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Another attempt at rampant illogic over health inequality

Summary:
This does not bode well for the standards by which the NHS, or any other part of the health care system for that matter, might be managed. For those who would run it seem capable of the most glaring illogic. We have further findings, perhaps mining of the figures, over inequality of lifespan over the economic spectrum: The health department data shows that in key areas the gap has widened since 2010 after narrowing over the previous decade. Seven years ago life expectancy for men in England’s most deprived areas was 9.1 years less than for those in the richest areas. By 2015 the figure had risen to 9.2 years. The equivalent gap for poor women also grew over that time, from 6.8 years to 7.1 years. The stark statistics are contained in the health department’s annual report, published this

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This does not bode well for the standards by which the NHS, or any other part of the health care system for that matter, might be managed. For those who would run it seem capable of the most glaring illogic. We have further findings, perhaps mining of the figures, over inequality of lifespan over the economic spectrum

The health department data shows that in key areas the gap has widened since 2010 after narrowing over the previous decade. Seven years ago life expectancy for men in England’s most deprived areas was 9.1 years less than for those in the richest areas. By 2015 the figure had risen to 9.2 years. The equivalent gap for poor women also grew over that time, from 6.8 years to 7.1 years. The stark statistics are contained in the health department’s annual report, published this summer.

They have been seized on by David Buck, a senior fellow at the King’s Fund health thinktank and a leading expert in public health and health inequalities. Buck told the Observer: “These are shocking figures. It’s shocking that we live in a developed country where inequalities in health are so wide and are getting worse.

Buck's findings, in detail, are here. Note what is being talked about, the figure being highlighted. It's life expectancy at birth. And no one at all is in fact measuring how long the lives of those born today will be. What is being measured is what's the average age of death of those born in or around 1940? OK, we can widen that time a bit if we like, say 1930 to 1950. Because this is indeed how we do it. We look at the average age of death of the generation just died and then say we think that's what the lifespan at the generation just being born is going to be.

It's important that we do understand how this statistic is being produced - just like we need to understand the detail of every statistic to understand what it is actually telling us. 

Some other information Buck points us to but doesn't particularly highlight might be useful here:

Looking at all the evidence, it does appear that there has been a flattening off of the fall in mortality rates since 2011, which is not consistent with the trend in falling rates seen in the 10 years up to 2011.

But there is no evidence to suggest that the long term downward trend has reversed (in other words that rates are increasing).

Well, which do we want to worry about, absolute levels or inequality? Further:

The increase in mortality rates in 2015 was not limited to England alone. It was seen across Europe on a comparable scale. The six biggest countries in the European Union (France, Germany, Italy, Poland, Spain, UK), all saw a fall in their life expectancies for both sexes.

Compared with 2014, in 2015 female life expectancy at birth fell in 23 of the 28 countries in the EU and male life expectancy at birth fell in 16 EU countries.

Something obviously happened in that single year of 2015 and it most certainly wasn't related to any domestic UK policy, was it? And do note again that this doesn't in fact tell us anything at all about expected lifespans of those born this year, it tells us something about who died in that year. One suspected culprit being a particularly nasty 'flu epidemic. And we're really most unsure that one of those is going to happen in 2094, aren't we?

We've got to understand a statistic and its composition before we try to make decisions based upon it. And given what's happening here that doesn't bode well for attempts to manage matters, does it?  

Tim Worstall

Tim Worstall is a British-born writer and Senior Fellow of the Adam Smith Institute. Worstall is a regular contributor to Forbes and the Register. He has also written for the Guardian, the New York Times, PandoDaily, the Daily Telegraph blogs, the Times, and The Wall Street Journal. In 2010 his blog was listed as one of the top 100 UK political blogs by Total Politics.

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