23 November 2018

Austerity or obesity: What is behind the UK’s stalling life expectancy?


A new report from the OECD suggests stalling life expectancy since 2011 may not be down to government spending cuts, but lifestyle factors such as obesity.

One of the organisation’s economists, Gaetan Lafortune, tells The Times that if austerity were to blame, it would not account for similar trends seen in other Western European countries, whose fiscal policies have been different to our own.  “Austerity does not explain why the reduction in 2015 occurred in many European countries and why this reduction was strong in the UK,” Lafortune says.

Note, for instance, that in 2015 life expectancy declined not only in the UK, but also in France, Germany and Italy.

Another study released this week, from Imperial College, does pin the blame on spending cuts. It states that “the funding squeeze for health and cuts to local government services since 2010 have had a significant impact on the most deprived communities”. The lead of that report, Majid Ezzati, says people in deprived areas are dying more quickly because detection of diseases like cancer and dementia is taking longer.

What are we to make of all this? Stalling life expectancy hit the headlines back in August after a report from the Office for National Statistics said life expectancy in the UK had grown significantly more slowly after 2011 than in previous years. Unsurprisingly, this provoked the ire of Owen Jones.

But things are clearly not as cut-and-dried as the outraged columnists might have you believe. Alan Evans of the ONS said at the time: “The slowdown in life expectancy improvements that has been observed in the UK since 2011 is also evident in a number of countries across Europe, North America and Australia. However, the UK has experienced one of the largest slowdowns in life expectancy at birth and at age 65 years for males and females.”

As with most areas of complicated public policy, the picture is a mixed one — certainly, the UK seems to have a worse problem than other places, but the general trend of slowing life expectancy is common to various developed economies, which suggests there is something else at play besides “austerity”. At the same time, the Imperial study suggests specific problems in the health service can contribute to problems in specific communities, which is not the same at all as saying that spending cuts/austerity equals lower life expectancy.

It’s worth pointing out that if spending alone were a guarantor of great outcomes, Americans would be crowing about their excellent healthcare — after all, the US government spends more per head than we do and gets far worse outcomes (partly because of the extraordinarily high cost of drugs across the pond).

Overall, the OECD offers a few possible reasons that UK life expectancy has stalled in recent years, including  “growing risk factors like obesity, a lack of physical activity and diabetes”, all of which fall in the “lifestyle choice” category, rather than being to do with, say, the number of nurses in the health service.

Indeed, the new Health Secretary, Matt Hancock, has already said he wants the NHS to put more of its focus on disease prevention rather than simply treatment. The Mayor of London, Sadiq Khan, has also jumped on the bandwagon with an announcement today that junk food advertising will be banned on public transport in the capital.

The point here is not that spending cuts (or falls in the rate of growth, if we’re talking about the NHS) have no effect, it’s that crudely attributing an outcome such as overall life expectancy to changes in government spending is so simplistic as to be almost useless. It’s an easy trick if you’re a polemicist or an opposition politician of course — saying “there are a range of factors at play” is hardly going to guarantee you top spot on the News at Ten.

John Ashmore is Deputy Editor of CapX