Intended for healthcare professionals

  1. Michael Marmot, director
  1. Institute of Health Equity, Department of Epidemiology and Public Health, University College London, London, UK
  1. m.marmot{at}

Falling life expectancy and rising inequality are twin indicators of a society in trouble

Something is going badly wrong with society in the UK and the US. Is it linked to Brexit and Trump? Of course, but they are the consequence not the cause of problem—although they are wreaking their own havoc. A simple summary measure of the success of a society is its health: life expectancy has fallen in the US for three years in a row,1 and in the UK it has stalled since around 2011.2

When attention was first drawn to the slowing of life expectancy gains in England,34 concern was raised that it was not “real”—perhaps a severe winter was causing a short term fluctuation. That speculation is given the lie by the latest publication from the Office for National Statistics showing that life expectancy has stopped increasing in England and marginally declined between 2015 and 2017 among men and women in Scotland and Wales and among men in …

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