England

Health inequalities in England are significant. There are two key measures of health inequality– life expectancy, a measure of how long we can expect to live and healthy life expectancy, which tells us how many of those years are expected to be in good health.

The length of our lives

In some parts of England, for some groups, life expectancy was reducing for the first time in a century before the Covid-19 pandemic. This is the case for women in the north-east England, for example.

On average, life expectancy in England is higher than in Scotland and Wales – for women, 83 years, and for men 79.1. In England as in Scotland and Wales, however, life expectancy has been falling since 2020, primarily a result of the Covid-19 pandemic. For example, female life expectancy fell by 1.1 years in Derby – but this was not the case everywhere. In Kensington and Chelsea, life expectancy for women increased by 1.7 years.

There are great discrepancies in people’s life expectancies based not just upon where they live, but the circumstances surrounding where they live. These building blocks of health - are known as social determinants of health and include factors such as income level, employment, housing and education. This is measured through the English Indices of Deprivation. These are official measures of relative deprivation for small areas, which ranks every part of England into a relative measure, based on income, employment, education, health, crime, barriers to housing and services as well as the living environment. Life expectancy data and IMD data are closely aligned. It is clear these factors make a huge different in how long we can expect to live.

There are huge gaps in life expectancy for those living in the most disadvantaged parts of the country and those in the most affluent. This gap is 9.7 years of life for men and eight years for women.

Men living in the most disadvantaged neighbourhoods can expect to live for 73.5 years whereas those in the least 83.2 years. For women, this is 78.3 years in the most disadvantaged neighbourhoods and 86.3 in the most affluent.

The quality of our health

There is a similar trend between deprivation and healthy life expectancy, which is a marker used to measure how many years we can expect to live in good health.

Those living in the disadvantaged areas can expect to live the smallest proportion of their already shorter lives in good health, and those living in the least ‘deprived’ parts of the country can expect to live the highest proportion of their lives in good health.

Women living in the most disadvantaged areas can expect to live 51.9 of their 78.3 years in good health. In the least disadvantaged neighbourhoods, women can expect to live 70.7 of their 86.3 years in good health. Women in the least disadvantaged neighbourhoods can almost expect to live healthily for as long as women in the most disadvantaged neighbourhoods can expect to live.[5]

Men in the most disadvantaged parts of England can expect to live 52.3 years in good health. In the least disadvantaged, this is 70.5 years – a gap of 18.2 years. This is a significant gulf; men in the most disadvantaged areas are expected to live in poor health long before they reach retirement age.

These statistics demonstrates an enormous gap in the quality and quantity of life in England. Given how closely this links to the quality of housing, services, education, the environment and jobs, such huge inequalities are avoidable. With greater focus on tackling the factors impacting our health, inequalities in life expectancy and healthy life expectancy can be narrowed.

Sources

Institute of Health Equity, Health Equity in England: The Marmot Review 10 Years On (2020)

Office for National Statistics, National life tables – life expectancy in the UK: 2020 to 2022 (2023)

Office for National Statistics, Life expectancy for local areas of the UK: between 2001 to 2003 and 2018 to 2020 (2021)

Office for National Statistics, Health state life expectancies by national deprivation deciles, England: 2017 to 2019 (2021)