Health gap widens as experts warn over DH plans

Health divides in England have continued to widen as experts warn that paying local authorities to reduce inequalities may backfire.

Although overall life expectancy at birth has risen across England, the gap between poorest and richest in each area has grown wider, data show. The figures update statistics to track health inequalities first published by the influential Marmot review in 2010.

Overall life expectancy at birth rose by 0.3 years for both sexes between the periods 2007-9 and 2008-10 in England. But the majority of the country’s 150 local authority areas saw widening gaps between the highest and lowest life expectancy within local populations.

The DH aims to cut the health divide by paying local authorities a ‘health premium’ if they can reduce inequalities. But in November, MPs warned that targeting resources away from areas of most need will 'undermine their ability to intervene effectively and further widen health inequalities'.

Speaking at the launch of the figures in London on Tuesday, Professor Sir Michael Marmot, lead author of the 2010 review, warned the DH not to ‘punish’ poorer areas for failing to reduce inequalities. 'A lack of improvement that is due to multiple deprivations shouldn't be punished. We should work harder to get that improvement,' he said.

Professor Peter Goldblatt of University College London, who co-authored the Marmot review, said there was a ‘real risk’ the policy may strip funds from poorer areas with the hardest task. ‘What I don't think we've seen is the detail of whether it would reward proportionately or not,' he said.

He added: 'There is evidence, for example, from some of the smoking initiatives that to get people in poorer areas to give up smoking is far more difficult than in better-off areas. The effort that you need to level up the [inequalities] gradient is far greater the further down the social gradient you go. Any scheme would need to take that into account.'

Across England, overall life expectancy at birth is now 78.6 years in men and 82.6 years in women. Life expectancy is highest in Kensington and Chelsea at 85.1 years and lowest in Blackpool at 73.6 years.

The Westminster area has the largest gap between highest and lowest male life expectancy in the country, at 16.9 years. Life expectancy of the London borough as a whole is 83.8 years. Among women, the largest divide is in Darlington, at 11.6 years. Average life expectancy here is 82.

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