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The ’rapid review’ of the latest Office of National Statistics data on life expectancy carried out by Blackburn with Darwen BC’s director of public health Dominic Harrison must be seen in context.
Mr Harrison acknowledges that caution should be applied to the speculative conclusions drawn from the snap analysis, with increases in female life expectancy – slowing more than men in recent years - used simply as an illustrative tool to highlight potential statistical trends that warrant further investigation.
However, the body of evidence showing significant recent changes in life expectancy continues to grow, as does anxiety that the financial pressures on services aimed at preventing and tackling ill-health may be the most significant cause.
There has been a growing chorus of experts calling for the government to carry out a deep dive into the data and strive at speed to gain an understanding of what is happening.
Michael Marmot, the globally renowned and respected professor of epidemiology at University College London, has repeatedly highlighted that the drop in the rate of life expectancy growth is “historically highly unusual” given increases seen over the past century. He admits that while conclusions over a statistical plateauing in life expectancy are not readily available, it is “entirely possible” austerity has been a contributing factor.
Moreover, the Institute of Health Equity in July last year said that previous increases of life expectancy at birth – one year every five years for women and one year every 3.5 years for men – had faltered since 2010 to one in every 10 and one in every six respectively.
Following on from the rapid review by Mr Harrison featured in LGC, he and other three other experts have carried out further analysis of the data, which was released to LGC today.
This analysis noted life expectancy among older women had shown the largest backwards shift, and by comparing current life expectancy for this group with what it should have been if previous upward trends had continued the gap at the age of 85 was 0.34 years lower for women and 0.23 lower for men.
The analysis therefore argues that recent changes cannot be “dismissed as a temporary aberration”.
It adds: “While the causes of this phenomenon are contested, there is growing evidence to point to the austerity policies implemented in recent years as at least a partial explanation.”
Among the most striking evidence is age-specific life expectancy data compiled at 10-year intervals.
The data for the most recent years (2010-12 to 2014-16) was between 2.1 and 3.5 times lower than at any time between 1981 and 2011, with the previous decade most similar in trend to the current one being 1881-1891.
The chief executive of the Association of Public Health Nicola Close told LGC that the public health community is not united on what life expectancy data is showing.
She said there is concern among some that the issue may be “oversimplified”, but said there is general agreement that further investigation into the statistical anomalies should take place.
Warwickshire CC director of public health John Linnane told LGC that a spike in death rates in 2015, which some have contributed to a strain of flu emerging that was not covered by the vaccine widely administered at the time, could be impacting on the data. He also said the slowing down in life expectancy rates could be due to people who were going through important physical development during a time of rationing - when more vegetables and fruit were consumed and people were more active - could have died in greater numbers in recent years, leaving a greater proportion of people who have led unhealthier lifestyles.
Whatever the contributing factors, Mr Harrison and his colleagues bemoan a perceived dismissive attitude in Whitehall over the emerging evidence and the need for further research.
To back up their point, they reference a statement by the Department of Health (as it was then known) in response to evidence of the 2015 mortality spike, which highlighted that 30,000 more people died in England and Wales than in the previous 12 months, as a “triumph of personal bias over research”.
Mr Harrison has an idea why that got such a terse response. He told LGC the emerging evidence “may raise very difficult questions, some of which will undoubtedly be political because they are to do with decreasing economies and the fair distribution of resources.”
Whatever the political perspective on how public services are structured and financed, and who is entitled to access support, it is the duty of politicians to act on credible evidence, however uncomfortable or unflattering it may be on their past decisions.
To do otherwise, is to fail on the fundamental principles of public service and irresponsibly expose people to potential risk.
Jon Bunn, senior reporter