Three year boost to healthy life expectancy in England if ’disease of disparity’ is overcome, finds IPPR

Report reveals stark regional health divides and draws direct link to levels of wealth, poverty, employment, education and public health services

Call for New Zealand style public health budget to allocate £35 billion of public finances to improving health and closing health disparities

New analysis reveals systematic correlation between wealth, poverty, social conditions and health. The IPPR think tank report also demonstrates that education, skills, welfare and public health services all have a strong link to health outcomes and life expectancy, and notes that all of these services have faced cuts over the last decade.

The report identifies clusters of areas of England where multiple disadvantages are conspiring to drive down health outcomes and prevent life expectancy from growing.

Northern cities and suburbs, midlands cities and coastal cities were identified as areas where public health was being particularly influenced by a combination of material conditions and lack of health infrastructure, according to the research.

IPPR says ambitious new government policy to ringfence £35 billion from public finances to deliver on public health priorities could transform health outcomes for the better – and also boost the country’s economy

The analysis shows that if health outcomes across the country matched those seen in parts of the country where health is traditionally best (the home counties and more affluent London boroughs) we would see:

• An increase in how long people can expect to live healthy lives in England of 3.3 years.
• An increase in average life expectancy in England of two years.
• A decrease in depression prevalence from around 11 per cent to around 8 per cent – the equivalent of around 1.3 million less people living with depression.
• A decrease in childhood obesity and overweight prevalence from 35 per cent to 32 per cent – the equivalent of around 40,000 less 10- and 11-year-olds with excess weight each year.

In a rebuke to the prime minister’s conference speech suggesting that the health disparity between Ribble Valley and Blackpool was due to ‘some royal jelly’, the think tank shows the reality is that variation comes down to differences in relative wealth, poverty, education and skills levels.

The analysis conducted by IPPR and LCP – a leading analytics consultancy – shows that just before the pandemic hit:

• Life expectancy in Blackpool was nine years lower than in Westminster. And compared to the best performing local authority in England, people in Blackpool also had around one third of the NVQ4+ qualification attainment levels; had three times the prevalence of depression compared to Hounslow; and had one third lower levels of children achieving a ‘good’ standard of development by age five.
• Healthy life expectancy in Nottingham was 14.6 years lower than in Wokingham. While at the same time, compared to the best performing local authority (Richmond), on average people in Nottingham were eight times more likely to be unemployed and have one seventh of the household income per household as those in Kensington and Chelsea.
• So called ‘behavioural’ health risk factors – like smoking, obesity and alcohol consumption – were highest in Kingston upon Hull. On average, compared to people in the best performing local authority, people in Kingston upon Hull had just over half the total wealth per person, and child poverty rate was five times higher than in Richmond upon Thames.

Data for every area of England can be viewed in this first-of its-kind health inequalities tracker produced by LCP – link here.

IPPR suggests that the government’s over-reliance on GDP - a poor predictor of health - often means it fails to invest in the things that would best support our health. The think tank suggests the Treasury introduces a dashboard of measures to supplement GDP – including the ONS’ health index. This, it says, would better cost in the value of health, after a pandemic that proved healthy lives are vital to a healthy economy.

IPPR also argues that the chancellor should announce and deliver a new ‘public health budget’ each year. This would ringfence up to £35 billion from the existing public financesfor the explicit goal of maximising public health and reducing disparities through investment in social infrastructure. IPPR’s analysis suggests priorities for an inaugural public health budget, including:

• Reverse the £20 cut to universal credit. The welfare cut will put an estimated 500,000 people in poverty.
• Invest in better skills and better pay, to make sure work supports good health for all.
• Level up the economy and productivity outside the South East and London, through strategic investment in the life sciences.
• Invest in innovative home and community care services, to ensure social care supports independence living.
• Establish a new free food scheme, providing nutritious and sustainable food for all families who need it.

IPPR points to New Zealand’s Wellbeing budget as an example of a country successfully moving away from GDP as a sole measure of prosperity, to good effect.

