******************** POSTING RULES & NOTES ********************
#1 YOU MUST clip all extraneous text when replying to a message.
#2 This mail-list, like most, is publicly & permanently archived.
#3 Subscribe and post under an alias if #2 is a concern.
*****************************************************************
NY Times, Aug. 31, 2019
Shortchanged: Why British Life Expectancy Is Falling
By Stephen Castle
HARTLEPOOL, England — Britons are no longer living longer than before.
Just ask Callum Hills.
His father died of a heart attack last year at age 52. Mr. Hills had
found him stricken on the floor in the middle of the night, and today is
still haunted by his memory.
“I keep having dreams, and he’s in them,” said Mr. Hills, a thoughtful
and articulate 23-year-old.
While attention is riveted on the Brexit turmoil in Westminster, with
dire forecasts of possible chaos, food shortages and recession, a
dispiriting trend is already visible in struggling towns and cities
across the nation.
For the first time in modern history, Britain’s gains in life expectancy
have stalled — at 79.2 years for men and 82.9 years for women for the
years 2015 to 2017. That is better than the United States, but Britain
is slipping down the ranks in Western Europe.
In 1841, life expectancy in Britain was around 40 for men and 42 for
women, and its rise through improvements in infant mortality,
sanitation, nutrition and medical care became a symbol of progress. In
recent times, the figures had generally improved by about three years
every decade.
But no longer.
Alcohol and drug abuse, poor diet, obesity, smoking and a lack of
exercise have taken their toll, increasing the risks of cancer, heart
disease and diabetes. Older people are dying prematurely, their
conditions worsened by isolation and depression, experts say.
Bait diggers searching for worms that they will use to fish for sea
bass. The remains of the once thriving shipyard of Hartlepool, England,
loom in the background.CreditMary Turner for The New York Times
Underlying many of the problems, they say, is the government’s austerity
program, which was instituted after the 2008 financial crisis and has
eaten away at funding for social programs, transportation and other
things that might counter the negative trends.
Things have probably not been helped by the chaos in Parliament over
Brexit, which has forestalled efforts to come to grips with the growing
problems.
While the rate of improvement in life expectancy had long slowed, “2010
marked a turning point in long-term mortality trend,” according to the
King’s Fund, a health research institute. Across the country, mortality
rates in the first few months of 2018 were higher than in any quarter
since 2009.
Among British cities, Hartlepool (pronounced HART-lee-pool), a proud
seafaring and manufacturing town battered by deindustrialization, has
suffered one of the largest drops in life expectancy. It has the
second-highest stroke rate in its region, its death rate tied to drug
abuse recently tripled, and its smoking rates are much higher than the
national average. Statistics on deaths from cancer and cardiovascular,
liver and respiratory disease are troubling.
The average life expectancy for men in Hartlepool was 76 years and one
month from 2015 to 2017, fully a year and a half less than in 2011-13.
For women, the figure of 81 years and four months ticked up slightly in
the most recent set of statistics, but is still lower than it was in
2011-13 or 2013-15.
In the town’s pockets of poverty, some lives are ending very
prematurely. Gemma Sampson, the vicar at St. Aidan’s Church, said that
two regular users of the church’s food bank have died since it opened in
2017.
One was a 56-year-old man who lay undiscovered in his apartment for six
days. The other was a homeless woman who had slept in a parking lot, got
help with accommodations but disappeared and was later found dead. She
was 43.
Such cases are extreme, but the broader trend has upset long-running
assumptions. At the sharp end of this is one of Britain’s most
cherished, if creaking, institutions: the National Health Service, which
many see as an efficient health care provider, particularly by
comparison with the United States.
But some wonder whether it might, inadvertently, be part of the problem.
The N.H.S. focuses more resources on acute care than on preventive
measures, mental health and early screening for cancer and other
conditions. That, said Michael Marmot, professor of epidemiology at
University College London and director of its Institute of Health
Equity, reinforces a tendency to favor medical procedures over efforts
to combat obesity, smoking, and drug and alcohol dependence.
“We need to fund our N.H.S., but let’s also talk about the health of the
population,” Professor Marmot said. “The causes of premature death are
an unhealthy diet, drinking, lack of exercise, et cetera. But the causes
of the causes are the conditions in which people are born, grow, live,
work and age.”
Several factors influence life expectancy, including an individual’s
genetic makeup, inherited disposition to addiction or conditions like
diabetes, and behavior.
