Stalling and declining life expectancy across the UK has been widely covered in the media. This blog explores recent changes in life expectancy in Scotland – how this varies across Scotland and some of the potential causes of stalling and declining life expectancy.
How long are people in Scotland are expected to live?
Figures published by National Records of Scotland in December 2019 showed that life expectancy for boys and girls born in Scotland in 2016-2018 varies. It was 77.0 years for boys and 81.1 years for girls. Simply how long someone lives isn’t the whole story though. At what age does good health start to decline?
Women will spend more of their later years in poor health than men, despite living longer. Boys born between 2016 and 2018 are expected to live in good health for 61.9 years. For girls, healthy life expectancy is 62.2 years.
So, women are expected to live for 18.9 years in poor health and males are expected to live in poor health for 15.1 years. That’s quite a lot of unhealthy life, and this has significant implications for public policy and public finances.
Life expectancy and healthy life expectancy also varies considerably by local authority area. Glasgow City has the lowest life expectancy and healthy life expectancy in Scotland. ScotPHO has an online profiling tool where you can view indicators such as life expectancy at a local level.
How does Scotland compare with the rest of the UK?
Life expectancy in Scotland is the lowest of all the UK countries – a position it has been in since the early 1980s.
Source: NRS Scotland
Is life expectancy in Scotland increasing?
No, gains in life expectancy have stalled in Scotland since around 2012. Life expectancy in Scotland for women has fallen from its highest level of 81.15 (in 2014-15) to 81.06 (in 2016-18). For men the peak was 77.10 (in 2014-16), in 2016-18 it was 77.05. It is yet to be seen whether this is a trend that will continue over time.
Life expectancy has either stopped increasing or has decreased in almost all local authority areas since 2012-2012. The charts below show how, in many cases, life expectancy increased between 2001-03 and 2012-14 but has decreased or not increased so quickly between 2012-14 and 2016-18.
Source: NRS Scotland
What about inequality?
Deprivation is strongly linked to life expectancy.
“The patterns of inequality in life expectancy between different places are not a matter of chance or fate, but a reflection of the stuff of life itself”.
There is a big difference in life expectancy for those living in the most and least deprived areas of Scotland. Men living in the 10% most deprived areas were expected to die 13.1 years earlier than those living in the in the 10% least deprived areas (69.6 compared to 82.7 years). Women living in the most deprived areas were expected to die 9.8 years earlier than those living in the least deprived areas (75.6 compared to 85.4 years).
The gap in healthy life expectancy is even higher between the most and least deprived areas – 23.9 years for females and 23.1 years for males.
Health inequalities and marked differences in the life expectancy of those living in the least and most deprived communities continue to persist. Whilst improvements in mortality have stalled across the whole population of Scotland, the issue is most acute in the most socioeconomically deprived areas, leading to a worsening of health inequalities.
The charts below show how life expectancy and healthy life expectancy varies across different areas ranked by deprivation level (SIMD 1 represents the 10% most deprived areas. SIMD 10 represents the 10% least deprived areas). People living in the most deprived areas (SIMD 1 and 2) are expected to live shorter lives and have longer living in poor health than people living in the least deprived areas (SIMD 8, 9 and 10).
Source: NRS Scotland
What is happening in other countries?
Whilst a slowing in the rate of improvement in life expectancy has been seen in many high-income countries such as England, Wales, Northern Ireland and the Netherlands, other countries, including many in Eastern Europe and Asia, have seen continuing or faster improvements in life expectancy. For example, Denmark has maintained gains in life expectancy for both men and women between 1997 and 2016.
The Scottish Public Health Observatory points out that countries with higher life expectancies have seen continuing improvements “which means that the slowdown is not due to attaining or approaching a ‘natural’ limit to lifespan”.
Leading expert Professor Sir Michael Marmot, University College London, commented that:
“Other European countries continue to get healthier. We are not. Something is going badly wrong with health and with the social conditions which shape our health.”
Why is life expectancy stalling?
The reasons for stalled increases in life expectancy have been widely discussed. Cuts in public sector budgets and pressures on health and social care services are seen as contributing factors. Flu and other conditions such as obesity and poor mental health have also been suggested as having an impact.
What can be done?
Many people believe that there is a need for public policies to address the fundamental causes of inequality, that public services should be provided depending on need rather than demand and that there is a need for a greater focus on prevention.
Only time will tell if predictions in life expectancy and healthy life expectancy are borne out. The policy decisions taken today will have enduring effect on the lives and lifespan of the people of Scotland. There are no easy answers or quick fixes.
Where can I find out more?
- King’s Fund: What is happening to life expectancy in the UK (October 2019)
- NRS: Life expectancy in Scottish areas 2016-2018 (December 2019)
- ScotPho: Recent mortality trends (October 2019)
- NHS Health Scotland: Stalling life expectancy is a warning light for public health in Scotland (February 2019).
- BMJ: Recent adverse mortality trends in Scotland: comparison with other high-income countries(October 2019).
Lizzy Burgess, Senior Researcher, Health and Social Care
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