Healthy Life Expectancy: A Watershed Moment?

Britain is getting older, that much we already knew. What we seem reluctant to admit is that the UK is also getting sicker, and much sooner.

The Health Foundation’s latest analysis on healthy life expectancy ought to be a watershed moment, though one suspects it will instead be filed alongside the many other warnings politely ignored.

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Over the past decade, the number of years people can expect to live in good health has fallen by around two years, to just over 60. In a country where the state pension age is 66, most people can now expect to spend several years in ill health before they retire.

The pandemic has led many to think of life expectancy as the key metric of national progress. But healthy life expectancy is the measure that matters. It tells us not just how long we live, but how well; and by that standard, Britain is going backwards. In the poorest areas, healthy life expectancy drops to the mid-50s, and the gap between the richest and poorest regions stretches to nearly two decades.

If this were happening in a failing state, we would call it a crisis; in the UK, we call it a report.

Of course, the usual explanations are already being rehearsed: obesity, smoking, alcohol, and poor diet.

But this framing risks missing the bigger point: these behaviours do not occur in a vacuum; they are shaped by income, education, environment, and opportunity.

Somehow, the UK has managed to build a society that makes ill health the default status.

The pandemic, with its lockdowns and detrimental effects, accelerated the trend, but it did not create it. The underlying issues that include rising chronic disease, widening inequalities, and a failure to focus on prevention were already entrenched.

The Health Foundation is right to call for a shift towards prevention and a broader focus on the “drivers of ill health”. But we need to be honest: we’ve been saying this for years, and it’s largely been ignored.

The economic consequences of ill-health are dire: among working-age adults, labour market participation is already reducing and increasing pressure on public finances. We are, in effect, storing up costs for the future while failing to improve lives in the present.

The Health Foundation describes the current moment as a “watershed”. Not because the data are new—they are not—but because the direction of travel is unmistakable. The uncomfortable truth is that Britain’s health is coming apart at the seams.

The UK is a country where people live longer, but spend more of those years in poor health; where inequalities widen and where the NHS struggles under ever-increasing demand.

The question is whether this really is a watershed moment—or just another missed opportunity.

This post was written by two old geezers who are just about in good health - thank you very much.