If this is a life and death story then we’d better get the details right
Aditya Chakrabortty tells us that this is terribly, terribly, important:
Still, there is one headline I’ll bet you haven’t seen, even though it directly affects your life. It’s about your life, and mine, and those of our families and friends and neighbours. I didn’t spot it either, until a few days ago when the Guardian ran a reader’s letter.
It came from Alan Walker, a retired professor at the University of Sheffield. Why, he asked, hadn’t this newspaper made more of the latest “shocking” figures on healthy life expectancy? I looked up the report from the Office for National Statistics, and he’s absolutely right: the findings are indeed “momentous”, and they should be on the front pages, because they expose a serious truth about the state we’re in.
And, well, maybe. But let us agree that falling life expectancy, falling “healthy life expectancy” is truly that momentous thing. We must therefore make sure that we’ve the details correct.
A little while ago, I interviewed the chief executive of the hospital where I was born, North Middlesex in London. On an office wall hung a map of her patch, marked with life expectancies for each part. The working-class suburb where I was raised, Edmonton, ranks among the most deprived in the country; the middle-class suburb where I currently live is among the least deprived. I could see them on her map, along with figures suggesting my two small daughters can expect almost a decade more of good health than girls living in my old home, just three miles away.
The first thing is - as we’ve said a number of times - that we’ve absolutely no idea what life expectancy, healthy or not, is by place of birth. Because we don’t measure it. We measure life expectancy by place of death. The reason this matters? People often do move 3 miles in their lives thereby moving from one patch to another. We have no link between that place of birth and of death in those statistics. We did in fact check this once with a coroner. No, no one does have access, even for statistical reasons, to the long form certificate that would allow collation of numbers by place of birth. At least, no one does in volume - it’s possible to get only individual such certificates and then only for good reason.
We really, really, do not know life expectancy by place of birth. With only 83% of UK residents actually UK born we’ve that inaccuracy at national level and it only gets blurrier from there on down - people migrate across local boundaries much more than they do national after all.
We’d also look just a tad askance at the healthy numbers. ONS estimates this by: “Healthy life expectancy measures health-related wellbeing and represents the average time an individual is expected to live in "very good" or "good" general health, based on how individuals perceive their general health.” This is something - potentially at least - subject to that famed hedonic adjustment. As life gets generally better then those standard aches and pains of age get reclassified from standards to ill health. We are not wedded to that but insist it’s a possibility.
We’d also suggest that referring us to the WHO numbers doesn’t quite work.
While our healthy life expectancy has been dropping, in Sweden it has been rising.
And, well, yes. The general trend for Sweden seems pretty similar to that for the UK with it really being just the last measurement period that differs. Both peaked in 2019 and we wonder what that could be associated with? The decline from 2019 also seems to be Europe-wide and world-wide. We’d suggest this is a very fragile basis upon which to base an argument insisting that everything must change.
But then, obviously, what do we know? We’re just reading statistics and thinking about them rather than trying to write a column for The Guardian.
Tim Worstall