Life expectancy

You might have seen this in the LRB from Danny Dorling. It's sobering stuff. Here's a flavour of it:

"Since 2011, under David Cameron and Theresa May, life expectancy has flatlined. [...] For the first time in well over a century the health of people in England and Wales as measured by the most basic feature – life – has stopped improving. Just as Macmillan had done, the government initially tried to blame the figures on flu deaths. But as the years have passed and life expectancy continues to stall it has become clear that flu isn’t the culprit. The most plausible explanation would blame the politics of austerity, which has had an excessive impact on the poor and the elderly; the withdrawal of care support to half a million elderly people that had taken place by 2013; the effect of a million fewer social care visits being carried out every year; the cuts to NHS budgets and its reorganisation as a result of the 2012 Health and Social Care Act; increased rates of bankruptcy and general decline in the quality of care homes; the rise in fuel poverty among the old; cuts to or removal of disability benefits. The stalling of life expectancy was the result of political choice."

Woah! You mean the Tories are killing people? Just like Macmillan did?

Spoiler alert: No.

Here's the ONS digest Dorling is talking about. It's a bit on the dry side, as these things are, but it shows a small improvement: "The rate of increase in life expectancy in the UK has slowed in recent years. In 2014 to 2016, improvements in life expectancy were higher than in 2013 to 2015 although they remained very slight", it says, weakly.

But wait! Dorling was talking about England and Wales. Surely the difference is that Scotland, which has a completely different NHS, devolved government, milk and honey, and so on, must be dragging up the average? Surely once those nasty Tories are out of the way, we can all live as long as the Japanese?

Um, no. "Life expectancy at birth remained highest in England and lowest in Scotland," says the ONS. Well, but that's historical? Surely it's because of those Tories being charge all those years ago? Now that devolution is in place, things are getting better?

Um, no: "Life expectancy at birth in Scotland has continued to diverge from the UK," says the ONS.

Let's be clear about all this. Here is a rather more colourfully-illustrated Government statistical paper. It shows us that this is what happened in the UK up to 2014 (and recall that things have got very slightly better since then):

Thrilling, isn't it? 

Dorling's point is this. You'll see that there was a little downward blip in about 2011-2012, i.e when that nasty Mr Cameron took over from the nice Mr Brown. So things are a bit flatline-ish if you draw a straight line from a point before the downward blip to the present day. 

Meanwhile, here is what happened to men across Europe:

And, just so you can see I'm not cherry-picking, here's what happened to women:

You can see the same 2011-2012 blip right across Europe. It was massive for the over-85s in France. Maybe that flu thing that the Government was talking about was real after all?

None of which is to explain why British male life expectancy at 85 is lower than German life expectancy. But nor is it to explain why British male life expectancy at 65 is higher than German life expectancy, or why British female life expectancy at 85 is higher than German life expectancy. (Or at least why they were so in 2013.)

There is a lot that goes into life expectancy. Smoking, public health, air pollution, diet, gun laws, migration and, yes, health services. But one of the most notable differences between the health care systems of Britain and other European countries is that we have a lot of state medicine (the NHS) and other countries have more private health care: why not say that their excellent private healthcare is why French people live so long, even before Cameron turned into Killer-Macmillan Mark II? Or at least Dorling could explain why those Spanish healthcare cuts of 2012 seem to have improved outcomes for old people?  

There are obviously arguments to be had about how much money should be raised in taxation, and about how the money that is raised in taxation should be allocated between different competing public demands, and even within the NHS there are competing priorities (would a glitzy advertising campaign promoting MMR be better at prolonging life expectancy than spending more money on hospices? would that be a better use of money?). Dorling might be right in saying that the Government has the wrong priorities. But you should not fall for his story that the Government has decided to kill people as a matter of political choice.