Chris Thomas, IPPR senior research fellow, said:

“While the prime minister and his health secretary have recognised that stark health disparities exist in this country, they are currently failing to address the underlying causes. It’s not a ‘royal jelly’ that explains the difference between Blackpool and Ribble Valley – it’s poverty and multiple disadvantage.

“Our analysis shows the material conditions of the places we live – and our exposure to poverty, wealth inequality, unemployment, poor education, worse early years development or lower access to local public health services – combine to undermine the health of many people in our country. This has a social cost, and an economic cost, and runs counter to the government’s ‘levelling-up’ rhetoric.

“At the spending review, the Chancellor should announce a public health budget that invests in the long-term health of the nation, not just short-term GDP gains. The government needs to learn the lessons of New Zealand’s ‘Wellbeing Budget’ and prioritise public spending in areas that boost the health and long-term prosperity of the nation. Creating good jobs, improving education, expanding skills and enhancing public health services will have a major impact on levelling up health across the country.”

Jonathan Pearson-Stuttard, IPPR associate fellow and head of health analytics at LCP, said:

“This research demonstrates the clear link between good health and a range of other socio-economic factors. It also highlights that significant inequalities exist and are deepening further. Investment and resources are required but must be targeted and be proportionate to need. There is a critical role for data and localised information in identifying the areas of most need and ensuring those communities are able to access the funds required to rebalance, rebuild and realise the opportunities that good health brings.”

Charlotte Augst, CEO of patient group National Voices, said:

"Our many members, who directly support people living with ill health, impairment and disability, know that the burden of illness falls very unequally on the different communities they serve. This disease of disparity has made it harder for us to manage the pandemic, and it will make it even harder to recover from it. Investing in health and wellbeing, and everything that is needed to help people to live as well as possible for as long as possible, needs to be at the heart of the government’s levelling up agenda. If we don’t narrow the gap, people’s lives will continue to be blighted by preventable pain, anxiety and loss of independence, and our health and care system will continue to fail those who most need it."

ENDS

Chris Thomas, the report’s lead author, is available for interview

CONTACT

David Wastell, Head of News and Communications: 07921 403651 d.wastell@ippr.org

Robin Harvey, Digital and Media Officer: 07779 204798 r.harvey@ippr.org

NOTES TO EDITORS

1. The IPPR paper, The disease of disparity: A blueprint to progress on health inequalities in England by Chris Thomas, will be published at 0001 on Tuesday 19 October. It will be available for download at: http://www.ippr.org/research/publications/disease-of-disparity
2. Advance copies of the report are available under embargo on request
3. LCP have developed a new tool to fully explore the data in this report. This includes a postcode search tool, a tool to create scatter charts, and a map generator. Maps showing the correlation between health and welfare, and jobs and skills below:

Detailed data for each area is also available and further shows the stark correlation between health and wealth. Explore it here: https://healthandwealth.lcp.uk.com/

4. The ONS' health index was created between 2015 and 2018, after a recommendation by the chief medical officer. It became a national statistic in Autumn 2021. More detail is available here. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/ healthandwellbeing/articles/developingthehealthindexforengland/2015to2018
5. Analysis for this report used publicly available data to provide systematic exploration of the interaction between wealth, welfare, healthcare, health, education and place. A full explanation of the methodology is available below (after release) or on request (before release). https://healthandwealth.lcp.uk.com/about
6. All links between health and other variables in this report are correlation. While the weight of the evidence points towards causation, that cannot be inferred by this study alone.
7. The £35 billion public health grant is based on allocating the equivalent proportion of total managed expenditure in England as in New Zealand’s wellbeing budget. Our recommendation covers England only, but may be more useful in the devolved nations, who are more advanced in supplementing GDP with other measures.
8. Lane, Clark & Peacock (LCP) are a GB based financial and data analytics consultancy, who combine in-depth knowledge of the health sector and traditional epidemiology, AI and actuarial science with real world datasets to tackle a range of pressing challenges across the healthcare and life sciences sector
9. IPPR is the UK’s pre-eminent progressive think tank. With more than 40 staff in offices in London, Manchester, Newcastle and Edinburgh, IPPR is Britain’s only national think tank with a truly national presence. www.ippr.org