Life expectancy

The national audit office recently published a report about life expectancy and how it varies between different socio-economic groups. It pointed out not only that there is a gap between the life expectancy in poor areas and the rest of the country, but also that the gap has got worse since the 90s. This despite the fact that the government set a target for a 10% reduction in this gap by 2010.




Earlier this week (before the report was published) Edmund Truell of the Pension Corporation happened to be speaking about this at an insurance conference in London. He said that someone living in Chelsea or Kensington could expect to live to 100, whereas the life expectancy in East Kilbride is shorter than in the Gaza Strip. He didn't state his sources, so I haven't been able check the accuracy of his statistics, but it's quite shocking if he's right.



The national audit office report is calling for these discrepancies to be addressed by looking at things like smoking and diet. Personally I would welcome these initiatives - as long as they can be made to work!

But I just want to add 2 alternative points of view on this:



(A) Financial implications - they may be worse than most people would think
(B) Worldwide perspective - there might be better places to focus our efforts


Financial implications

The first thing to say is that even if the financial implications are sobering, that's not a reason to let poor people suffer bad health and die early! But I think the financial implications are probably broader than most people would initially realise, and I wanted to make that point. I will refer to three areas:


(I) NHS - improving health may be more costly rather than less
(II) Pensions - longevity could worsen the pensions black hole
(III) Care for the elderly


(I) Cost to NHS - improving health may be more costly rather than less



Typically commentary looking at the cost to the NHS of obesity/smoking/whatever simply counts up all the money spent on obesity/smoking/whatever -related conditions. However, I saw an article (I wish I could remember where) a few years ago. It pointed out that there are two effects:

(i) obesity and smoking bring about illnesses and conditions which have to be treated (this is a cost)
(ii) obese people and smokers die early. Because their lifespans are shorter, ongoing NHS costs are reduced (financially, this is a benefit)

It claimed that when you take into account both effects, the true lifetime cost to the NHS of a healthy person, an obese person, and a smoker are £210k, £187k, and £165k respectively.

Furthermore, pro-smoking lobby group Forest claims that the tax income from cigarettes is around £9billion, compared to NHS costs of treating smokers of only around £2.7billion according to a bbc news article a couple of years ago.

(II) Cost to pensions - this would worsen the pensions black hole

A google search for "overall UK pension scheme deficit" gives answers ranging from £70billion to £212billion, depending on when and how they are measured. This is out of total pension scheme assets of around £1.5 trillion (according to IFSL research, relating to year-end 2008). Out of a total UK GDP of c. £1.4 trillion this is a fairly big number.

Part of the volatility comes from stockmarket volatility, but part of the problem is that people keeping on living longer, and we have to have more money in our pension funds to make sure we can keep paying them their pensions. Decreasing the life expectancy gap should both:

(a) improve the overall life expectancy of the country, and
(b) improve the life expectancy of those people most likely to have to rely on state benefits in their retirement



(III) Care for the elderly - there would be more old-age care costs
A few days ago, Cosla (the body representing Scotland's 32 councils) questioned the future of free personal care for the elderly because of the cost. If people are living longer, this cost could potentially worsen.

I would like to repeat that even these costs may be significant, I don't think this should stop us from trying to improve people's health. (I would hope that is obvious!)



Worldwide perspective

According the UN world population prospects report, life expectancy in the UK is (on average) 79.4 years. The national audit office report suggested an average life expectancy gap of around two years. How much do you think the life expectancy is in Swaziland?

According to the UN report, it's the worst at 39.6 years (see table A16 on page 79). About forty years worse than us. So while I applaud the proposed efforts to improve the health of our nation, I wonder whether there are other parts of the world that might be more in need?