We've yet another dodgy report from yet another dodgy think tank being written up today. You know it's dodgy when the writye ups, to create the narrative, arrive before the full paper can be checked to see what they're really saying. But here's part of the report:
While most people will live to state pension age and beyond, a large proportion are unlikely to get there in good health, especially in more disadvantaged parts of the UK – places like inner city Glasgow, where the healthy life expectancy is just 46.7 years – close to 20 years lower than the national average of 65.
No, that's not really true.
The difference in disability-free life expectancy between women born in the most and least deprived areas was 11.6 years in 2001-04. By 2007-10 it had increased to 13.4.
And that's absolutely not true. The problem, here is that no one is understanding what these numbers are, how they're collected, and they are thus using them in highly inappropriate manners.
Lifespan, healthy lifespan, these are not the numbers from people born in certain locations. Nor of people in certain income bands, social classes or anything else. They are collated from the places and ages at which people die. It's vital to understand this difference.
As an example, consider two people who live at some point in their lives in those inner-city areas of Glasgow. One is born there, joins the Army, retires to Eastbourne and dies at 90. The other is born in Eastbourne, drifts along, gets tied into drug addiction and dies at 40 in some squat in Glasgow with a needle in his arm.
That first person, given that we count these things as where people die, leads to the average age at death in Eastbourne rising: that second, for the same reason, lowers that average age at death in Glasgow. But clearly and obviously neither of them have anythiing at all to do with the average age of death in their birth places. And yes, people do indeed move around: and one of the greatest prompters of people moving is a change in their economic circumstances. So, therefore, a goodly part of what we're seeing here when poor areas have lower lifespans than rich ones is not that living in a poor area kills you but that people self-select into poor or rich areas based upon their wealth.
Another way of approaching the same point is to consider the mistake that Michael Marmot has been making for decades. There is most certainly a link between economic inequality and health inequality. Living in a disease ridden slum will indeed make you more susceptible to said diseases. However, there's also an obvious link between health inequality and economic inequality. One acquaintance was hit with a series of severe illnesses in his mid-40s. Sufficiently bad that he entirely dropped out of the workforce for four years. All terrible of course: but his subsequent economic inequality was a result of his initial health inequality, not the other way around.
If we start to assume that this lifespan inequality is a direct and sole result of economic inequality then we're going to get any plans to solve it all entirely wrong. It's vital that we also accept that health inequality happens, as does movement of the population, and that both of these will lead to the economic inequality that we see.