Not everyone’s invited to the 100 club: The changing face of Britain’s life expectancy – Published in “i”

More people turned 100 in 2020 than in any other year in British history, but a gulf in life expectancy between the most and least deprived areas shows that age is more than just a number. By Etan Smallman

 

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The oldest person in history, according to Guinness World Records, was Jeanne Calment. She took up fencing at 85, was still cycling at 100, ate almost 1kg of chocolate a week and only gave up smoking at 117. She lived until 1997 – when she was 122.

Kane Tanaka, the world’s oldest person alive today at 118, rises at 6am and keeps her mind sharp by beating care-home staff at her favourite board game, Othello, before studying maths in the afternoon.

Bob Weighton from Hampshire said it was “just one of those things” when he was named the oldest man in the world in February 2020 at 111. Weighton, who died at 112 three months later, credited his longevity to something rather prosaic: “Avoiding dying.” As he told i last year: “Somebody has to be the oldest!”

In the future, will more of us be reaching “ripe old ages” like theirs? What counts as a statistically “good innings” these days, and what factors are involved?

Life expectancy is not just the average age of death in a population. It tells us about the progress of humanity over the centuries, and how our duration on this planet is still determined to a large degree by class, sex and geographical divides.

Since 1900, globally, life expectancy has more than doubled – now standing at 72.6.

As figures from the Global Change Data Lab show, not a single country today has a lower life expectancy than the nation which had the highest in 1800 (Belgium was top with 40). And most people across the world can expect to live as long as those in the very richest countries did in the middle of the 20th century.

But inequalities still abound. A person born in the Central African Republic (the country with the lowest life expectancy) can expect to die at 53, more than 31 years earlier than someone from Japan (the nation with the highest).

The average age of death in the UK stood at just under 40 in 1800, 45 in 1900 and 69 in 1950.

Today, life expectancy at birth is 82.9 for females and 79 for males, and one in three females and one in five males born today are likely to live to celebrate their 90th birthday, according to the Office for National Statistics (ONS).

It was revealed last week that more people turned 100 in 2020 (7,590) than in any other year in British history, with the ranks of centenarians increasing by nearly a fifth, compared with 2019.

It was driven by historical birth patterns, as those celebrating the milestone were part of the spike in births following the end of the First World War.

But not all is rosy. It also emerged this month that excess deaths due to the pandemic contributed to life expectancy in England falling last year to its lowest level in almost a decade.

Public Health England (PHE) said life expectancy fell by 1.3 years for men and 0.9 years for women – the lowest since 2011 for both sexes. Covid-19 was the leading underlying cause of death among males, replacing heart disease, and the second-largest cause of death among females after dementia and Alzheimer’s disease.

The gulf in life expectancy between the most and least deprived areas was higher than at any time in the past two decades – showing that “the pandemic has exacerbated existing inequalities”, said PHE.

Even before Covid, between 2011 and 2018, there was a continuing slowdown in improvement to life expectancy in the UK. In England, its growth stalled for the first time in more than a century and people are living for more years in poor health, according to a landmark review published last year.

Sir Michael Marmot also found that for the most deprived women, lifespans went into reverse.

He blamed “social and economic conditions, many of which have shown increased inequalities” and said similar trends can be observed across the whole of Britain.

England is ranked 27 out of 208 countries for life expectancy by the Global Burden of Disease Study. Northern Ireland is in 36th place,

Wales is 35th and Scotland is ranked 46th. Statisticians come up with the figures using “life tables” based on recent mortality rates and population estimates. Some measures also take into account projected numbers of deaths and factor in predicted improvements in health in the coming decades.

Chris White of the ONS says the figures are crucial for policymaking, helping to determine “decisions about the affordability of pensions and whether you need to raise the state pension age”.

Life expectancy also shows the efficacy of the Government’s health im- provement strategies. “It’s there as a kind of overarching index of success of policies which are aimed at tackling components of mortality risk further down,” he says.

