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Fri, 27 November 2020

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Increased mortality does not happen in a vacuum

Increased mortality does not happen in a vacuum
4 min read

The sudden rise in mortality rates and fall in life expectancy looks unnatural. It is simply inconceivable that the state of our public realm had nothing to do with it, says Louise Haigh


Research in the British Medical Journal (BMJ) has revealed the shocking fact that 10,000 more people died in the first seven weeks of 2018 than in the same period in 2017. The study finds there was no external factor which might have caused the 11% rise – no unusual cold snap, natural disaster or flu outbreak, outside normal expectations.

This is a crisis that began with a huge spike in mortality in January 2015 and has been continuing since. A study by Hiam and Dorling, also published in the BMJ in late 2017, found that delayed discharges from hospital were having a significant effect on mortality rates, both through delays in patients accessing correct care, and from the increased pressure on available beds caused by delays.

There are already too many areas in our country where healthy life expectancy is unacceptably low. The average baby girl born in Manchester between 2014 and 2016 will live to be 79, but only until age 54 will she be healthy. That’s nearly a third of her life spent grappling with health issues that will not affect the average woman born on Orkney until she is 71.

Regional and class inequalities in health are sadly nothing new, but a more distinct and recent change is taking place. In my city of Sheffield, the healthy life expectancy for women – a troubling 57.5 – has dropped by four years since 2009-11, while healthy life expectancy across the country has held basically steady.

Health inequalities have always plagued Sheffield; in my maiden speech I talked about the difference in life chances and life expectancy between people growing up in the east and west of my constituency.  You can expect to live as much as ten years longer depending on where you’re born in Sheffield.

And our city has suffered much over the last decade, first from the financial crisis, when our economy shrunk by almost as much as Greece, largely overlooked in national coverage. Since then we have been subject to vast cuts to the council’s funding which have seen public services pared back to levels which would have been unrecognisable in 2008.

This is putting strain on services right across the spectrum as the safety net falls away. Our police deal with ever more non-crime cases, while crime rises and the amount they can do with their funding falls year on year.

It is axiomatic that life expectancy cannot increase forever and a slowing in its growth and concurrent rise in mortality rates was at some point to be expected – but it’s the sudden change that looks unnatural. It coincides with the era of austerity and it is simply not conceivable that the state of our public realm had nothing to do with it.

As Green, Dorling, Minton and Pickett found, “having a large population share of elderly people may put greater pressure on health and social care, but issues will only arise if these services are underfunded or operate inefficiently.”

We know that increased mortality does not happen in a vacuum, and in an environment where constituents tell me they can’t get a GP’s appointment for several weeks, where people in work on insufficient hours need to visit a food bank and where care visits only last 15 minutes, the toll on our collective health and wellbeing is going to be grave.

So increased funding for health and social care is not the only solution to the crisis – indeed with an ageing population, a slight increase in mortality is unavoidable. But it is the blockage in the system, with too few beds and longer hospital stays, that is restricting our capacity to take on the problems with diet, poverty and public services higher up the chain that are restricting people’s healthy lives. 

 

Louise Haigh is Shadow Minister for Policing and Labour MP for Sheffield Heeley. Her Westminster Hall debate is on Wednesday 18th at 4.30pm

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