Black stones balancing

Public health: Life expectancy inequity continues to grow in Wales

A joint paper by Public Health Wales and Cardiff University has shone a light on the worrying trend of depreciating health inequalities between Wales’ most and least deprived areas.

The paper details how the gap in life expectancy increased amongst both men and women between 2002 and 2020 – this was primarily caused by large drops in life expectancy in Wales’ most deprived areas, including a sharp decline for women between 2018 and 2020.

During this period, the difference in life expectancy in women rose from 4.7 years in 2002-04 to 6.3, whilst for men it rose from 6.4 years to 7.6 during the same period.

Ciarán Humphreys, Consultant in Public Health at Public Health Wales, said: “The lives of many living in our most disadvantaged communities are being cut short too early, and this is getting worse. This research points us to where we can make a difference.

“Healthcare has a role to play, and strengthening our public health efforts has the potential for even greater impact in addressing this gap. However, the greatest contribution to this gap in how long people live lives beyond these services and programmes, and relate to the basic building blocks for health, the conditions into which we are born, live, work and grow.

“Without these building blocks – such as having enough money to buy the food we need, and warm safe homes, our mental and physical health suffers.

“We believe that to address these unfair differences in loss of life, we need clinical, public health and cross-sectorial action on health inequalities, supported by a policy environment that prioritises health equity in all policies. As we face this cost of living crisis, we need to act together across these wider determinants that fundamentally shape our health and well-being.”

The paper also found that around a year’s worth of the life expectancy gap was down to deaths that were considered “treatable” by healthcare services – this included circulatory, respiratory, and cancer-related deaths.

An even bigger factor was deaths that were preventable by public health interventions – this contributed around two years’ worth of life expectancy gap for women and 3.5 years for men.

Jonny Currie, Honorary Clinical Lecturer, Division of Population Medicine, Cardiff University, added: “The greatest rise in deaths however was from causes neither directly treatable by medical services nor preventable through public health programmes.

“This category saw an increase in contribution from 1.6 to 2.7 years for women between 2002-04 and 2018-20 and from 1.6 years to 2.4 years for males, partly driven by a rise in deaths in adults over 75 years but also from a myriad of causes not strictly defined as avoidable, despite a clear socio-economic gradient in such deaths.”

The paper concluded that “sustained investment in prevention post-COVID-19 is needed to address growing health inequity in Wales; there remains a role for the NHS in ensuring equitable healthcare access to alongside wider policies that promote equity.”

To access the paper, click here.

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