Lifestyle and life expectancy

During the summer, life expectancy figures were published for England and Wales showing huge disparities between different parts of the country. I was intrigued to see that people in Dorset have some of the highest life expectancies in the country. When I looked in to the background I found that the disparities in life expectancy reflected shocking differences in lifestyle and here is what I wrote in the Dorset-based Marshwood Vale Magazine.

………………………………………………………………………………………………………………………………………

You already knew it was a good place to live but now it’s confirmed by official figures. In the whole of England and Wales, people in East Dorset have the highest life expectancy; men live on average 83.0 years and women 86.4 years. North Dorset and Purbeck also appear near the top of the list. By contrast, the lowest life expectancy is in the North West of England with men in Blackpool living for an average of 73.8 years and women in Manchester living for 79.3 years. These figures are shocking in that people in the North West can expect to die nearly ten years earlier than their East Dorset counterparts.

Wimborne Minster
Wimborne Minster
Let’s compare the different regions to see if that sheds any light on why life expectancy is so different. East Dorset extends from the edge of the Bournemouth/Poole conurbation in the south to the Wiltshire border in the north. The North and West of the region retain a rural feel but there are several centres of population in the south including the historic market town of Wimborne. The region has very low levels of deprivation and violent crime and low unemployment. It scores well on most health indicators although the rates of malignant melanoma and of injury and death by road accident are higher than the national average. Even in East Dorset, however, there are 1400 children living in poverty (1.6% of the population).

Blackpool promenade - DSC07204
Blackpool promenade showing the Tower
Blackpool is a well-known seaside town with its iconic Tower, Pleasure Beach and Illuminations. It is also one of the most densely populated boroughs outside London. Like many former “bucket and spade” resorts, Blackpool has suffered badly from the shift to foreign holidays and now has high levels of deprivation and high unemployment. Many former guest houses have been converted into multiple bed-sits providing poor but cheap accommodation attractive to people unable to find affordable housing elsewhere. 8200 children (6% of the population) live in poverty and there are high levels of violent crime, drug and alcohol misuse and teenage pregnancy. One third of women smoke during pregnancy and nearly a third of the total population are smokers. The outcome of these behaviour patterns is high levels of death related to smoking and early death due to cancer, cirrhosis, heart disease and violence.

The two regions could hardly be more different and the comparison suggests that people’s social and economic conditions are closely linked to their health. We should, of course, be pleased that health in East Dorset is so good but, as a civilised and prosperous nation, we should be concerned about the health of people in Blackpool and in other parts of the North West. Not only is it possible to live longer and more healthily but, in regions where health is poor, huge burdens and costs are placed on healthcare systems. The only way to reduce these health inequalities in the long term is to tackle the social inequalities. This means increasing employment, investing in housing, and addressing lifestyle issues such as excessive alcohol consumption, smoking and substance abuse, all of which are linked to poor health and which are rife in Blackpool. Tackling these inequalities is a matter for government policy and requires huge investment as well as the political will.

I want to focus on one issue, excessive alcohol consumption, as it has been in the headlines recently. The issue of alcohol consumption raises many uncomfortable questions. Alcohol is a drug, but one that is legal and consumed with few restrictions. It is also recognised to cause significant harms, both to individuals and to society. There are as many as a million alcohol-related hospital admissions each year in the UK, alcohol fuels crime and civil disorder and is estimated to cost the economy up to £20 billion a year. It has been suggested that the overall harm caused by alcohol is greater than that due to some illegal drugs such as cannabis and ecstasy. The issue was recognised by the government in 2012 when it published its Alcohol Strategy aimed at tackling problem drinking. One of the key proposals was to introduce a minimum unit price for alcohol.

