2 years longer for men in the least deprived areas of England than men in the most deprived areas, while women in the least deprived areas can expect to live 5.8 years longer than their peers in the most deprived areas. As well as being measured from birth, life expectancy is also measured at age 65. The focus here will be on the latter as this data shows clearly a recent development that links gender, deprivation and health outcomes. Life expectancy at 65 is simply the expected number of years of life remaining at a 65 years of age, given that a person has reached that age.
The graph below shows the life expectancy in England, separately for men and women, for a 65 year old according to the level of deprivation of the area in which they life. The results, group the areas into fifths (quintiles). They show the levels over the period 2001 to 2004 and the change between those years and the period 2007 to 2010.
There are a number of changes of interest to us here. Firstly, as with the life expectancy from birth data, unequal increases in life expectancy at age 65 between 2001-2004 and 2007-2010 have widened the gap between the least and most deprived areas. For both men and women, the increase in life expectancy was biggest in the areas of lowest deprivation (1.8 and 1.7 years respectively) and smallest in the areas of highest deprivation (1.2 and 1.0 respectively). This widened the ‘deprivation gap’ to 4.1 years for men and 3.5 years for women.
Secondly, in line with expectations, women on average continue to outlive men. In the years up to 2010, women’s life expectancy at 65 exceeded men’s by about three years. However, the average increase in life expectancy between 2001-2004 and 2007-2010 was slightly greater for men (1.55 years) than women (1.3 years). This had the effect of narrowing the overall gender gap.
However, what is really striking about the latest inequality in life expectancy data is that the deprivation gap is now beginning to overtake the gender gap. Men in the least deprived areas of England now have a higher life expectancy at age 65 than women in the most deprived areas. In the period 2001-2004, the life expectancy for 65-year-old men in the least deprived areas of England (quintile 5) was about the same as that of women in the most deprived areas (quintile 1). Since then, however, men in quintile 5 now have a life expectancy one year more than women in quintile 1. Further to this, the life expectancy of men at 65 in quintile 4 has now also surpassed that of women in quintile 1. This reflects changes we have also been seeing in the life expectancy at birth data which shows that men on average can now expect to live as long as women in the most deprived areas.
Despite overall increases in life expectancy, inequalities remain. Health inequalities were targeted by the previous government with some success, and the Marmot Review of 2010 brought additional focus to the topic. But health inequalities are complex and the impacts of interventions in this area will not be seen for some time. As such, the worry is that range of austerity measures being implemented now - that exacerbate poverty and so impact on health - will not show their effects for years.