While the average life expectancy continues to rise in the UK, there are worrying trends within the statistics. I do not think it possible for life expectancy to keep rising inexorably. In the same way that we wouldn’t expect the world record for the 100 metre sprint to keep falling, we cannot realistically expect to keep living longer and longer.
That aside, I have two main concerns which are hidden by the headline figures. Firstly, the inequalities that exist in life expectancy in different regions of the UK are worrying because there appears to have been little progress in addressing them. It makes me feel that whatever I do to help my patients, in the grand scheme of things, I only have a small impact on their health, because as little as 10% of their health is due to the healthcare they receive. Being unable to effectively have an impact on the social determinants of health is frustrating.
Secondly, headline figures of overall life expectancy hide the trends in healthy life expectancy. This can be expressed as either the number of years spent in good health, as defined by the ONS, or the percentage of life expectancy spent in good health. In other words, it’s not just about the quantity of years, but the quality of those years. This has enormous relevance to health and social care, because it is those people who are no longer in “good health” who are the main users of health and social care.
In the period, 2014-2016 women in the UK, on average, lived to 82.9 years old, but over 19 of those years were spent in poor health. This is an increase on the average amount of time spent in poor health compared to 2009-2011. So although life expectancy increased between the two time periods the reported proportion of life spent in good health actually went down. The same trend is apparent for men (see ONS report).
When compared to European countries, recent figures for suggest that UK healthy life expectancy is about average, though there is a lot of variation between countries. It’s worth noting that the two standout countries as far as life expectancy is concerned (Malta and Sweden) also have the highest absolute and relative levels of healthy life.
So it would seem that although we continue to live longer than ever before, which is the case in most countries, advances in life expectancy are slowing, perhaps due to a combination of the limitations of the human body, healthcare or, more likely, the lack of willingness to address the social determinants of health. It remains to be seen if we can increase the quality as well as the quantity of life.
Samir Dawlatly is a GP partner at Jiggins Lane Medical Centre in Birmingham. The views expressed here are his own and don’t necessarily represent those of any organisation he works for.
Competing interests: I am a GP partner at Jiggins Lane Medical Centre, a partner of Our Health Partnership. I am an occasional member of the RCGP online working group on overdiagnosis.The views expressed here are my own and don’t necessarily represent those of any organisation I work for.