Intended for healthcare professionals


Life expectancy gap between rich and poor in England widens

BMJ 2019; 364 doi: (Published 28 March 2019) Cite this as: BMJ 2019;364:l1492
  1. Gareth Iacobucci
  1. The BMJ

England has seen “significant widening” in life expectancy between rich and poor people, largely because of a fall in how long women in the most deprived parts of the country live, the latest figures show.1

The Office for National Statistics data show that life expectancy at birth of males living in England’s most deprived areas was 74.0 years in the years 2015 to 2017, whereas it was 83.3 years in the least deprived, a gap of 9.3 years. Women in the least deprived areas of England were expected to live 78.7 years in 2015-17, while those in the most affluent were expected to live 86.2 years, a gap of 7.5 years.

Since 2012-14 the gap among women has increased by half a year, because women from the most deprived areas are living 100 days less, while those in the most affluent are living 84 days longer.

A similar pattern was also apparent in Wales, although significant changes were not detected. Here men in the most deprived areas were expected to live 73.6 years while those in the richest areas were expected to live 82.4 years, a difference of 8.8 years. For women in Wales the respective figures were 78.2 and 85.8 years, a gap of 7.6 years.

Women and men in the least deprived areas of England and Wales were expected to live for nearly two decades longer in good health than those in the most deprived areas.

Ben Humberstone, deputy director for health analysis and life events at the ONS, said, “Our wider analysis of mortality shows that life expectancy in the UK has stopped improving at the rate that was expected before 2011. We will be carrying out further work to analyse the factors contributing to this trend, including the impact of deprivation.”

Michael Marmot, an expert on health inequality in the UK, discussed stalling life expectancy this week at the final meeting of the Lifepath project in Geneva (, which reported that socioeconomic circumstances have a similar effect on mortality as factors such as smoking, alcohol, and obesity. He argued that health inequality was “not inevitable” given the extent to which it has shown to be affected by the policies of individual governments.

“We’ve seen recent increases in inequality in the UK. It can get bigger, smaller—it can change very quickly. It’s not inevitable that it should be as big as it is,” he argued.

He said that fluctuating levels of child poverty in the UK were an example of how government policy could make a difference to health inequalities. “We’ve seen deliberate policies to increase child poverty,” he said. “Previously, we know [that] half a million children in the UK were taken out of child poverty because of government action.”

Russell Viner, president of the Royal College of Paediatrics and Child Health, said that universal early years’ services continued to bear the brunt of cuts to public health services, with no targeted help provided for children and families experiencing poverty.

He said, “This is a substantial threat to the good progress the government is making. Without increased investment in public health services, ensuring a healthy future for our children will be difficult to grasp. I urge the government to support these vulnerable families by reversing public health funding cuts and giving them the help they so urgently need.”


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