The poor die younger than the rich

In England, the gap in life expectancy between poor and rich people is increasing – with women experiencing the worst outcomes.

In a major paper published in the journal The Lancet Public Health, a team led by epidemiologist Majid Ezzati from Imperial College London, UK, reveals that the long-established gradual rise in average life expectancy among English women has stalled in three out of five of the “most deprived” social strata, and actually reversed in the other two.

Ezzati and his colleagues used registration data from the Office for National Statistics to examine population and death records from 2001 to 2016, and analysed them by age, cause of death and socio-economic status. All up, the research covered 7.65 million deaths.

The study found that the gap between average age of death in the country’s most and least affluent groups had increased across the board – but much more so for women.

In 2001, women at the poorest levels of society could expect to die 6.1 years before their wealthy peers. By 2016, the difference had increased to 7.9 years. Over the same period, the gap between poor and rich males increased from nine to 9.7 years.

Looking at female death rates in more detail, however, revealed an astonishingly bad picture.

“Since 2011, the rise in female life expectancy has stalled in the third, fourth, and fifth most deprived deciles and has reversed in the two most deprived,” the researchers write.

In the poorest two levels female life expectancy dropped by 0.24 years for the worst hit, and 0.16 years in the next group.

In 2016, the researchers discovered, death rates from every disease and at every age were higher among poor people than among the rich.

“The largest contributors to life expectancy inequalities were deaths in children younger than 5 years (mostly neonatal deaths), respiratory diseases, ischaemic heart disease, and lung and digestive cancers in working ages, and dementias in older ages,” the researchers write.

Most of the causes of early death among the poor, they note, “can be effectively prevented and treated”.

The scientists conclude with a call for the urgent introduction of “proportionate universalism” – the provision of healthcare services in a way that delivers at a scale that is appropriate to the level of need within any given community.