The 20th century had only two sharp declines in life expectancy in the UK: in 1918, when Spanish flu killed 228,000 people and Britain was counting the cost of the First World War, and in the early 1940s, with deaths from the Second World War.

Since the 1950s, the graph shows a smooth upward curve of almost uninterrupted improvement. This was fuelled, from the late 1940s onwards, by the introduction of immunisation, which led to the transition from infectious diseases to non-infectious diseases being the largest cause of death.

White says: “One of the biggest changes is improvement in living standards, which people perhaps don’t necessarily associate with this.” In short, we owe a huge amount to better housing and universal healthcare, free at the point of use, introduced in 1948.

According to a paper published in the Journal of Economic Perspectives, several developments have triggered these leaps in life expectancy, including new ideas about personal health and public administration in the wake of the Enlightenment in the 17th century, the germ theory of disease popularised in the 19th century and awareness of the dangers of smoking in the middle of the 20th century.

But average age of death is not the only important metric; one can also look at “healthy life expectan- cy”. Results from a 10-year study conducted across the UK and US and published last year found that being rich gives an average of an extra nine years of life without disability or disease.

If you want to achieve an extra decade of healthy life, and can’t simply rely on the dividends of wealth, research by Harvard university in the US in 2018 suggests there are five key – though not exactly revelatory – things you should do by the age of 50.

You need to have a good diet, exercise regularly, maintain a healthy body weight, abstain from smoking and make sure not to drink too much alcohol.

Researchers found that those who maintained the healthiest lifestyles were 82 per cent less likely to die from cardiovascular disease and 65 per cent less likely to die from cancer when compared with those with the least healthy lifestyles over the course of a 30-year period.

A study by three US institutions in 2019 found that individuals with greater optimism are more likely to achieve “exceptional longevity”.

The most cheerful men and women had, on average, an 11 to 15 per cent longer lifespan, and 50 to 70 per cent greater odds of reaching 85 years old compared with the least optimistic groups.

One thing that is far harder to control is the air we breathe. A study published in 2020 found that human-made air pollution is killing almost nine million people a year and reducing lifespans globally by three years.

The international team of authors, led by Professor Jos Lelieveld of the Max Planck Institute for Chemistry in Germany, found that more people are dying early from breathing toxic air than from malaria, HIV, war and smoking.

Chris White, of the ONS, says that one of the reasons life expectancy has been stalling in recent years – even before Covid – may be that “you get tail-offs after periods of sustained improvement”.

In the 2000s, there was a particular focus on improving life chances for those with coronary heart disease, increasing access to cardiac surgery for poorer groups and rolling out smoking cessation clinics.

He adds that austerity is also a “plausible factor”, as well as a spike in mortality from different strains of flu.

“But there is evidence that across this whole decade really we just haven’t seen the kind of health improvements that we’ve seen in the Noughties.”

Forecasting human longevity, though, is a thankless task. According to a paper published in the journal Science by academics from Cambridge University and the Max Planck Institute, on average, predictions of maximum life expectancy made throughout the 20th century were proven wrong within just five years of publication.

 

FAST FACTS: WOMEN vs MEN

  • One thing every country in the world has in common is that women, on average, live longer than men, though the gap varies widely.
  • In Russia, women outlive men by an average of 10 years, while in
  • Bhutan the difference is less than six months. In the UK, it is more than three-and-a-half years (life expectancy at birth is 79 for males and 82.9 for females, according to ONS figures).
  • The available data indicates that women’s lifespan only started to overtake men’s in the middle of the 19th century. Men tend to smoke more than women and, research suggests, advances in medicine mean that women are no longer disproportionately affected by infectious diseases in the way they were in the 19th century.
  • There are also biological differences – a combination of chromosomes and hormones mean that men tend to have more fat surrounding their major organs, which results in higher levels of cardiovascular disease (the leading cause of death globally, ahead of cancer).
  • Women, despite having higher rates of physical illness and hospital stays across their lifetimes, are more robust when they get sick than men – though scientists are still working to understand why.

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