Jane McDermott, Programme Development Healthy Ageing, Centre for Ageing Better, discusses healthy ageing and inequalities
Having lived in the North of England for much of my life, it is easy for me to recognise that our levels of poverty and inequality can be higher than other parts of the country. Deprivation is visible in our communities, from our towns and cities to those rural and coastal areas which have too often been left behind.
Working in education, social inclusion and employability, I’ve seen how these inequalities can impact on peoples’ access to safe and accessible housing, affordable transport, and good quality employment.
In recent years, my work within the field of healthy ageing has shone a spot light on how health inequity impacts on individual health and wellbeing, and I’m deeply concerned for many of our communities.
Being in good health as we age is fundamental to our quality of life. Good health enables us to stay safe and well in our own homes for longer, to work and be active participants in our communities, and to maintain social connections and family life.
Looking at current projections for disability free life expectancy, we know that good health in later life is more likely to be experienced by those in the most well-off areas. However, poorer communities, as well as women and black and minority ethnic groups, are much more likely to be living with disabilities and disease as they grow older.
A report by the Centre for Ageing Better, The State of Ageing in 2019, highlighted some of the shocking health inequalities in Britain today. For example, almost half of the poorest men aged 50 and over have arthritis compared with just a quarter of the wealthiest. For women, the difference is 66% of the poorest compared with 42% of the wealthiest. Inequalities like this cut across many other health conditions too.
When it comes to life expectancy, the data is clear. Men and women living in cities like Liverpool, Manchester and Newcastle can expect to live shorter lives, and experience more years living with disabilities or health conditions that could have been prevented. This in comparison to the longer lives enjoyed by those living in Kensington, Plymouth or Birmingham.
But how have we got to this point? As many in the North will attest, one of the reasons for this is the legacy of insufficient funding for local authorities across the country.
According to the Institute for Fiscal Studies, local councils in England have seen an average cut to their budgets of almost 26% since 2010. And the picture is getting bleaker; the Local Government Association predicts an £8 million funding gap by 2025, all of which risks worsening the day-to-day lives of the people living in our communities.
The World Health Organisation has determined that social determinants like geographical locality, education and access to a health care system are major causes of health inequalities. And these factors are often influenced by the disparate distribution of resources, wealth and power. In their recent report Health for Wealth, the Northern Health Science Alliance demonstrated the link between poor health and productivity, this specifically when comparing the North and South of England.
The toxic combination of cuts across local government and years of underfunded health services, matched with a lack of access to good quality housing and employment for those living in the least well-off communities, hits the poorest the hardest.
In his speech prior to his contribution to the Medical Committee of Human Rights in 1966, Dr Martin Luther King said “of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death”.
Surely, we have to take note of this. We need to create policies – and provide funding to support them – to enable the necessary structural changes for nurturing good health and wellbeing. Having access to safe and accessible homes, all age-friendly environments and infrastructure, good quality and fulfilling employment are critical to ensure we all can live long and happy later lives.
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