The situation in Blackpool illustrates many of the problems of alcohol misuse. More than a quarter of adults drink hazardously or harmfully. Alcohol consumption is thought to be a key factor in violent crime and domestic violence as well as in the occurrence of heart disease and cirrhosis; alcohol contributes significantly to the low life expectancy. Blackpool has many licensed premises and in one part of the town there is one off-licence for every 250 people. Some pubs and clubs stay open until 5 am so that there is an entrenched drinking culture; as one pub landlord put it “The mainstay of Blackpool is the river of alcohol that runs through it and keeps it alive”.

Public health officials in Blackpool want to limit opening hours for pubs and had hoped the government would bring in minimum unit pricing for alcohol to stop supermarkets and off licences selling alcohol for “pocket money prices”. These very cheap sources of alcohol contribute to “pre loading” by drinkers at home before going out. Now the government has abandoned national plans for minimum unit pricing, several councils in the North West intend to impose this locally.

Despite the high life expectancy of people living in Dorset, the region is not exempt from the effects of alcohol. The large numbers of licensed premises in the town centres of Bournemouth and Weymouth attract alcohol-related problems such as violent crime. For the health and safety of the people involved and to make our town centres pleasant places for an evening visit we need to redouble efforts to curb problem drinking.

2 thoughts on “Lifestyle and life expectancy”

  1. I received the following query by email from Richard Malim and I am putting it in as a comment which I will answer and also in case anyone else would like to contribute to the discussion:

    “I was interested in your article in this month’s Marshwood Vale, in which you give life expectation in the Northwest for men of 73.8 years and for women 79.3 years : for East Dorset 83.0 and 86.4 years.

    I expect the literature deals with the element you do not mention. The figures for East Dorset reflect the influx of fit 55 to 70 year olds from other areas of the country who might presumably expect to enjoy anything up to 25 years or more of life, and thus skew your average figure.

    Conversely a proportion of fit Northwestern 55 to 65 year olds leave those areas for their retirements elsewhere ( some in East Dorset) and again your average figure will be distorted, because those fit persons are not in situ to be counted.

    I wonder if anybody knows to what extent the figures ought to be adjusted, and should be grateful for your comment.”

    Like

    1. Thanks, Richard, for your comment. The first thing to establish is that these life expectancy figures are projections based on the current profile of the region concerned. We wouldn’t, therefore, want to correct them for different influences although we might want to understand why they are high or low, which is really what you are asking.

      East Dorset has a high proportion of people over retirement age (32% as opposed to the 19% nationally). The age range of people moving in to the region is apparently younger than the population but not enough to change the age structure of the population. I found some figures for migration in and out of East Dorset and they don’t provide evidence for large movements of people (see second reference below).

      The life expectancy figure doesn’t tell us anything about mobility, it just tells us that in East Dorset people live long lives. The migration figures don’t support mass movement of healthy elderly and so the life expectancy more likely reflects socioeconomic influences i.e. East Dorset is mostly middle class and people have money.

      Blackpool also has a higher than average number of elderly people although the distribution is not as skewed as in East Dorset. It’s a very different region as I tried to point out in my article. One fact that stands out for me is the distribution of excess deaths in the male population which is weighted towards the 25-44 age groups in Blackpool whereas elsewhere it is in the 55-74 groups. This most likely reflects lifestyle and the effects of alcohol and tobacco. Indeed, up to three years of the low life expectancy in Blackpool can be attributed to violence/self harm/overdose, digestive diseases (cirrhosis) and circulatory disease. So, men really are dying younger in Blackpool.

      Another fact that stands out is the yearly “churn” in Blackpool which amounts to 7500 people out of a population of 140,000. This represents the better off leaving and poor from the rest of the North East coming to the town for the HMOs (Houses in Multiple Occupancy).

      Here are some useful web sites:
      http://www.eastdorset.gov.uk/democracy/docstore/1201/120116141252-0c0f7cee-1741-45a9-9ea1-4d7222e88734.pdf
      http://www.dorsetforyou.com/159835
      http://blackpoolccg.nhs.uk/wp-content/uploads/2013/06/Public.pdf

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s