But the way families, communities and governments shape or mitigate
those tendencies matters, too.
Danny Dorling, a professor of geography at Oxford University, argues
that “the link with austerity is not easy to correlate, but it is
incredibly strong.”
Hartlepool’s representative in Parliament, Mike Hill, agrees. “There is
no doubt that austerity has hit Hartlepool, and that there is a
connection with life expectancy,” said Mr. Hill, a member of the
opposition Labour Party.
Hartlepool has had to cut around 20 percent of its budget of 100 million
pounds, about $120 million, and shed about 500 employees. Local
officials say the town has dipped into reserves and increased local
property taxes, but acknowledge some cutbacks in programs.
Others see austerity as an aggravating factor in a complex picture of
unhealthy lifestyles compounded by poverty, lack of opportunity and
hopelessness.
In Hartlepool, the expected life span in the most deprived areas was far
shorter than in the most affluent areas — 11.7 years lower for men and
10.2 years lower for women, according to the 2018 local authority health
profile.
The food bank at St. Aidan’s Church helps people like Shelene Brown, 38,
who said she was unemployed and had no money in the bank with a week to
go before the next welfare payment.
Her diet will be what she was given: pasta, bread and some canned
produce stuffed into two plastic bags, with no fresh vegetables or fruits.
Slight, with delicate features and dyed red hair, Ms. Brown has battled
heroin addiction, and said that at times she has “hit rock bottom.” She
added that she suffers from anxiety, depression and asthma attacks that
recently landed her in the hospital.
A busy afternoon in the Little Kings and Queens hair and nail salon.
Hartlepool hit hard times after its ship building and manufacturing
industries shut down.CreditMary Turner for The New York Times
Fewer than half of Hartlepool’s residents eat the recommended portions
of fruits and vegetables, and fruit consumption ranks among the lowest
in England. This partly reflects lifestyle choices: popular fast food
meals include options like the “parmo” — breaded, deep-fried chicken
covered in béchamel sauce and Parmesan cheese — that pack as much as
2,000 calories.
But healthy food is often more expensive than calorific processed meals.
And when times are tough, cheap drink or drugs provide temporary escape,
multiplying what Professor Marmot calls “deaths of despair.”
At the help and advice center of the Oxford Road Baptist Church, Ian
Jennings, 47, who does not take drugs, is nonetheless never far from
their effects.
In the once-respectable street where he was raised and still lives, some
houses are now boarded up and he has seen men armed with machetes.
“People have still got a choice to make,” Mr. Jennings said. “They have
still got to make that choice but, because there’s no money kicking
around, they have nothing to live for, nothing to look forward to. They
can’t afford to go downtown to have a drink, so they drink in the house
or take drugs.”
As a child, Mr. Jennings remembers eating fresh vegetables from his
father’s garden. “I have been trying to get healthier; I do know I am
overweight,” he said. “What people will do, because they haven’t got the
money, they think I’ll go out and buy fish cake and chips or kebab.”
Professor Dorling said that cuts to social care — or even to bus
schedules — may also affect life expectancy by leaving older people
isolated and depressed.
“Once somebody stops visiting, many old people give up,” he said. “As
wages have fallen so much in real terms in Britain, the cost of fuel or
train tickets to visit elderly relatives may be having an effect.”
Austerity has also had an effect on younger people. The Belle Vue
community sports and youth center has impressive facilities, but after
losing about a third of its funding and around half of its full- and
part-time staff, it can no longer offer a program for children with
behavioral problems. A proposal to encourage and organize sports at 19
local schools has been axed.
“These are the things that keep young people from antisocial behavior,”
said Alan Clark, who attended the center as a 5-year-old and is now the
chairman of its board of trustees. Under austerity, he added, “the
social fabric of the nation is being destroyed.”
Community spirit nonetheless remains strong in Hartlepool, and Mr. Hills
was overwhelmed when local people raised more than £2,000 for his
father’s funeral.
Mr. Hills looks fit, is a member of a running club, has a job as a youth
worker and is trying to give up smoking. But one of his aunts also died
prematurely, at 40, and he thinks it would be better to move away.
“I need to leave,” he said, “because I want to live past 50.”
_________________________________________________________
Full posting guidelines at: http://www.marxmail.org/sub.htm
Set your options at:
https://lists.csbs.utah.edu/options/marxism/archive%40mail-archive.com