Research and analysis

Mortality Insights from GAD - July 2022

Published 28 July 2022

The impact of socio-economic differences on life expectancy

Welcome to Mortality Insights. In this edition, and in light of the Queen’s recent momentous celebrations, we explore mortality patterns across various socio-economic groups.

We consider differences in life expectancies across local areas in the UK, and how the pandemic has disproportionately affected people with different socio-economic backgrounds.

Please note, throughout this article we use period life expectancies. This means that they do not take account of projected future changes in mortality rates. Please see this ONS article for more information on the difference between period and cohort life expectancies.

The Platinum Jubilee

This year, Her Majesty the Queen has celebrated her Platinum Jubilee, marking 70 years as a reigning monarch for the UK. When the Queen was born in 1926, the life expectancy at birth for females in England and Wales was 62 years. The Queen has surpassed this by over 34 years.

The International Longevity Centre currently estimates that around only 0.15% of the UK population are the same age or older than the Queen. Several other members of the Royal Family have also enjoyed a long life; most recently, Prince Philip reached the age of 99 and the Queen Mother was 102 at the time of her death.

The life expectancy of a female born in England in 2022 is currently projected to be 83 years, an increase of 21 years in life expectancy since the birth of the Queen.

While life expectancies have improved drastically, every individual’s chance of reaching this age can vary significantly. With that in mind, we consider studies on how life expectancy varies between groups of people in the UK with different socio-economic backgrounds. We also look at how COVID-19 may have exacerbated these differences.

Finally, we consider how the mission to narrow the gap in healthy life expectancies may be achieved, as set out in the government’s recent Levelling Up White Paper.

Life expectancy and deprivation groups

Life expectancies depend on many factors, including but not limited to, genetics, access to healthcare, housing, nutrition, wealth and education.

Research has shown those living in affluent areas are likely to live significantly longer than those in more deprived areas.

The Index of Multiple Deprivation (IMD is a measure of relative deprivation in England. The IMD ranks each small area in England from most deprived to least deprived, based on characteristics including income, employment, education, health, and crime.

There are other similar measures in the rest of the UK. These ranks are grouped into deciles so that:

• decile 1 represents the most deprived 10% of small areas in England
• decile 10 represents the least deprived 10% of small areas in England

In 2017 to 2019, males and females in the most deprived areas could expect to live almost a decade less than those in the least deprived areas. This gap is wider for males (9.4 years) than for females (7.7 years), as illustrated in Figure 1 below.

Figure 1: Life expectancy, England, 2017 to 2019

Source: Office for National Statistics (ONS)

Figure 2 illustrates the disparity in mortality rates between 2015 and 2019 from leading causes of death.

It illustrates how death rates, after allowing for differences in age profiles of various groups, are significantly higher in the deprived areas for all causes. In the case of respiratory disease, the death rate is more than double in the most deprived compared to the least deprived area.

Figure 2: Mortality rates from leading causes in most- and least- deprived areas, England, 2015 to 2019

Source: Public Health England (PHE) based on ONS data

Lifestyle-related factors which are known to contribute to the reduction in life expectancies include:

• smoking (in 2019, smoking prevalence in the most deprived areas was almost twice as high than in the least deprived areas)
• poor diet and obesity
• excessive alcohol consumption and drug abuse
• poor quality housing
• less access to green space

All these factors tend to be more common in deprived areas. They contribute to ill-health and are risk factors in the leading causes of death.

Variations and changes

Using the IMD, the ONS regularly analyse life expectancies at birth across the most- and least- deprived areas.

Figure 3 shows the change in life expectancies at birth for males and females across the deprivation deciles over the period between 2015 to 2017 and 2018 to 2020.

The data underlying Figure 3 has also captured the increase in mortality in 2020 resulting from the COVID-19 pandemic.

Figure 3: Change in life expectancy at birth by sex and deprivation deciles, between 2015 to 2017 and 2018 to 2020

Source: Office for National Statistics (ONS)

Over a typical period in time, we would expect life expectancies to continue increasing, as they have over the last century. However, the life expectancies for those in most deprived areas has seen a negative change, where these have decreased by up to 6 months.

In contrast, life expectancies in more affluent areas have either seen no change (such as deciles 5 and 8) or a relatively small reduction for males, and an increase for females. This is illustrated in Figure 3. This suggests that the gap in life expectancies between the most and least deprived groups in England has widened over recent years.

COVID-19

Figure 2 suggests that individuals living in disadvantaged areas were already experiencing higher rates of mortality from underlying health conditions, even before the pandemic. These conditions and other risk factors are likely to have increased the severity of COVID-19, and increased mortality rates.

Research suggests the higher prevalence of overcrowded housing, and jobs that cannot be done from home in low-income areas, led to higher rates of mortality from COVID-19.

ONS data shows the mortality rate for deaths involving COVID-19 at the start of the pandemic was twice as high in the most-deprived areas. This is compared with the wealthiest areas, based on data released in August 2020. This is evidence that the pandemic exacerbated the inequalities that the most disadvantaged communities face.

Will the gap continue to widen?

Related to life expectancy is healthy life expectancy, which refers to the period for which individuals can expect to live in good health.

Analysis by the ONS suggests that those living in more affluent areas also enjoy higher healthy life expectancies, compared to those in more deprived areas. This means they are likely to spend a higher proportion of their lives in a state of good health. With males from the most deprived areas expected to live less than 75% of their lives in good health, whereas those from the least deprived areas spending almost 85% of their lives in good health.

The recent Levelling Up White Paper sets out a mission to narrow the gap in healthy life expectancy between local areas by 2030. It also sets out an aim to increase the healthy life expectancy more generally by 2035.

The White Paper sets out how to achieve the overarching ambition to improve wellbeing more generally in the UK. These include improving health of the most disadvantaged communities by:

• piloting an initiative for healthy eating and school cooking revolutions
• introducing a new Tobacco Control Plan
• setting up Community Diagnostic Centres

These are expected to contribute to narrowing the gap in healthy life expectancy between areas where it is highest and lowest. It would be expected that improving healthy life expectancy would also increase overall life expectancy in the targeted groups.

Final thoughts

The lifespan differences between some members of the Royal Family and the public, and those between subgroups within the public, can be largely attributed to the same reasons.

Nobody knows how life expectancy will improve in the future as there are many uncertainties, including unknown longer-term effects from the pandemic.

However, the focus on trying to reduce disparities in life expectancy between different socio-economic groups will hopefully contribute to an overall increase in average life expectancy.

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