Women in the UK are living shorter lives on average than most of their counterparts in Europe, according to an analysis by Public health England.
Spanish women have the highest life expectancy in Europe at birth, at 86.3 years in 2016. The average for the UK is 83, taking 17th place out of 28 EU nations. Men in the UK do better, in 10th place and with an above-average life expectancy of 79.4, but men in Italy, the leading nation, can expect to live to 81.
Life expectancy at birth is 83 years for women in the UK, 0.6 years below the EU average
The data, from Eurostat, is for the UK as a whole rather than its constituent countries but is being published by PHE as part of its annual Health Profile for England. Data from the Global Burden of Disease study on premature death shows a similar picture.
“We are in the middle of the pack and we would like to be at the top. There is no reason why we shouldn’t be as healthy as anywhere in Europe,” said Prof John Newton, director of health improvement at PHE.
“It is certainly of concern that we have worse outcomes than other European countries,” he added. “We tend to do badly in men with the respiratory disease and in women with cancer, especially breast cancer. It is a sign of the numbers developing the disease.”
Many of the causes of chronic, long-term diseases in the UK which shorten lives are preventable. Obesity is causing a big surge in the numbers of people developing type 2 diabetes. The report shows the numbers with diabetes are expected to rise swiftly, from just under four million last year to nearly five million in 2035. Along with alcohol, obesity is also one of the factors behind the rise in breast cancer. Apart from the human cost, the bill for the NHS will be huge.
Most of the strategies to reduce obesity are aimed at children. “In many ways, it is easier to intervene,” said Newton. “We have a duty of care for children. But it is equally important that adults are enabled to eat a better diet.”
There is strong policy support for childhood obesity programmes, he said, such as the sugary drinks tax, curbs on advertising junk food to children and pressuring food companies to cut the sugar, salt and calories in their products. There is little directed specifically at adults. However, said Newton, “nearly all of the measures will also improve adult obesity. Effectively we are taking calories out of the national diet,” he said.
The report also shows that healthy life expectancy – the number of years people live before they begin to suffer from illnesses – has not much changed in recent years. Women in 2014-16 were spending nearly 20 years of their lives in poor health (19.3 years), while men spent just over 16 years in poor health, according to data from the Office for National Statistics included in the report.
Women born in England can expect on average to spend 19.3 years, 23.2% of their lives, in poor health
The leading cause of poor health, responsible for more than 22% of the pain and suffering, is low back and neck pain, which can be caused by a number of things, including injury and rheumatoid arthritis. After that come skin diseases such as acne and psoriasis, says the report. Third for men is sight and hearing loss, while for women it is migraine. Fourth for both is depressive disorders.
Long-term conditions such as diabetes, high blood pressure, and cancers underlie some of these problems.
The leading cause of death for women is dementia and Alzheimer’s disease, responsible for 15.8% of deaths, with heart disease second at 8.3%. For men, that is reversed, with heart disease causing 13.6% and dementia and Alzheimer’s 8.3% of deaths. However, PHE says that dementia and Alzheimer’s will become the leading cause of death in men too, possibly within two years. This is attributable to people living longer; since the 1970s the number of 85-year-olds has tripled and will reach more than two million by 2031.
The Alzheimer’s Society said that one million people will be living with dementia by 2021 and that the disease has not had the attention it deserves.
“We have stressed for a long time that dementia was set to be the 21st century’s biggest killer – it has already become so, and what is the stark reality for women is now also set to be the case for men,” said Sally Copley, director of policy. “What makes this more sobering is that it is the only leading cause of death that we can’t cure, prevent or even slow down, showing the critical need to tackle the dementia crisis.”
Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said there were genetic and socioeconomic reasons people were developing long-term conditions affecting their health, “but there remains a clear connection between the quality of our patients’ lifestyle and their overall health”. That included poor diet and lack of exercise.
“GPs are acutely aware of these dangers, which is why we will always try to take into account the physical, psychological and social aspects of the person sitting in front of us, including how their lifestyle might be affecting their health and the ways in which they can work to improve it. Often simple lifestyle changes can have a big impact on long-term health and wellbeing,” she said.
“With many patients coming to see their doctor with more than one problem, however, finding time to properly assess someone’s lifestyle can be difficult within the constraints of a standard 10-minute consultation.”
Newton said there had been some “notable successes” in preventing ill-health, citing the steady drop in smoking and in teenage pregnancies. In the last seven years, smoking prevalence has dropped by a quarter to 15%. By 2023, just 10% of the population could still be smoking.
Of great concern, however, are the social and economic inequalities in health. “People in wealthier parts of the country enjoy 19 more years of good health than in poorer parts of the country,” he said. “They live nine years longer – for men – and seven years longer for women. These are unacceptable variations.”