‘Deaths of Despair’ Aren’t Just a U.S. Problem

The United States isn’t the only country experiencing what economists Anne Case and Angus Deaton called “deaths from despair.” The U.K. is one of the most economically advanced and stable democracies on the globe and yet the life expectancy of its people appears to be stalling, with striking differences by gender and geography.

According to a new report from the National Center for Social Research life expectancy in the U.K. is expected to continue to increase but the size of these increases is substantially smaller than in previous years. A more detailed study by the Office for National Statistics compared 20 countries and found that between 2005-2010 and 2010-2015 the U.K. had the greatest slowing in life expectancy at birth for women and the second greatest slowing for men (behind the U.S.).

While the exact causes of these divides are still being debated, it’s hard not to draw parallels with the debate in the U.S. As Case and Deaton show in their book “Deaths of Despair and the Future of Capitalism,” life expectancy in the U.S. recently fell for three years in a row, a reversal not seen since 1918 or in any other wealthy nation in modern times.

The economists traced this not only to the rising number of deaths from suicide, drug overdose and alcoholism but to deep and widening inequalities within modern capitalism, which they argue is no longer delivering for the working-classes and, in particular, people without university degrees. The independent Institute for Fiscal Studies in Britain recently partnered with Deaton to conduct a comprehensive review of inequality in the U.K.

As in the U.S., deaths from suicide, drug overdoses and alcohol-related liver disease have also been rising among middle-aged people in England, although on a smaller scale and especially concentrated among the less-well educated. There are also sharp and worrying differences across the country, with a gap in life expectancy at birth between the least and most deprived areas in England of 9.4 years for men and 7.4 years for women.

Between 2012-2014 and 2015-2017, for example, women who live in the most deprived areas of the country saw a statistically significant reduction in life expectancy at birth of almost 100 days while women who live in the least deprived areas saw an increase of 84 days in life expectancy. As one statistician at the Office for National Statistics noted, the fall in life-expectancy at birth for women in the most deprived areas “has led to a significant widening in the inequality in life expectancy at birth in England.”

These differences are also reflected in the number of years that people spend living in “good health.” In 2016-2018, healthy life expectancy was 63.1 years at birth for men and 63.6 years at birth for women. However, as with life expectancy generally, our healthy life expectancy has been rising at a slower rate. It is also now falling for women.

While this means that most people can expect to live a larger proportion of their lives in poorer health, there are striking differences by gender and geography. Men have gained five months in healthy life expectancy since 2009-2011 but women have lost three. And while men who live in the most deprived areas of the U.K. can expect to have only 5.8 years of “good health” from 65 years of age, men who live in the least deprived areas of the country can expect to have more than double that (13.3 years).

Whereas the affluent, leafy borough of Richmond-upon-Thames has the highest healthy life expectancy for men, at nearly 72 years, head northwards to the town of Blackpool, a deprived area where unemployment, alcohol and opioid addiction is rife, this figure is nearly 19 years lower (53.3 years).

Northern towns such as Hartlepool, which provided strong support to Brexit, have in recent years seen some of the steepest falls in life expectancy; whereas men could expect to live to nearly 78 years in 2012-2014 by 2015-2017 this had fallen to 76 years. This might not sound like a big change but any decline in life expectancy is largely unprecedented in a modern democracy.

These disparities are no doubt part of the frustrations that underpinned the Brexit vote in certain parts of the country, and it is not yet clear how the U.K.’s de facto departure from the European Union, to take place at the end of this year following a transition period, will impact areas that areas experiencing greater levels of deprivation. Some of them – particularly those reliant on manufacturing companies — will experience new trade frictions after Brexit.

For the Conservative government, the new data will be taken as further justification for an agenda that aims to close the stark economic and social divides between the regions. So far, this has involved committing 100 billion pounds ($130.5 billion) toward infrastructure projects, devising new rules for government spending so that it benefits more deprived regions and sending new research agencies (and perhaps even the House of Lords) north.

Those may prove the easy calls to make. Any plans to address the imbalance in opportunity and economic prospects across the country will not only need to focus on trains and bridges but also introducing a radical new skills agenda, non-university education and tackling the inequalities that plague primary and secondary school education. Given the government’s new ‘leveling up’ mantra, and Boris Johnson’s awareness that he is now far more dependent upon non-graduates for votes, such an agenda is definitely on the radar. Whether it turns into concrete action remains to be seen.