In recent years Britain has been hit by one health crisis after another. First came the COVID-19 pandemic—then backlogs in health and social care that the coronavirus exacerbated, and a long winter of strikes and overwhelmed emergency departments. But in the background, long before the pandemic hit, an even more disturbing story has been unfolding. Britain has endured a grim decade during which perhaps a quarter of a million people died younger than expected.
By our calculations, that is the number of extra deaths Britain has suffered, compared with similar countries such as France and Denmark. The reason is that, in the early 2010s, life expectancy stalled in Britain compared with long-run trends and other countries. This slowdown in life expectancy struck all age groups, not just the elderly. And it disproportionately affected the poor. If you travel just 10 kilometres from the poshest part of Kensington in London to New Cross Gate, life expectancy for men falls by a staggering 18 years, from 92 to 74. The burden these deaths place on the living is not just weighed in grief. When more people are dying and life expectancy is stagnating, a greater number of people are also living in ill health.
An ambulance drives past St Thomas’ Hospital in central London.Credit:AP
Life expectancy in Britain, as in almost all other rich countries, had been rising for nearly two centuries. But something went wrong in the early 2010s. Life expectancy at birth today, at 81, is just eight weeks longer than it was in 2011. In a best-case scenario, in which the pace of improvement between 1980 and 2011 had been sustained, life expectancy today would have been over 83. By The Economist’s calculations, that is no minor difference: it implies that between 2012 and 2022 approximately 700,000 Britons died sooner than they might have.
Two features make this figure even more worrying. Death comes mostly when people are old. But the slowdown in life expectancy has occurred across all age groups. Mortality rates have stalled for infants, and risen among young adults and the middle-aged. Death rates for 30- to 49-year-olds have steadily increased in Britain since around 2012, in sharp contrast with neighbouring countries.
Although the deaths have been spread across generations, they have not been spread across the income spectrum. Life expectancy has fallen among the poorest in society but risen for the richest. A poor English girl could on average expect to live 6.8 years less than a rich girl in 2011, but 7.7 less in 2017. For boys, the gap increased from 9.1 to 9.5 years over the same period.
The combined effect of the pandemic and global demographic trends can explain only some of Britain’s missing multitude. Though other rich countries have also experienced slowdowns, Britain has done the worst out of a cohort of its European peers. After stripping out the effects attributable to covid and the broad European slowdown from the toll of 700,000, you are still left with those 250,000 unexplained deaths.
A runner passes street art in appreciation of the NHS placed near to the Francis Drake Bowls Club in Hilly Fields Park, in Lewisham, London.Credit:AP
Working out what has gone wrong is not easy. In America, where life expectancy has fallen even more sharply in recent years, “deaths of despair” from drugs, alcohol and suicide have done the most harm. The same is true for Scotland, where drug deaths have more than doubled in a decade; Dundee is now the drug-death capital of Europe. Yet although a similar problem may be brewing in England and Wales, the rate of drug deaths is nearly four times higher in Scotland.
The recent struggles of the National Health Service (NHS) have played their part. Hospital waits of record lengths and a crisis in primary care jeopardise timely treatment. But delays in medical care cannot explain all the extra deaths, especially before the pandemic. Besides, the greatest improvements in life expectancy come not from treatment but from better diagnosis and prevention, and wider prosperity. This is where Britain appears to have fallen short. It could do much better in all three.