The problem, generally, is staying in a home, not finding one
Sir Michael Marmot is insistent that economic inequality leads to health inequality. Well, OK, perhaps it does. Marmot also adamantly refuses to consider that health inequality leads to income inequality but that’s just something general to his world view rather than specific to this research.
What he’s telling us today is that the last decade has seen an increase in that health inequality. That there’s been a stalling of the expansion of lifespans too.
Hmm:
Marmot says the worsening of our health cannot be written off as the fault of individuals for living unhealthy lives. Their straitened circumstances and poor life chances are to blame. His institute’s work has established that healthy lives depend on early child development, education, employment and working conditions, an adequate income, and a healthy and sustainable community in which to live and work.
Austerity has taken its toll over the last 10 years in all of these areas, says Marmot in a foreword to the report. “From rising child poverty and the closure of children’s centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to food banks in large numbers, to ignored communities with poor conditions and little reason for hope … Austerity will cast a long shadow over the lives of the children born and growing up under its effects.”
His proof depends upon the idea that cuts in sure start centres for children born in, say, 2008, has led to changes in the lifespans of those born in, say, 1958, or 1948.
No, really. Peeps are dying now in their 60s and 70s because how they were brought up as toddlers mattered. That is his argument. But the influence of current austerity cannot be upon what happened those decades ago, can it? Thus there’s a certain lack of evidence for the link being made.
There is also that other point. Marmot blames inequality. Yet inequality has fallen since 2008. That is, Marmot is full of it, as he has been for some time on this point.
The language we use matters - it provides clarity to our own thoughts and enables…
It is now generally acknowledged that the structure of the NHS needs to be overhauled…
In the film Apollo 13, a loss of oxygen causes the crew to start inadvertently…
There's an idea out there which seems intuitive but then so many ideas do seem…
When we think about the darkly opaque goals of modern central bankers as they relate…
As the papers recently filled with the distressing images of desperate souls looking to escape…
View Comments
He also disregards migration. We know that the long term trend is for healthy people to move to more prosperous areas. It is difficult to understand how this factor can be ignored.
Indeed. If you move from Afghanistan, Iraq, Somalia or Romania to Lancashire you might gain a few years of life expectancy, but you're going to bring the British average down. We don't book our deaths by where you were brought up, but by where you dribbled away.
I am sure that I have read Tim before, pointing out that it is more likely that the causation is from poor health to lower income (and moving where housing costs are lower), rather than the other way round: a view with which I readily agree.
On top of that, we have annual government spending on healthcare, expressed as pounds per capita and index-linked for inflation. This shows upward-trending spending on healthcare - with the minor exceptions of 2011 (-0.2%), 2012 (-0.8%) and 2013 (-0.1%): which nowhere near balanced the excessive increases in 2009 (+19.0%) and 2010 (+5.2%) - a pair of desperately profligate flings by the Gordon Brown government to win the then upcoming general election.
So what explains why all this extra spending on healthcare is not forcing better health outcomes - most obviously through the ages of death of those who die. That is after noting that the UK mean ages of death for both men and women are actually still increasing; it is only the rate of increase that has gone down.
Is it that increasing spending too rapidly leads to less cost-effectiveness and less value-for-money? Is it that nearly all of the low-hanging healthcare fruit has been picked, and we are now awaiting further improvements in medicine and medical technology. Or (as commented by James above) are there (around 20+ years after significant government easing of immigration controls) now biases being introduced into the death statistics through noticeably high levels of historical immigration from places where healthcare provision got people off to a less-good start than usual for UK births and long upbringing?
What does Sir Michael Marmot think of these alternatives to his 'explanation'?
Best regards
there’s been a stalling of the expansion of lifespans too
That's what he claims (and the BBC parrots), but he's wrong:
https://iea.org.uk/no-life-expectancy-is-not-falling/
The rate of increase in life expectancy has fallen, but it's continuing to increase. Nobody with any knowledge in this area expected it to continue to increase indefinitely at the same rate (except Aubrey de Grey).
Does anybody expect it to continue indefinitely at any rate?
As I said, there's this chap - a bit (lot) of a weirdo, but certainly not stupid. He's expecting it to increase to infinity sometime soon.
Basic physics is going to result in a platau'ing of lifespans anyway.
To deny that being in poor health significantly reduces your capacity to earn is frankly bizarre. There is a clear and obvious way that happens. How working a zero hours contract cause ill health when the vast majority of people on zero hours contracts say they like them is not.
A few extracts from the the Marmot report - it's long so the Professor may not have written these bits:
"but both pointed to those with Pakistani and
Bangladeshi ethnicity having the lowest life expectancy "
From wikipedia , estimates of people reporting a Pakistani ethnic or mixed Pakistani origin:
2001 (actual) 747,000
2011 (actual) 1,175,000[1] and increasing at over 200k a year ( not sure it's increasing that much myself, but it will be higher in 2021, i'd bet my life on it )
Later the report says on Air Pollution:
"Air quality has emerged as a major equity issue in the
years since the 2010 Marmot Review. Poor air quality
harms health, including raising risks of mortality and
morbidity. Most deaths related to air pollution are
due to heart disease, stroke and chronic obstructive
pulmonary disease, and air pollution has also been
linked to cancer and childhood and adult asthma
(279) (323).
Pollution levels are, on average, worse in areas of
highest deprivation compared with areas of lowest
deprivation. In 2017 the Chief Medical Officer for
England’s annual report was based on the risks of
air pollution and described a “triple jeopardy” for
deprived communities and places, showing these
places faced higher risks from, “social and behavioural
determinants of health…higher risks from ambient
air pollution exposure…[and] greater susceptibility
to the impact of pollution” (325)"
Ok, so more local authority spending on car-accessible sure start centres and care homes in poor wards isn't the way to go. Let's congestion charge, and work out other measures to deal with this air pollution. What have the cleanest areas got, apart from richer people, and copy some of their practices.